AMA offers a better plan to get young doctors to live and work in country Australia

Australian Medical Association (AMA) President, Dr Mukesh Haikerwal, has called for the scrapping of the Government's unpopular, unfunded and ultimately unworkable bonded medical schools places program and replace it with an AMA plan that will attract young doctors to work in country Australia and keep them there without compulsion.

Dr Haikerwal unveiled the plan ahead of Friday's Council of Australian Governments (COAG) meeting in Canberra for consideration by all governments desperately seeking solutions to the rural medical workforce shortages.

"The AMA plan would encourage young doctors into rural areas much earlier than current arrangements allow," Dr Haikerwal said.

"A at this time of their lives and training, they are setting up their professional and personal networks and will only wish to maintain them in rural environments if the experience is positive and they are not being forced to stay.

"Medical students could commit to a period of service in a rural area towards the end of their studies or on graduation from medical school.

"In return, a student or graduate would be given relief from HECS debts along with an annual incentive based payment.

"Participants in this scheme – which provides proper support – would have greater life experience and would be in a much better position to make an informed decision about their future.

"Funding would be scaled so that it properly targeted areas of workforce shortage, so that rural areas would attract higher incentives than other areas.

"The incentives would be flexible to allow a doctor to move from a rural area to an outer metro area if personal circumstances dictated.

"Unlike the unfunded bonded places, this scheme would deliver benefits in a much shorter time frame as graduates could be working in workforce shortage areas in as little as two years, and the rural placement would not be an affront to the civil liberties and goodwill of potential students.

"In contrast, it will be six or seven years before the current cohort of unfunded bonded students will be required to start their bonded service.

"The AMA is determined that more doctors are supported and encouraged to work in rural areas.

"The evidence clearly shows that doctors who go to country towns voluntarily are much more likely to stay there to live and work and maybe even start a family.

"The current unfunded bonding arrangements take advantage of young people who are desperate to study medicine and give little thought to their future.

"I urge the Prime Minister, the Premiers and Chief Ministers to seriously consider this plan as the best possible option to get more doctors living and working in country Australia."

Background:

In February 2006, when the PM announced 400 new medical school places, he indicated that a proportion of them would be bonded. The recently leaked COAG Communiqué also states that the bonding arrangements would be made more onerous.

The Government has in place some well thought out programs to lift rural workforce numbers. The recruitment of medical students with a rural background, and the provision of more opportunities for their early exposure to rural medicine are sound evidence-based policies that will deliver long term sustainable improvements in medical workforce numbers.

Available evidence suggests that the current unfunded bonding programs will not lead to long-term improvements in rural workforce. At best it is a short-term solution aimed at a long-term problem. Few students remain in rural or deprived urban areas after their required period of service has ended.

Overseas retention rates of bonded doctors in workforce shortage areas is around half that of doctors who practised in these areas voluntarily.

The AMA Rural Reference Group believes that rural communities are best served by doctors who want to practise in these areas and are not forced to do so by conscription.

Making bonding arrangements tougher is not the right answer. The Government is sending a message that if you can afford it, you can buy a full fee paying place and can eventually practise medicine wherever you wish. If you can't pay, you may find yourself locked into a bonded place.

Tougher bonding arrangements may force many graduates to work overseas.

The AMA believes that students should not be forced to sign up to a bonded place in order to gain entry to medical school.

At 17 or 18 years of age, people are ill-equipped to make such a decision. By the time it comes to fulfilling the terms of their bond, their personal circumstances will have changed significantly.