NSW welcomes new interns

Despite a national internship shortage, more medical graduates than ever secured an internship in NSW in 2017. Official numbers reveal 1000 interns found a training position – up from 983 the previous year.

While it’s good news for NSW, there continues to be an undersupply of doctors in rural and regional Australia as the overall number of medical students coming through the ranks exceeds available internship and vocational training positions.

The Australian Medical Students’ Association (AMSA), which represents 17,000 medical students, continues to advocate on behalf of those students who have missed out on a placement this year.

“It is disappointing for someone to work so hard for up to seven years of medical school, only to be unable to formalise their qualification as a doctor,” AMSA President, Rob Thomas said.

“In 2016, there were 3648 graduates with only 3413 total internship positions being made available. With increased medical student numbers, these figures are set to worsen.”

Medical graduate numbers have more than doubled in the past 10 years, but internship and vocational training positions have not caught up to meet this oversupply.

AMA President, Dr Michael Gannon said the current situation is ludicrous.

“Now we’ve got the ridiculous situation where we’ve got people who are trained in Australian medical schools, understand our system, are proficient in English, and understand our unique health system – but there’s not enough internships for them,” Dr Gannon told 3AW.

“One of the points that we keep making to the Government is that, while they need to invest in the training programs, the internship’s even more important than that, because if you don’t satisfactorily complete your intern year, you’re not fully registered as a doctor.”

In NSW, this year’s interns embarked on the next stage of their career in January. The AMA (NSW) / ASMOF (NSW) Alliance welcomed this latest crop of doctors by going out to hospitals across the state to meet them. Alliance doctors and representatives visited Concord, Gosford, Hornsby, John Hunter, Orange, Port Macquarie, RPA, Westmead, as well as Royal North Shore, St Vincent’s, Nepean, Wagga Wagga, Coffs Harbour, and Tamworth. They also spent time at Lismore, Tweed, St George, and Blacktown Hospitals.

These meetings were a valuable opportunity for interns to hear about the benefits of Alliance membership, upcoming events, and advocacy that the organisation conducts on behalf of doctors-in-training, as well as activities conducted by The Alliance’s Doctors-in-Training Committee.

Dr Tessa Kennedy, chair of the Doctors-in-Training Committee, echoed concerns about the training pipeline crisis, but added DITs face many other challenges.

“As medical graduate numbers have surged in recent years we’ve seen increased competition to enter all specialty training programs, leading to increasing numbers of graduates stuck in unaccredited training purgatory,” she said.

“As well, greater competition and recurrent job uncertainty as we work through short contracts adds extra stress for DITs, and makes us more vulnerable to workplace bullying and harassment. This is especially the case if we feel like we can’t complain, or that putting up with inappropriate behaviour is just part of the job. Fortunately, this culture is starting to change.”

Dr Kennedy adds many junior doctors are also concerned about maintaining a work/life balance.

“We have heard from a lot of members wishing to improve the flexibility offered in training programs – while some programs offer the option of less than full time training and try to support trainees who become mums, dads, and have other life stuff happen along the way, many of us still uproot our lives every term change to move to another part of Sydney or the State (or even country!) “on rotation” for the better part of a decade.

“A common theme seems to be a desire to make medical training more compatible with life, so doctors can lead lives as full and healthy as their patients; to start trying as hard to look after ourselves and each other as well as we do our communities.”

In an effort to better meet the needs of junior doctors, the DIT Committee is launching monthly meetings – these will alternate between mixed business meetings discussing a range of issues relevant to DITs and more in-depth themed meetings that will put a spotlight on a single issue.

The first themed meeting will focus on junior doctor mental health, as part of the committee’s broader agenda to promote doctor wellbeing, a key focus for 2017.

Dr Kennedy adds, “Along with the Federal Council of Doctors in Training, our NSW DITC will continue to advocate for more specialty training places, particularly in regional and rural areas that have the capacity to provide quality training, as well as maintaining or improving teaching, mentoring and support. We are also advocating for better workforce planning – trying to figure out how many GPs, dermatologists, anaesthetists and other specialties we need across the country, and pushing for a national training survey to monitor the paths and progress of trainees. This is particularly important to get a better idea of how many unaccredited registrars are out there.

The DIT Committee is also launching a new initiative, the NSW Hospital Healthcheck, which will compare different hospitals on a range of metrics relevant to DITs, from leave provision to term choice, parking to overtime and pay, among other issues. This will provide comparative data to help us target our advocacy efforts where needed, to highlight where problems exist, but also where things are going well – and what other sites might learn from how those doing well.

“The DITC will also start to link more closely with your RMO associations, who understand your local issues best. We want to help share both troubles and triumphs experienced by JMOs across the State, connecting our ideas and unifying our voices.”

Note: 992 intern positions were filled in the NSW Prevocational Training Networks, plus two job shares. NSW also supports a further six intern positions in Bega (2) and Goulburn (4), which are filled via the ACT intern training network.