Restricted career paths for overseas students graduating from Australian medical schools: legal and policy considerations

To the Editor: We welcome the thoughtful analysis from Elkin and Studdert on international students missing out on internship places.1 Given the impending shortage of available internships in Australia, this is of considerable interest to the over 500 international students who graduate each year.

Sydney Medical School (University of Sydney) should be commended for explicitly discouraging international students’ expectations of internship.2 Sadly, this is an isolated example. We agree with the authors that universities have an ethical obligation to ensure this information is adequately conveyed to current and prospective international students. Education policymakers and medical school administrators should be forthcoming with vital information on the future of training for international students in Australia. The Australian Medical Students’ Association is currently developing a comprehensive information booklet, which we will distribute to prospective international students. Among other details, this will clearly outline the issue.

However, the issues raised by Elkin and Studdert are not confined to international students. The authors observe that the recent health ministers’ communiqué only guaranteed internship to students in Commonwealth-supported places.3 This not only excludes international students, but also local fee-paying students at private universities and those in state-funded places.

The authors argue that international students have no legitimate expectation that they will be provided with an intern place on graduation, given the “clear” statements from the federal government. However, there has been no similar guidance for local private university or state-funded students. Do these students have a legitimate expectation of internship? One could argue that state-funded students do, given the funding bodies are the same ones that will also provide their internships. While Australian permanent residents and citizens currently have first or second priority for internships, depending on their state of study and the state to which they are applying, it seems that in the future these students may miss out in favour of Commonwealth-supported students covered by the health ministers’ guarantee.

Elkin and Studdert concluded that Australian courts would be unlikely to find that international students hold a legitimate expectation of internship. It is less certain whether this conclusion might apply to state-funded students or Australian permanent residents and citizens at private universities. At a minimum, these applicants too deserve “full and frank information” about their internship prospects.