Just what we don’t need! Another medical school

4 minute read

Rural

By

Julie Lambert

A feasibility study is announced for a new four-year post-graduate medical degree at CQU's Rockhampton and Bundaberg campuses

Central Queensland University’s plan to open a new medical school has met with a chilly reception from medical students and senior doctors alike.

CQU has announced a feasibility study into a new four-year post-graduate medical degree at its Rockhampton and Bundaberg campuses, saying the “absolute best case scenario” would see the first students begin training in 2021.

Vice-Chancellor Scott Bowman had written to the Australian Medical Council regarding the plan for an “innovative” medical course in partnership with the Central Queensland and Wide Bay Hospital and Health Services, the university said.

Professor Bowman pointed to the success of James Cook University, which has campuses in Townsville and Cairns, in training doctors for rural careers.

“We know if you look at the experience of JCU about 80% of the doctors in north and far north Queensland who are trained up there stay up there,” he said.

“We want our people to be able to train as doctors and deliver their skills to our local communities.”

The Australian Medical Students Association slammed the plan as selfish and wasteful, arguing resources should go into fixing the bottleneck in rural training positions.

AMSA’s Rural Health Committee challenged the Queensland and federal governments to block all of the new medical school proposals on the table at present.

They point out that medical graduate numbers already exceed training places overall, and in  the rural sphere existing federally funded rural clinical schools are operating in the proposed locations.

“Along with Charles Sturt, La Trobe, and Macquarie, yet another university is selfishly ignoring the message that Australia is currently producing too many medical students, and the evidence that an increase in student numbers is not translating to more rural doctors,” AMSA rural health co-chair Nic Batten said.

The University of Queensland Rural Clinical School was already training medical students with the Central Queensland Health Service at Rockhampton, the Wide Bay Health Service at Bundaberg and Hervey Bay, and the Darling Downs Health Service at Toowoomba.

“What will happen to these students and their opportunities for rural training if the new medical school is allowed to proceed?” she asked.

Dr Ruth Stewart, president of the Australian College of Rural and Remote Medicine, said medical education was already a “very crowded space”.

“The philosophy of rurally embedded medical training is a good one, but we’ve got enough medical schools,” she said.

“They are doing a feasibility study; it will be interesting to see what that shows and to make sure it is clear and transparent.”

According to the CQU outline, early estimates would involve 20 to 30 medical students at the Rockhampton and Bundaberg campuses doing a four-year medical degree, on top of a three-year course in medical science or another related discipline.

Days earlier, an AMA Medical Workforce and Training Summit reaffirmed that new medical schools were not part of the answer to resolving health disparities.

“The take home message from the day was that Australia does not need any more medical school places,” AMA President Dr Michael Gannon said after the March 3 summit.

“There was a clear recognition that the focus needs to shift away from pumping more students into medical schools towards giving medical students more opportunities to train in rural areas, as well as delivering postgraduate training places in the areas and specialties where they are needed.

“We need smarter policies than we have seen from governments in the past. All too often, the opening of a new medical school, or importing more doctors from overseas, is seen as the solution to our medical workforce needs.

“This mindset is driven by short-term political needs, rather than the long-term health needs of our communities.”

AMSA’s Ms Batten said many Queensland students, from rural and urban backgrounds, wanted to become rural doctors, but the training bottleneck hampered their ability to continue their careers in the country.

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Crystal
Crystal
6 years ago

Hate to disagree, we do need more doctors. Most research shows 1. a serious number of doctors are gtoing to choose to work shorter hours. 2. more GP’s are retiring than we are producing tranned graduates in the last 5 years, 3. When in the hospital system for too long, the focus beomes on getting int speciality fields, and good terms for those who would like to round their experience to work in smaller communities as gp’s is
DENIED.
Our problem is the intern year and post years are in the “old school” thoughts – well mid 1990’s that is. We need to acknowledge our uni graduates are what they are, much better qualified to work In semi-supervised settings, making decisions, not being “dumbed down” by being a lacky for teams in big tertiary centres. They are good enough to work in general practice from post intern year, There needs to be ability to do so, not trapped in a program. Provider number locations should be available to work in GP surgeries who would then have better qualified doctors than some OS ones in registrar GP positions. Then along with this they need to still be able to continue 1-2 shifts in an ED department on a weekly basis – this will give them a feeling for rural / remote work, and make GP choices for the future on a better basis, Not be trapped into 2-3 yrs in hospitals, forgetting valuable learnt training in undergrad years. Let them put knowledge and ability to work where its needed, they are capable and then make career decisions a year or 2 down the track.

