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What are the long-term prospects for all these new Aussie graduate doctors?

I couldn’t agree more with Richard Murray, Dean of Medicine at James Cook University.

There is no shortage of doctors in Australia and never has been - the problem is one of mal-distribution.

The numbers speak for themselves - 3.3 doctors per 1000 head of population in Australia compared to an average in the developed world of somewhere between 2-3 doctors per head of population.

So what gives with the massive increase in the number of doctors graduating from Australian medical schools at the moment? Surely the architects of this policy have, either some cunning plan that we are not privy to, or have grossly miscalculated.

Either way we have a problem.

Whilst there has been much discussion in the press about what will happen with the immediate crisis there appears to be little consideration given to the long term consequences (intended or not) of doctors pouring out of medical school, like a cars approaching a motorway pile-up.

So indulge me, if you will, in a little bit of good old-fashioned speculation.

I have tried to imagine what the future holds for this surplus workforce as the years roll by, so here goes.

 

  • Some will leave the profession - disillusioned by their investment in a highly specialised education they cannot use and cannot easily transfer to another career.

  • Some will go overseas - and there is plenty of interest from other countries with genuine shortages. Some will return, but most will not be able to, given the oversupply.

  • The specialist colleges will close ranks, displaying more of the defensive behaviour that has drawn the attention of the ACCC in recent years.

  • Doctors will have to accept lower incomes, particularly in urban practice, based on simple supply and demand pressures.

  • Expect more unnecessary services being provided (and cost to Medicare) as doctors over-service smaller numbers of patients to keep themselves busy.

  • More part-time work and job sharing - a trend already gathering pace due to the feminisation of workforce.

  • More corporatized medicine - it will be a buyers market and doctors will find their bargaining power eroded.

  • More doctors will choose to do full-time locum work as they find their urban job prospects becoming limited and unattractive.

  • Ultimately ... even more saturation of doctors in the cities, more cost to the country and the same old problems in rural areas.

I don’t mean to sound dystopic. People, especially smart people, have a way of working things out for themselves over time and I am sure that no-one is going to starve. However, thwarted career ambitions and healthcare cost blow-outs are not desirable and they do seem inevitable to some degree.

I, therefore, back the call for urgent review of current policy. Much like the climate change debate, it is easy to dismiss speculation as alarmist, until the water is lapping at the foundations of your waterfront property.

Of course the real issue here (as it has always been) is what to do about the mal-distribution. This problem has not gone away. Perhaps a topic for another blog.

If you can think of any other unintended consequences, feel free to comment below.

Dr John Bethell, Director

Wavelength International

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Comments

  • CB 02/10/2013 7:44pm (4 years ago)

    I'm going to play Devil's advocate:

    I put this fact to you: We, as a profession, have had it very good for a very long time. Until now, when we entered medical school, we knew we had a job. We were never going to make as much as our business colleagues but we knew the worst case scenario was that we could "just be a GP" (3 yr training program, nice salary and yes I'm still training 9 years post grad).

    So how many of you sniggered at your collegues doing a bachelor of communications, graphic design or even law, the majority of whom have been employed out-side their vocation for years? The point being is that they got more from uni than just the technical skills of how to do a job. And we have transferable skills too.. a strong science background, incredible analytical skills and a general understanding of how people "tick".

    Yes, we are going to have to be creative and campaign strongly to balance employing as many of these new graduates as possible without eroding too many of our conditions. And we're going to have to work hard and possibly harder than we already do (although for some of us, that is hard to imagine). But this is the job that we love...

    And that's the point isn't it? None of these students entering med school are stupid. They know its going to be competitive.There aren't any guarantees anymore. There are other rewarding, better paid jobs out there.

    But they love it and will put up with all the stuff that comes with it.. just like we do.

  • jbethell66 02/10/2013 8:50pm (4 years ago)

    Thank you for a great point, though a subtle difference here might be that students entering medical school are lead to believe, directly or by inference, that there is a pot of job security gold at the end of the university rainbow. If that is the case then they might legitimately cry - "false advertising"!

  • testing 27/10/2013 12:59pm (4 years ago)

    Once we start getting more medical graduates working in bars, collecting garbage and driving taxis like in canada's physician unemployment dilemma..the invisible hand of economics will work its magic and fewer will join the physician ranks and supply/demand will work it self out...unfortunately free market economics doesn't work well in health care....if you have only a few pt, have no other skill set to rely on and have bills to pay then cost of care goes up (not down)...you see someone needing acute care...chichinq...the poor pt has no choice so smack a hefty fee as now there is no income security and better turn a dollar! Slap on price controls and regulations then it'll be an even bigger waste of time...look at china that pays its doctors less the homeless can make begging on the streets.
    I disagree that doc have transferrable skills....some may....most are useless at almost everything else...ask any business person, banker, financier who the biggest schmucks are out there?

  • ABramovitz 27/10/2013 6:57pm (4 years ago)

    <i>More doctors will choose to do full-time locum work</i>
    Disagree. The locums are drying up, with more and more graduates available to fill those jobs at award rates. I predict within ten years locum jobs (and the companies relying on this industry) will be gone. Doctors will turn away from locums as they place a premium on job security.

  • Sarah 08/11/2013 11:17am (4 years ago)

    The major problem is going to be large numbers of junior doctors unable to enter college training. I think locums are here to stay as we require a flexible workforce. More and more doctors will work part time especially with the huge numbers of female medics. state awards will become less generous. A few years ago in the UK doctors were concerned about the increased number of graduates. Currently the requirement for locums in the UK is very strong.

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