31 March 2011

NSW Health gets obstructionist to ANU graduates

| johnboy
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The ABC has a story on the ANU’s Medical School getting the bad news that NSW Health Department intern places will be restricted to graduates from NSW Universities.

And there we were thinking there was a shortage of doctors.

Maybe if NSW Health doesn’t want to play ball with the ACT we should stop playing ball with them and the huge numbers of Canberra region patients treated in ACT Hospitals?

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Wasn’t it last year that all states decided to only guarantee internships to students from their state, because there are too many interns? (International students now have no guarantee at all.) I remember hearing that so I don’t think this is just an ACT v NSW thing. Interstate people can apply but they get lower preference. The article is unclear on whether it’s removing the guarantee or the ability to apply altogether. If it’s just the former, it’s not unusual at all.

It’s a bit strange because so many people go interstate to study then wish to return, and you’d think for rural places they’d want anyone. And like somebody has said, we have to send a lot of specialist patients to Sydney, so being immature and refusing more co-operation would be stupid and worse for us in the long run.

Didn’t the former CEO of the ACT Health leave to head up the national health workforce agency to stop this sort of thing happening?

Um, I think you have misunderstood what a GP is. A GP is not some kind of under-doctor, a GP is actually a specialist.

All medical students have to jump through some training hoops before becoming a fully-fledged doctor. However at that point, they are NOT a GP. They can work in a hospital. After doing their internship and post graduate years, they can call themselves a doctor, and can also start applying to the specialist colleges for admission as a trainee.

To become a GP, at that point they can apply to enter the RACGP or ACRRM, and undertake years of training. Only after graduating as a Fellow of one of those two colleges can they be a GP.

Same as to become a surgeon, or a radiologist, or whatever. A GP is not what comes out of the medical schools.

I appreciate that GPs are required to do hospital internships, but do they really need to do them? Or could people go down the ‘GP’ track, which might lead to more reduced qualification (eg doesnt allow them to staff emergency departments) but reduces training time/hospital internship pressure?

Everyone has to do internship to essentially complete their training and gain their full registration. Internship needs to be done in an accredited hospital with a teaching program and suitable rotations.

Following that, GPs do at least an additional 12 months in a hospital as mandated by their college. They are generally encouraged to do terms such as paediatrics, O&G and psychiatry.

Should doctors intending to become GPs do hospital internships anyway?

There is a massive bulge of medical students moving through the universities at the moment. In a couple of years the big numbers of them will hit the workforce, and intern places need to be found for them. Currently, those places do not exist. It’s a huge, massive problem that is being tackled, but the challenge is enormous.

Already, we have the unwanted situation where universities are selling fee-paying spots in medical degrees to overseas students, with the proviso that they will not be given intern positions in Australia but will have to return home to do their post graduate training to qualify.

The story you linked to is being pretty selective. I heard them talking about this on 666 yesterday afternoon, and what seems to be the case is that ANU students are no longer guaranteed internships in NSW hospitals. They are not excluded from them, just not guaranteed a place. A bit different, in that they can still get internships but only if there are vacancies after the NSW students have taken their placements.

Something to do with increasing numbers graduating from NSW medical schools was mentioned as a reason for it.

I think you’ll find the ACT fired the first shot in this war. Intern placements to TCH used to be part of the NSW allocation process. With the advent of the ANU Medical School, ACT Health decided to cut ties. The ACT now gives preference to students from the ANU, Victoria give preference to students from Victoria, QLD give preference to students from QLD. Why should NSW be any different? ACT excluded themselves from the system, now its come back to haunt them.

Besides, the story is likely being over-dramatic. It means that people from interstate usually don’t get the sexy/popular rotations such as RPA, RNS,St Vinnies and POW. They are more likely to get Liverpool and Dubbo. It shouldn’t affect those that want to be placed in rural areas.

As for not treating NSW patients at TCH. Well the NSW residents would be inconvinienced no doubt, but I’m not sure how the ACT would fare considering NSW chips in a truck load of money to fund TCH, and TCH ships patients who need ultra-subspecialised care to Sydney. Is this another first shot you want to fire? I’d hate to see our kiddies with leukaemia have to travel to Melbourne to get treatment.

Strange one. Can anyone shed light on the reasoning? Something specific to internship?

You’d think if the ACT trains doctors from rural NSW and treats patients from rural NSW then those doctors should be able to go home and treat the patients locally. I also thought there was a shortage and rural towns were crying out for doctors.

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