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John Caska
John Caska
6 years ago

If we are already producing too many Medical Doctors locally has any move been made to restrict or stop Medical Doctors from other countries coming to Australia. It appears there is not a Doctor shortage in Australia just a maldistribution. .
We should morally then not accept Doctors from mostly poorer countries who are trained at great expense by their poorer citizens & bring them here when we have a Doctor surplus & the poorer countries struggle to get good medical attention despite paying for the education of doctors who leave once they have graduated. This would be like reverse foreign aid & greatly assist these populations keep their Doctors who are also familiar with the local conditions & language.
It would be very different if these Doctors paid full price for their medical education in their countries as they then “own” their degree & can use it as they wish..

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Lou Lewis
Lou Lewis
6 years ago

Even though I am no longer a member of the AMA, not due to any recent events of the past 10 or so years, but events going further back, so I have no dispute with the current leadership of the AMA.
I think that what AMA president Dr Michael Gannon said , namely, that we do not need any more medical school places is 100% correct and his reasons for saying that are even more pertinent than just having an oversupply of doctors.
What Dr Gannon is saying is that there is a problem servicing rural health that is not being addressed by just stacking numbers of doctors in country towns and hoping that they will stay there and become, what I consider, a truly country doctor, with skills that we city GPs no longer have or are encouraged not to pursue because there are so many specialists in the city that patients want referrals to.

The rural doctor does not have that great choice and in many cases the buck stops with the rural doctor. When I did my training at Orange base Hospital in New South Wales I realised that I did not have the skills to go into rural practice and quite frankly, as hard as it is for me to admit, I was quite afraid of being left on my own with no peer support in the case of a huge emergency such as a multi-vehicle accident.
I agree that the current system is not working, but churning out and importing more doctors is not going to solve the problem. There has to be a better solution to attracting city and even rural students to rural medicine, but is obvious that the current approach needs to be changed,
I do not profess to know the answer but one thought I have is that no doctor should be the only doctor in a small town of say 1000 people. Maybe the government should invest in building small trauma hospitals or units that can be manned ( or womanned to be PC )) 24/7 and these people be paid a decent wage even though they may not be working as trauma specialists all the time. They could help take the load off some of the general practice work of the local doctors and at the same time also learn skills on how to manage the simple medical problems that a lot of patients go to the doctor for, not just trauma and doom and gloom. I know that this will cost a lot of money but not only will it save lives but it will make life working in a country town much less formidable for city trained doctors ,knowing that in their town there is a trauma unit that can share the load and the heartbreak that goes with a major traffic accident.
I envy the country doctors, indeed I admire them, for their skills and their confidence and I would like to think that these skills can be imparted on a new group of young doctors, and the doctors who are mentoring or sharing their skills should be more than adequately rewarded by the government ,and if I only got a piddly 1% increase in the rebate every year and the rural GP/teacher/mentor got a 5% increase I would not object, considering they are basically working 24/7 and when they go on holidays they do not have the privilege of just closing the surgery for a few weeks like I do, but have to employ somebody to take over their surgery and also ensure that person is adequately trained and capable of doing the demanding work of a country GP.
So even though I do not have all the answers, I am sure that people like Dr Michael Gannon and his committees will brainstorm ideas and come up with workable solutions.
The only thing I can say that may be a negative to working in a rural area is that some people think that only monetary incentives will get doctors to work there. It has to be more than just money, it has to be that you know that there is a support network in place that can help you in times of crisis. I have heard of towns offering $200,000 for a doctor and have had no takers. Why would they, when they can earn at least that much working less than 40 hours a week in a city general practice.
I would like to hear what other people’s suggestions would be to make rural practice a viable and long-term commitment without penalties (as was the case with the now-defunct bonded scheme) and be both financial and socially enriching.
Cheers
Lou

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