Money Matters Medical Markets Coping with the 'Tsunami of Medical Students'
Coping with the 'Tsunami of Medical Students'
Saturday, 01 March 2008
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In 2004, the government doubled the number of medical student places to address the national shortage of doctors. Termed a ‘tsunami of medical students' by experts, the first waves of this student influx are crashing into our tertiary hospitals and the early signs are that the system will be unable to cope.

A/Prof Alistair Vickery from UWA's OuterUrban clinical school said the crest of this wave is presently in Year 5 at UWA and will graduate next year from Notre Dame. Notre Dame will put an additional 50 or 60 students into the mix in 2009. The wave will break in 2010 when around 300 medical students graduate from UWA.

"2012, there will be close to 1000 junior medical officers in the hospitals and over 1200 medical students seeking clinical attachments. The government must recruit and retain supervisors and trainers and that will have to happen in the next 12 months," he said.

UWA's A/Prof Fiona Lake, founder of the innovative Teaching on the Run program, said that the current clinical training system is not set up to cope with these numbers.

"We can train that number of people in a state the size of WA and do it well, but we need to redistribute where the teaching occurs and we need to put in different kinds of resources to support it. There is enough clinical material and people but they are not supported," she said.

The solution, they both believe, lies not in the tertiary hospitals but in the community. Even then, it is not a simple matter of pressing secondary hospitals and GPs into service.

"GPs are fairly hard pressed with the duties they have, but then you have to look at the model of how you support the learning in those areas. For example, one secondary hospital has an enormous amount of clinical material, but the clinicians are so stretched there, they don't have time to take breaths, let alone supervise junior doctors," Fiona said.

"We need more than just patients, we need people able to mentor and support the students - and I'm not talking about didactic-type teaching staff, but some of those aspects of clinical care like clinical reasoning, understanding how things work at the coal face, etc."

Alistair's new model of training at the OuterUrban clinical school in Joondalup, where he teaches medicine and psychiatry to around forty students, is also part of the solution. But the looming crisis needs more than just models. According to Alistair, capable clinical supervisors are needed and they are needed now.

"We have to recruit and retain high quality supervisors. We could draw from the pool of retired doctors and doctors who aren't teaching at the moment. There will also be a push for more GPs to provide more training," he said.

Fiona felt one incentive to recruit more supervisors, drawn from a recent trip to Canada, was to pay for their time.

"They actually pay their clinical teachers. This is not academics, this is people who do service around the place. There is research that suggests the quality of teaching is better when you pay people. You can't pay tachers at the rates they would be getting for clinical care but maybe there needs to be some kind of recognition and that is one way to support the whole system of teaching."