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It’s not a tsunami — sea-levels are on the rise

Andrew W Perry
Med J Aust 2008; 188 (3): 191-192.
Published online: 4 February 2008

To the Editor: I write to voice my objection to the use of the term “tsunami” by many in the medical education community when describing the massive increase in medical student numbers that has begun as a result of recent government initiatives.1-5

Although it is true that the government has opened the floodgates, as opposed to the water restrictions they applied in the mid 1990s, I believe describing this increase using the metaphor of a tsunami is a misnomer.

I do not disagree with the potential for this phenomenon to wreak mayhem with the quality teaching and supervision of medical students and junior doctors and their access to adequate employment in both prevocational and vocational places. Nevertheless, I believe that we need to adopt a more accurate term to describe this impending event.

A term I have heard on a number of occasions is that of the “rising sea levels” of medical graduates, which (although less dramatic) I think is more accurate, because this expression indicates that the change (likely a sea change) is going to be long-lasting, if not permanent, rather than a flash flood, as signified by “tsunami”.

If we are going to continue to describe this impending increase as a “tsunami”, the only benefit I can see is that it may encourage us to learn lessons from the real event. As a result of the 2004 Boxing Day tsunami, a tsunami early warning system was put in place to alert citizens of an impending tsunami and give them a small window of time to prepare. A number of medical education groups, including the Australian Medical Association Council of Doctors in Training, have started sounding the alarm about the increase in medical students. It remains to be seen whether this warning will be heeded in time. One only has to look to the fiasco in the United Kingdom this year with junior doctor allocations to see what happens when adequate preparation is not made for impending change.

Will a student who enters medicine in 2010 feel that, during their medical education voyage, they are receiving a quality education? And when they graduate, will they find a rich sea of prevocational and vocational opportunities? Or will they feel like a drop in the ocean of fellow graduates scrambling to gain a properly supervised training position?

  • Andrew W Perry

  • Emergency Department, Royal Adelaide Hospital, Adelaide, SA.


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