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The Forum > Article Comments > From an international medical student to the health minister > Comments

From an international medical student to the health minister : Comments

By Ming Yong, published 26/10/2012

Having spent $300,000 on an Australian medical degree, why should a student then be forced to pay for their internship?

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greensquare:

...Your altruistic defense of foreign doctors falls flat. There should be a royal commission to investigate the medical industry, and in particular the area of the GP. When two thirds of drug addicts using the drug injecting rooms at Kings Cross are there to inject the prescription pain killer oxycontin, should we not assume that doctors are actually producing their own patients, (as one among many examples)?

...If the GP is simply acting as a traffic policeman, directing patients to specialist services, surely our system of medical professionals is actually oversupplied. We the patient could handle this particular application of the health service ourselves. For what the GP is required for in our communities, his is a task that could be handled as efficiently by lesser trained medical staff at a fraction of the cost to consumers (and generally the tax payer), negating the need for foreign doctor imports altogether.

...The medical industry is a prime example of negative over-regulation that is strangling the life from Australian society.

...Finally, foreign doctors are in this country for their own purposes alone; it is naïve to believe they are here to save Australians from deliberately manufactured doctor shortages! A “cushy” high paid job as a GP is the motivation.
Posted by diver dan, Saturday, 27 October 2012 7:44:50 AM
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For the work shy, in danger of being made to go to work for a living, give me a call.

My wife has a list of the doctors in our district who will give you a "doctors certificate" to get out of it.

Give her your certificate, with the doctors name obscured, & she can tell you which doctor wrote it. They all use just half a dozen pre written certificates, [like our teachers use on school report cards], they use. Thus it only takes them about 50 seconds to collect another bulk billing fee. Wouldn't want to waste too much time on it now would they.

Ming is probably one of those worth having. I'm sure there are cheaper, & easier ways to get the bit of paper he desires. It is unfortunate he will for ever be scared by this rip off.
Posted by Hasbeen, Saturday, 27 October 2012 11:27:20 AM
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While I sympathise with Dr Yong's position, this article completely misses the point.

FACT - the annual fees for international medical students are no different to students studying degrees like commerce/law. Many of them have large debts, and cannot find work in Australia.

FACT - an Australian internship is ONLY good for Australia. It won't help someone find a job overseas. Opening up a lot of internships now means we then have to create a whole lot of residency positions next year.

FACT - forcing health departments to open up internship positions will not only create jobs where none are needed. Why should any government department fund positions that they don't require? Should the DPP start hiring an excess of lawyers as there is a job shortage among law graduates?

FACT - an internship is a vital training role. Opening up more positions outside of hospitals will result in substandard training of all doctors. Personally I'd prefer to have doctors who can do their job rather than cutting waiting times by a few minutes.

FACT - the doctors being imported are already fully qualified. The newly graduating medical students do NOT have the training to fill these positions. The shortfall will decrease each year as the number of medical students increases.

FACT - this issue has been well known as early as 2005, before most current international students enrolled. There has never been a guarantee of a job for international OR domestic fee paying students. If the universities lied and said it wouldn't be a problem, then this is an issue between them and their students. The government should not be forced to pick up their slack.
Posted by P450, Saturday, 27 October 2012 11:56:37 AM
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Diver Dan, I'm very happy you've said all of that... I'm actually doing a thesis on the topic of pretty much everything you have just brought up.

The first thing I can say is: You're absolutely incorrect about all of those massive, unsubstantiated assumptions. It seems you're on a bit of a vendetta against GPs and the doctors within Australia.

May I first refer you to an article written by Barbara Starfield (Starfield, B., et al., The effects of specialist supply on populations' health: assessing the evidence. Health Aff (Millwood), 2005. Suppl Web Exclusives: p. W5-97-W5-107.) I will summarise the main findings of this review of primary care below:
- Primary care (i.e. GPs) is THE most important tier of a nation’s health system;
- It's the field of medicine that directs itself to the total needs of a patient and their family, and has an emphasis on the integration of health services whilst trying to limit any fragmentation of care
- Secondary Care (i.e. specialists) is extensively (36x) more expensive than primary care - as well as not having the same population-level beneficial effects on health outcomes
- Hence - it is more efficient, and has a better outcome for patients to have their treatment with a GP (obviously there is a point in time when specialist care is needed for some cases)
- Hospitalisation rates inversely associated with access to primary care and the number of primary healthcare providers
"It is not just the supply of GPs or primary care clinicians that is associated with improved health outcomes. In the US, having a primary care physician rather than a specialist physician as the regular source of care is associated with better five-year mortality (after controlling for independent variables)" (Quote JWP)
If we have less highly-trained GPs out there - these health outcomes will NOT be the same. (I can give you 100 articles to read to back up what I am saying)
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Posted by northstar, Saturday, 27 October 2012 12:53:33 PM
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I'd love to know what your "Cushy" job is Diver Dan - I can assure you, MOST GPs are certainly not in a CUSHY job. After undergoing 5 years of medical school, 2 years of intern and residency, a further 4 years of General Practice Training and then having a life which is surrounded by your patients is by definition not a CUSHY job

P450 - FACT: There is a RURAL DOCTOR SHORTAGE. Have you not heard? There ARE positions to fill. It is NOT all about ED waiting times.
FACT: The issue is actually between the state and federal governments as they ALLOWED for the increase in medical student numbers - hence, their responsibility to increase training roles in THEIR Health System.
FACT: The shortfall will decrease ONLY if we create more training positions... how does this not make sense to you? The imported doctors are not favourable as they are not AUSTRALIAN trained.
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Posted by northstar, Saturday, 27 October 2012 12:53:54 PM
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...Well northstar, you will obviously pass with flying colours when you submit your thesis which backs-up AMA propaganda ensuring the system will never work for the sick in our communities; especially those without the means to pay “bribes” to pass through the doors of a doctors’ surgery.

...I am a bit “over” my observations of watching the under-resourced chronically ill in our communities (which includes children of single mothers), manipulated by the medical fraternity into parting with money they “don’t have” to qualify for medical treatment.

...We live in a world of “rich and poor”. Who do your wonderful medical fraternity, the ones whom your thesis will be inclusive of, cater to? Let us be honest, primary health care in Australia is designed by market forces, to wring-out dollars from a captive audience, primarily first and foremost as the objective. It is private enterprise at its worst!

...The shortage of doctors can be easily fixed by reducing doctor quality not increasing it. This may be easily achieved by eliminating the power of the AMA to manipulate at will, Government policy.
Posted by diver dan, Saturday, 27 October 2012 8:43:04 PM
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