1. Getting the Balance Right
How Can Medical Schools Help?
Brendan Crotty

2. Australian Medical Graduates 1999-2014
MTRP 19th Report 2016

3. Australian Medical Graduates 2014-2019
MTRP 19th Report 2016

4. Graduation December 2011

5. Getting the Balance Right
Issues surrounding the predicted oversupply of doctors and the consequences for the distribution of doctors in Australia, including the role of IMGs in rural areas

6. We need to train generalists!
Rural and regional health Needs
Burden of chronic disease / disability
ageing population with multiple chronic diseases
epidemics of obesity and diabetes
cancer
degenerative disease
mental health disorders
Continuing regional/rural w-force shortages
We need to train generalists!

7. Generalist Specialists and Subspecialists
General Practitioners
Procedural GPs

8. Deakin Clinical Schools
Geelong
Warrnambool
Ballarat
RCCS
More medical students per capita outside Melbourne than in Melbourne
Expansion of Monash and UoM RCS’s
UND students in Ballarat

9. Students not convinced of need for Murray Darling Medical School
The Australian
HIGHER EDUCATION
Students not convinced of need for Murray Darling Medical School

10. Expansion of Victorian Intern Positions
More interns per capita outside Melbourne than in Melbourne
High achievers choosing internships in Melbourne
Regional interns leave for vocational training

11. Vocational Training Bottleneck
Australian Medical Graduates
Vocational Training Bottleneck
MRTP 19th Report 2016

13. MABEL Policy Brief 3, 2017

14. Key findings The goal of policy should be to:
Continue to select medical students with rural backgrounds and facilitate rural immersion options in undergraduate training
Enhance the number of trainees in general practice and other generalist specialties
Ensure more vocational training is undertaken in rural settings
Further develop workforce capacity, including accessible locum support and PD
Enhance the ability of doctors in rural communities to continue practising and undertake advanced skills training
Target financial incentives more carefully
Develop regional specialist service hubs
Continue, though with likely decreasing reliance, the 10-year moratorium and 457 visas

15. Integrated Rural Training Pipeline for Medicine
MYEFO
Integrated Rural Training Pipeline for Medicine
Up to 30 new regional training hubs at RHMT sites. Over $14 million per year to universities through a competitive process
Targeted STP expansion in rural areas – 50 new places in 2017 and 50 in 2018
Rural Junior Doctor Training Innovation Fund to enable rural-based interns to spend time in rural general practice

16. General surgery training: South west regional hub
Geelong, Ballarat, Warrnambool, Hamilton, Colac
12 accredited training posts
Surgical trainees based in the region for the most of their training
Offer rotations to metropolitan training hubs
…….. only if reciprocal subspecialty rotations are available to SWRH trainees.

17. Victorian Regional Medical Training Networks

19. Victorian Regional Medical Training Networks
Four regional training networks
Use RCS facilities and IT
Trainees will complete the majority of their (generalist) p/g training in the region
Integrated hospital-based GP training
Network staff: accreditation and development of programs
Training provided by regional clinicians

20. Integrated Rural Training Pipeline for Medicine
‘New places (and hubs) will be restricted to ASGC RA 2-5 areas and should be designed to enable a specialist trainee to complete the majority of their training within a rural region, with only limited metropolitan rotations where this is necessary to meet fellowship standards.’
Is this possible with 26 hubs?
Gold Coast, Newcastle, Wollongong and Geelong excluded ‘

21. Thank you