The training tsunami

Martin B Van Der Weyden
Med J Aust 2008; 189 (7): 353. || doi: 10.5694/j.1326-5377.2008.tb02075.x
Published online: 6 October 2008

* Wallace N. Intern glut “risks patient care”. Sydney Morning Herald 2008; 26 Aug: 2.

The NSW Medical Students Council has called on the federal government to cease the expansion of medical student places and to invest further in hospital training positions.* There is concern that the current system will not cope with the “training tsunami” expected to follow the recent policy earthquake that heralded an unprecedented surge in medical student numbers.

Reflecting their angst, the Council noted: “Within hospital environments, we are seeing the emergence of a sort of ‘turf war’, with students from the same and different universities ... competing to find patients”. This territorial scuffle is not confined to medical students. There is increasing competition for access to clinical teaching and learning from other players: traditional nursing and allied health students, new flocks of international medical students and graduates, physician assistants, and nurse practitioners.

Australia is not alone in this. In the wake of mass demonstrations by students and consultants in London and Glasgow, protesting the direction of the Modernising Medical Careers system that had resulted in widespread disquiet over dwindling educational resources and opportunities, delegates at the 2008 British Medical Association annual conference narrowly voted to cap the numbers of medical schools and students in the United Kingdom.

While we are assured that working parties are preparing a considered response to our impending crisis, the casual observer may well feel these deliberations are trapped in bureaucratic power plays between federal and state jurisdictions. Above all, there is an enervating sense of non-urgency.

Ultimately, this training tsunami will have an impact not only on students, but also on doctors involved in prevocational and vocational training. At risk is the quality of future generations of doctors.

By all means, indulge in endless procrastinating committees and reports, but effecting systemic change can be slow. In the looming crisis, we need answers. And we need these soon.

  • Martin B Van Der Weyden



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