Rural doctor shortage will not be solved by overseas doctors, GPs tell Federal Government
The initiative will reduce the amount of overseas-trained doctors entering the primary health care system by 200 each year. (ABC News: Damien McIntyre)
Despite more locally trained Australian doctors than ever before, governments are still turning to overseas-trained doctors to fill the general practitioner gaps in regional and remote Australia.
Under Federal Government requirements introduced this month, overseas-trained doctors must obtain a Health Workforce Certificate from a Rural Workforce Agency to get a visa.
The initiative is aimed at reducing the rise of doctors in cities and improving GP numbers in rural areas.
But the focus on distributing foreign doctors to challenging, often isolated remote areas has concerned medical professionals.
Australian Medical Association WA president Omar Khorshid said encouraging more overseas-trained doctors in the regions was problematic.
“We need to ensure the quality of their training and their practice which is pretty hard to do,” he said.
“They may not have the cultural awareness and knowledge of the system in order to be able to practice and actually the toughest part is you actually need to be a better doctor to practice in the rural areas than you do in the city.
“Another problem we do not think of is that if we are taking doctors from another country, often countries where they need their doctors, what is the impact of the healthcare of the people from that originating country?
Omar Khorshid AMA WA president says Australia needs to focus on training the right people to the right levels to provide doctors for rural areas. (ABC News: Alisha O’Flaherty)
“There is definitely an ethical problem with us relying on overseas-trained doctors to fulfil our needs as an Australian community and it is certainly much more important that we focus on training the right people to the right levels to provide that workforce ourselves, rather than relying on other countries,” Dr Khorshid said.
Chair of the Midwest GP Network Ian Taylor is based in the regional community of Geraldton, Western Australia, after moving from the city 35 years ago.
He said while international doctors had served country Australia well, they should not be relied on to make up the shortfalls.
“We are actually training more doctors locally than ever before,” he said.
“But we are still struggling to get them to come regional and you have to ask why.”
More country kids in medical school
While there are already initiatives like rural clinical schools and regional placements in country practices, Dr Khorshid said more could be done to attract a local workforce of GPs to the regions.
“We know from many studies that the best way to keep doctors in the bush is to find some rural kids, get them to go to medical school give them rural experience while they are in medical school and then they are much more likely to go back there for their careers.”
In many professions like teaching, aviation and journalism, young graduates must seek jobs regionally to gain experience.
While the Rural Clinical School in WA allows 90 students to spend their second last year of medical school in a regional location, Dr Taylor said all medical students should be expected to do a regional stint.
“Asking doctors in their training to spend six months in the country is not onerous.
“To use a good Australian expression, sometimes you have got to ‘suck it and see’ and if we could just try to get these young doctors to spend a bit of time in the country with good support from colleagues, they could get a taste of just how great working in the country is.”
Dr Khorshid said more needed to be done to make living and working in the regions more attractive to local doctors.
“Country people are entitled to exactly the same quality of health care as their fellow Australians in the city,” he said.
“It is really important we do not end up with a two-tier system and it is important there are incentives for doctors to go bush.
“It is usually not just about money, it is about making sure a town can support a young doctor’s family, making sure the doctor has connections with the community and that they have enough support for their practice that they can get away and have a holiday and are not the only doctor in town.
“If you get those things right, doctors tend to stay in town. If you get them wrong doctors stay a year or two but then they leave for their own personal circumstances.”
Overseas-trained doctors will be directed away from well serviced metropolitan areas, to places of workforce need. (ABC News: Sebastian Neuweiler)
More locally trained doctors by 2022
Rural Health West is one of the rural workforce agencies that can issue Health Workforce Certificates to overseas-trained doctors.
Chief Executive Officer Tim Shackleton said the new requirements would ensure better distribution of doctors across the country.
“We understand and appreciate the service and wonderful support overseas-trained doctors have given many regional parts of WA,” he said.
“But we do also appreciate with the additional investment in Australian trained doctors we need to use whatever mechanisms we can to ensure those Australian doctors end up servicing and working and living in rural and remote WA.”
He said the State and Federal Governments had made significant investments in training more Australian students, meaning by 2022 more than 400 students would graduate from medical school in WA.
Federal Minister for Regional Services Bridget McKenzie was contacted by the ABC for an interview.
In a statement announcing the new requirements she said the initiative would allow the Government to better manage the growth and distribution of the national medical workforce.
“The visas for GPs initiative won’t reduce the number of GPs currently providing services but will reduce the rise in doctors in city areas and improve numbers in rural areas where they are needed,” she said.
“The new requirements will ensure the right balance of specialist GPs is available to the Australian community, while also providing opportunities for Australian trained doctors,” Senator McKenzie said.