Under this system, general practice trainees remain employed by NSW Health, allowing easy transition between hospital and community-based general practice training placements, and portability of entitlements such as annual leave. Several trainees at the conference praised the program and Davis told The Sun-Herald and The Sunday Age it was helpful because losing entitlements by switching employers “definitely turned students off and significantly impacted women, who were more likely to be GPs”.
Butler said the results of the single employer model in the Murrumbidgee would inform a possible further trial in South Australia.
Department of Health secretary Dr Brendan Murphy told the conference that growth in GP numbers was only 1.8 per cent a year, while growth in other medical specialists was 4.2 per cent a year.
He said there were many reasons why medical students were not choosing to specialize in general practice, including the financial rewards and the focus on “high throughput medicine”.
“Far too many of our young doctors are not choosing to go into general practice, which is the area we have the greatest predictive need in the future,” Murphy said.
“Some colleagues and many of the general practice groups say that some of their other specialist colleagues are earning more money for the same or less hard work, so that’s part of it – the reward for the job.”
Several conference attendees spoke about junior doctors graduating with a high burden of debt and gravitating to the best-paid work as a result, while others described a retention problem in general practice because of financial pressures and burnout.
Davis told this masthead that financial sustainability was important, but money was not the main motivation of most medical students.
“We’re still at the stage where we have come into medicine because we care about people and want to make a difference in the community,” Davis said. “Most students, if they get adequate exposure to general practice and have a good experience would be very likely to go into the career.”
Davis said students were not applying for general practice because of the lack of value placed on primary care. She welcomed the new government putting more funding into general practice, but said universities also needed to invest more in making it the “go-to profession”.
“We do most of our training in medical school in tertiary hospitals in the city and it’s usually a small subset that go out and do rural general practice placements,” Davis said.
“We’d love to see that really increasing, or even a flipped model where you do most of your training in the community and rotate into hospitals – I think something like that would encourage more students to go into general practice.”
Murphy said the government had “massively expanded” the John Flynn Placement Program to expose junior doctors to general practice, especially in rural and regional areas. This is a voluntary program.
He said the National Medical Workforce Strategy, endorsed by health ministers late last year, showed Australia had enough doctors – more than the OECD average including those trained in Australia and those trained overseas – but the workforce was not properly distributed.
Murphy said a related problem to the undersupply in general practice and other areas such as psychiatry was oversupply in other specialties such as emergency medicine and orthopedic surgery.
This problem arose partly because hospitals relied on employing junior doctors to fill positions in emergency medicine departments, but did not have the staff specialist positions available once the doctors completed their training.
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