The AMA calls for more medical school spots for unis producing more generalists and rural doctors and for an independent planning body.
Despite a doubling of domestic medical graduates in 13 years, the strategy of “training more doctors and hoping they will end up where they are needed” is not working, says the AMA.
Between 2007 and 2020, medical graduates rose from 1544 to 3066.
But a long run of “reactionary, ad-hoc and cynical” workforce allocation strategies by the government has resulted in a sustained “maldistribution” of the workforce, according to a new position statement issued by the AMA.
This poor workforce distribution has a “direct impact on the provision of quality patient-centred care”, it says.
The current bottleneck in the health system results from an increase in Commonwealth-subsidised training positions (CSPs) for early medical training without equivalent investment in specialist and prevocational training, it says.
This has resulted in no improvement in access to rural and remote medical care and the under supply of specialists despite increases in the number of doctors.
“CSPs must be allocated according to community needs, and accountability mechanisms developed to ensure medical schools deliver sustainable outcomes,” it says.
Rather than reallocating existing medical places in attempts to improve “chronic geographical shortages”, new policies should be informed by data and community needs.
Increases or redistribution of CSPs must also consider capacity of the medical school, to avoid overcrowding and poor clinical experience.
The AMA proposes “accountability measures” for medical schools to track whether graduating students are “meeting community and workforce needs”.
“Additional or continued allocation of CSPs should be extended to medical schools that actively facilitate students to have quality learning experiences in rural, remote, and community settings; and have curriculums and processes providing career guidance and support for students to enter specialties that are undersubscribed such as general practice.”
The association encourages data-driven decision making, coordinated by an “independent health workforce modelling and planning body” to consult with stakeholders to future proof allocation and implementation.
“Robust workforce data and analysis must drive medical workforce policy, planning and decision making.
“This includes advising the Commonwealth on the number of CSPs and full fee-paying medical school numbers and overseas trained doctor recruitments strategies and targets to optimise Australia’s medical training outputs to meet community need.”
The AMA adds that any increase in medical school CSPs should be balanced with equivalent investment in downstream specialists and prevocational reform to encourage workforce distribution reflective of “geographic and specialty workforce needs”.