Seeking a cure-all



By Lauren Ahwan

Medical graduates need more training from senior doctors during their internships at public hospitals to help them feel prepared for the workforce, says the Australian Medical Association.

It says overseas students are facing a double whammy in not only being shortchanged on training but also being forced to fight for a limited number of intern places to become independent practitioners.

One-in-four graduates from Australian medical schools are without an intern-placement guarantee.

All domestic students in South Australia are promised a placement but about 50 international students each year are not.

AMA SA president Andrew Lavender says the graduates who do secure an internship are missing out on valuable medical training because senior doctors do not have enough time to teach them.

“The worst-case scenario is the failure to train adequate numbers of people to meet the needs of the community,” he says.

The AMA’s concerns coincide with alarming findings from a federal government study that found junior doctors feel inadequately prepared to perform even the most basic tasks, such as calculating safe drug doses for patients and writing prescriptions.

The Education Department study, finalised almost two years ago but released only this year, found that just 36 per cent of junior doctors believe they are well prepared to do wound management while 71 per cent of final-year students feel unable to determine accurate drug doses.

Junior doctors and medical students also are concerned about their ability to write prescriptions and interpret X-rays, the study found.

Dr Lavender says senior doctors already are overworked and simply do not have the time to train interns.

“The main problem with training is the amount of staff time that needs to be freed up,” he says.

“We believe that about 20 per cent of all existing clinical time should be devoted to training and given there already is a GP shortage, we say they need to increase staff numbers by 25 per cent to achieve this.”

He says present training is “dependent on the goodwill” of senior doctors who “donate” extra time to hospitals for teaching.

Australian Medical Students Association president Ross Roberts-Thomson, who is a final-year medical student at the University of Adelaide, says that increased teaching time for graduates is crucial.

“The doctors of tomorrow deserve to be trained by the best doctors of today and under any new funding agreements, the government of the time must ensure that senior clinicians are allocated quarantined teaching time as part of their hospital workload,” he says.

“The government should ensure that being a medical educator is an attractive choice for senior clinicians.”

Royal Adelaide Hospital intern Matthew Rackham, 24, has two teaching sessions a week.

Each lasts two hours and he estimates he spends a further 70 hours a week working at the hospital.

He says the training he has received so far has been vital to learning the practical elements required to become a doctor but believes it is a struggle for senior doctors to find the time to teach.

“They have to take time out of their work and the consultations (teaching sessions) are really busy,” Dr Rackham says.

“A lot of them work very long hours, as long as what we do, but we are 30 years younger than them, in many cases.

“I don’t think senior doctors are very well supported. It’s not a matter of them not getting paid to teach; they just don’t have time to teach.”

Fellow intern Brenton Systermans, who is based at Flinders Medical Centre, agrees the training has been valuable but says there is not as much of it as he initially expected.

“I probably haven’t received as much on-the-job education as I would have liked,” he says.

“A lot of the teaching we receive as doctors is done on the run, rather than in tutorials and there hasn’t always been as much of it as I had hoped. But I’ve felt well supported at FMC and if I ever felt I needed clarification on a decision, I’ve always been able to ask.”

DOCTOR PROGNOSIS

• The base salary for South Australian medical interns is $56,925.
• Australia had 1335 medical graduates in 2006.
• Australia is expected to have 3108 medical graduates in 2014.
• More than 200 students are enrolled in medicine at the University of Adelaide this year.
• An extra 100 students will be able to enrol from 2011.
• Flinders University will have 136 medical school places in 2011.
  Source: Medical Deans Australia and New Zealand, University of Adelaide, Flinders University
  

Article from The Advertiser, June, 2010.