Debate is heating up over a proposal to establish a third medical school in New Zealand.
The Waikato University and Waikato District Health Board bid aims to initially train 60 graduates per year to solve rural doctor shortages.
It aims to offer a four-year medical degree course for graduate students, specialising in rural medicine.
“We have been relying on foreign-trained doctors to supply many of our health workforce positions for many years so there is a huge scope to increase the number of New Zealand-trained doctors” says Waikato University Vice-Chancellor Professor Neil Quigley.
An abstract article in this week’s New Zealand Medical Journal argues that with 80 GP’s retiring each year and New Zealand’s population growing by 80,000 per annum, more rural doctors are needed.
Researchers say the Waikato trainees would be more diverse in background, in contrast to students from the country’s two existing medical schools who, they say, are more likely to come from privileged schools with high socio-economic backgrounds.
Professor Quigley says the Waikato students would be exposed to rural medicine early on, and chosen for their expressed commitment to serving less populated communities.
“They will be trained in a way that focuses all of their attention on the importance of community medicine, of the importance of service to the communities in which they grew up” he says.
But both the Auckland and Otago Medical Schools’ believe a third offering is both expensive and unneeded.
“We’re looking at a very substantial government investment to establish a medical school, particularly at a university that doesn’t have a longstanding investment in health” says Auckland University Dean of Medicine Professor John Fraser.
He says New Zealand trains 490 doctors per year currently, which is set to rise to 600 by 2020, in line with carefully calculated health workforce needs, with some current graduates already struggling to enter GP training programmes or find hospital placements.
“There is a considerable shortage of post-graduate training places at the moment so an additional 60 graduates from a 3rd medical programme would severely impact upon the number of available training places in New Zealand” says Professor Fraser.
He argues around 18% of the current Auckland and Otago medical student intakes are Maori and Pacific, with a further 15 per cent chosen from rural backgrounds in an effort to encourage more students into rural medicine. On top of this, he says, all medical students spend time in rural placements as part of their compulsory training, some of which last for a full year.
Professor Fraser says while many junior doctors used to head overseas after qualification, fewer jobs in Australia and the UK mean far less are now leaving and that GP training positions, of which there are 180 per year, are currently over-subscribed, with nearly 27 per cent of students now opting for a career as a GP.
However Waikato University is confident being fully-immersed and exposed to rural training will result in 60 per cent of its students taking up a career in the regions.
But what neither Auckland, Otago, nor this new Waikato proposal can guarantee is that students will actually commit to working and settling in areas of rural or provincial need once they are medically qualified. Many rural positions remain difficult to fill because doctors aren’t attracted to the regions for family, professional development or collegial support reasons.
Voluntary medical student bonding, introduced by the government some years ago, is only partially helping fix shortages, and has not been enthusiastically endorsed by students.
Medical schools here say compulsory bonding programmes have not worked well overseas, as doctors regularly leave an area as soon as their bonding time is complete while others still are able to legally extract themselves from their bonding agreements.
The Waikato business case is currently being considered by the government with no decision yet in sight.