Letters
Health services administration
Volume 199 - Issue 4

Extending the medical workforce debate: let’s talk about self-sufficiency

Authors:  Dev A Kevat and Shanti Raman

Med J Aust 2013; 199 (4): 238. || doi: 10.5694/mja12.11847
Published online: 19 August 2013
To the Editor: Until recently, Australian medical workforce planning has seemed a rather ad-hoc affair. We have self-induced an undersupply of doctors (having actually reduced student numbers in the mid 1990s,1 taken a decade to increase production, and now have crashed into entirely foreseeable undersupply of intern placements). The establishment of Health Workforce Australia has promulgated some much needed detailed, future-focused planning, although the fragmented ...
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To the Editor: Until recently, Australian medical workforce planning has seemed a rather ad-hoc affair. We have self-induced an undersupply of doctors (having actually reduced student numbers in the mid 1990s,1 taken a decade to increase production, and now have crashed into entirely foreseeable undersupply of intern placements). The establishment of Health Workforce Australia has promulgated some much needed detailed, future-focused planning, although the fragmented data landscape has clearly proved challenging.2-4

Australia’s medical workforce “shortage”, which is worse in rural areas because of maldistribution, has resulted in a great reliance on international medical graduates. We question whether this reliance on overseas-trained doctors is a de facto or “silent” policy, or a reactive response to the perceived shortfall in the national health workforce.

Globally, there is currently an alarming shortage of skilled health care workers, particularly in developing countries. A significant contributor to this shortfall is the reliance of developed countries on overseas-trained health care workers to meet their workforce needs.5 Australia contributes to the drain of doctors from countries already poor in terms of medical human resources — we import more than 3000 doctors a year, with a likely seven of the top 10 source countries having low or middle incomes.6 Many of these countries have doctor-to-population ratios of less than one per 1000, while Australia’s ratio is more than three per 1000 population.

Australia is a signatory to international voluntary codes of conduct regarding health care worker recruitment,7,8 and is arguably well placed to play a leading role in developing and implementing ethical approaches to the recruitment of overseas-trained doctors. To achieve the ethically appropriate goal of self-sufficiency, we will have to continue to improve our forecasting of future needs; and greatly improve co-ordination and resourcing of training places as the number of graduates increases. The opportunity to channel the increased workforce towards rural areas should also not be lost.

We call upon students, doctors, academics, colleges, and policymakers in the relevant agencies and governments to help Australia move beyond lip-service and begin an open conversation on self-sufficiency. Progress will need to accelerate to meet the needs of our own population and to make Australia a more responsible global citizen.

Authors

  • Dev A Kevat1,2
  • Shanti Raman3
  • 1. School of Public Health, Monash University, Melbourne, VIC.
  • 2. Cairns Base Hospital, Cairns, QLD.
  • 3. Community Paediatrics, Sydney and South Western Sydney Local Health Districts, NSW Health, Sydney, NSW.

Correspondence: dev.kevat@monash.edu

Competing interests

No relevant disclosures.

References

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