Australia's reputation at risk over medical intern crisis

Some 150 international medical students don't have intern placements for next due. The situation is critical, for students and the healthcare sector, writes Sydney University Medical Dean Bruce Robinson.

Medical students

About 150 international medical students graduating from Australian universities do not have an intern position for next year due to funding shortfalls. We are at a critical point.

If graduates cannot secure an internship locally they will have no option but to take their chances in the competitive matching programs in their home countries. In some home countries, there are no opportunities. In Canada, US and European Union, the odds are against them.

The damage to the reputation of Australia as a higher education destination is one thing. Future international student numbers will be affected; students will continue to use both the local and international media to tell their stories.

In my view, though, reputational damage is less important than the personal consequences for the students, young people who have come here in good faith, worked hard, passed their exams, become alumni of our universities but now may potentially find the whole exercise was a waste because they have limited opportunities to get their registration.

We are still hopeful that a satisfactory outcome can be achieved, but at the moment internships appear to have become another political football with negotiations and discussions going back and forth between Canberra, state governments and medical school deans with no resolution.

Over the last few years, we and other medical schools have argued that international students add a great deal to Australian medical education and community. Namely:

International student fees fill funding holes. Medical education is not fully funded and international medical students bring more than $15 million a year into the University of Sydney alone. That is a lot of salaries and training, which will not be paid for if we don’t resolve this issue.
The 847 international medical students attending universities in NSW contribute the best part of $85 million a year to the state’s economy in university fees and living expenses.
Across Australia, we have a shortage of doctors and recruit internationally to fill workforce gaps. Last year, like most recent years, more than 3000 visas were issued to international doctors to work in Australia. It is nonsensical to reject graduates of our own universities when we are advertising widely for both junior and senior doctors.
In its recent workforce planning report, Health Workforce Australia identified the reliance on internationally trained doctors as a significant area of risk for Australia. HWA has factored into its workforce planning that 70% of international graduates remain in Australia, so we need to find a way to include them and support them in their training.
There is capacity for more interns to work in public and private settings. We know that many public hospitals would greatly appreciate additional interns. We know that many interns do a great deal of overtime and in discussions have said they would prefer to reduce their working hours. Increasing the number of interns and reducing the working hours of others would be more productive, potentially safer, and may actually not require significant additional funds. There is also capacity outside the public hospital system to employ interns.

Medical Deans Australia and New Zealand has been pushing hard to find a resolution and all medical schools have agreed on the need for change to the management of international medical students, including caps on the total number and other points. The Department of Health and Ageing has put $10 million on the table to avert a crisis with this year’s graduates but that money is contingent on the states contributing a total of about $8 million in addition for all students to secure a place for 2013.

At this point, we have not been able to engage with the NSW Ministry of Health and there is no commitment to provide the additional funds that would allow this year’s graduates to secure positions.

Internships for 2013 are the immediate priority, but clearly this is something that needs to be resolved for the longer term. All parties will need to work together to achieve fair management of this matter.