I was sent this link today http://www.araratadvertiser.com.au/news/national/national/general/anger-as-medical-graduates-miss-out-on-internships/2573501.aspx.
For over 2 years now I have been saying that time will come when the market will be saturated and doctors will be treated as any other graduates with no guaranteed job. The only problem is that medicine is more complex than any other profession. No internship/housemanship means you cannot practise as a doctor after spending so much money and time(if you are not sponsored)!
Australia was also having shortage of doctors few years ago. The number of medical schools almost doubled over the last 10 years. At least it just doubled and almost 20-30% of their intakes are international students. Their locals also do not go overseas to do medicine. In Malaysia, our medical schools increased from just 4 in 1995 to about 36 in 2012, a whooping 800% increase!! On top of that, we send thousands to do medicine overseas.
Since last year, certain states in Australia have already started to have shortage of internship post. Obviously, citizens and PRs will be given priority. The news below which appeared today is a clear indication that Australia will not guarantee anymore internship post for international students. The door is closing for sure ! The same is happening in UK as well.
So, you say it will NOT happen in Malaysia? …………………… time will tell.
Anger as medical graduates miss out on internships
MEDICAL graduates will be forced interstate or overseas to secure internships next year, potentially costing the state government more than $20 million in lost investment.
Students and universities are angered by the waste and the dire shortage of available positions for junior doctors, which means 146 NSW graduates will miss out on completing their mandatory year of training locally.
A Sydney Medical School review of the true cost of a medical degree found it cost $85,000 a year of study in 2010, with $35,000 of that funded by the state government in the form of in-kind support from the NSW Ministry of Health; health system employees who teach for free; and the use of medical facilities for training.
The state funding also applied to international students, but with internships first offered to local graduates, international graduates were likely to miss out.
Nearly 90 per cent of international student graduates would work in NSW if they could, said the University of Sydney’s medical society president, Zac Turner, potentially filling dire shortages in rural areas.
”Given the cost to Australia in training them, it seems a waste to send them home, and unfair since without that one year internship, they cannot become a registered doctor,” he said.
Sean McIsaacs has applied for internships next year in nearly every state, but said he was preparing to get rejected by all of them. The final-year student from Vancouver said he was unlikely to secure work back home in Canada either, since he would be classified as an international graduate, for who there were few positions.
”This shortage of places is unprecedented,” he said. ”As international students we’ve shown our own initiative to come here as full fee paying students who want to contribute to the Australian workforce, and we were hopeful the government would reach out to aid us.”
The University of Sydney’s international students’ representative, Blaise Wardle, said given Australia was a net importer of doctors, locally trained international students should be valued. ”It seems preposterous to allow this resource to disappear,” Mr Wardle said.
”There would be enough work for them – if only the state government was willing to fund internship positions.”
Last week the Health Education and Training Institute released provisional numbers for medical internships next year, with 894 internship places available for an estimated 1040 NSW graduates -a stand-out year for shortages.
The University of Sydney’s dean of medicine, Bruce Robinson, said international applicants were warned there was no guarantee of an internship.
”But the argument we have been making is that we ought to be getting a return on our investment and not be losing locally-trained graduates interstate or overseas,” Professor Robinson said.
The NSW Health Minister, Jillian Skinner, said the government had no obligation to offer an internship to every applicant.
”As part of the 2011-12 state budget, the NSW government committed new funding of $11.2 million over four years to support the establishment of additional intern training opportunities,” she said. ”However, this is not just a state responsibility; there needs to be an agreement between the Commonwealth, the universities and the state government about providing internships for all medical students.”
Pagalavan's Avatar 
There is a difference between the system in Australia, and Malaysia. The number of Internship places in Australia is fixed, based on the number of ‘trainers’ and hospitals available, and the funding provided by the individual states. They cannot take in more housemans, than there are finite available places.
The number of housemanship places in Msia on the other hand, is completely flexible, not based on anything except the willingness of the JPA to keep employing. Even when positions are full, they can still continue to absorb graduates under contract.
The effect will therefore be different. It will only be a problem, if the JPA decides to stop taking people in. Will they do that? Remember, this is a political decision, and judging from what happened when they MMC de-recognise the Ukraine med school, it may politically NOT possible for JPA to NOT absorb ALL graduates who apply.
Yes, they may give you a HO post under contract but will not guarantee you a job after that! Even then, how many can the government take? They also have their financial limitations.
http://pagalavan.com
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JK is right in describing the situation in Australia. The number of internship places are appropriate because of this system. There is no ‘shortage’ of interns – even if more places were to be created they would be supernumerary unless hospitals and services expand with that increase.
In Malaysia, we could do with more interns/housemen IF we had a mature health system where some of the larger district hospitals were converted to general hospitals which have specialist services. We have many large towns which could do with a general hospital. However, the govt has no money to do this and this also takes time, much later than the medical tsunami that is about to hit us.
I foresee a situation where the govt will only hire those from public unis and those it has sponsored. Maybe even some well-connected private unis. They cannot hire all the graduates without a substantial increase in services (which cannot happen in the timeframe we are talking about). If I am proven wrong and they do hire everyone, then you will have more housemen that patients in each hospital.
Definitely, the problems of oversupply will happen sooner. The question is whether the government will realize it or not…at moment, even the medical fraternity, in large, still in denial state. Hopefully, in future more demands for doctors available. Not only from MOH, but private sector as well..In US, doctor even works at factory clinic, insurance companies, pharmaceutical manufacturer, non-governmental health related agency, private research institute, or even film maker studio. But many of them are doing a non-clinical practice. The pay may not lucrative as those in private hospital practice but still can earn a happy life…the issue is, are the new generation of young doctors prepared to face such scenario?
Might be a good time to repost this table I came up with a few months ago:
Country – Med schools – Population – Med schools per million people
United Kingdom – 32 – 62.2mil – 0.51
United States – 134 – 313.1mil – 0.43
Australia – 21 – 22.9mil – 0.92
New Zealand – 2 – 4.4mil – 0.45
Singapore – 3 – 5.2mil – 0.58
Hong Kong – 2 – 7.1mil – 0.28
Malaysia – 35 – 28.3mil – 1.24
We are by far the highest among countries we would like to compare ourselves to. Australia is already facing problems with their ratio.
AND, we have 1000-2000 students at least returning from overseas each year, which is the equivalent of another 10 med schools (increasing the ratio to 1.59). As Dr P mentioned, the above countries don’t have a comparable number of med students studying overseas as well.
Not to forget that many medical schools in Malaysia have 2 intakes per year, offshore programs etc…
Yes, actually we have almost 50 medical schools if we include all the intakes. ACMS is very proud that they are the only university in the world which is offering 5 medical programmes!!!! Crap…….
Im a second year student from one of russian medical universities, after following your blog for more than one and half years now Im thinking of dropping out without wasting time here.
The teaching system here is a disaster, there’re students who got free Pass Marks for their finals examination during valentines and that was for hardcore subjects like Anatomy!
It was my fault that I didnt do my research before enrolling into this so called uni and got fooled by an agency claiming that the course will be taughed and conducted fully in english as the uni said according to WHO the last 3 clinical years will be lectured and conducted fully in local language which is Russian.
Even lecturers here merely speaks proper English but money, of course, on the other hand talks so loud that there’re students who made through semesters without attending even a single class or examination.
This is really worrying me plus your blog posts scares me to death, literally.
I like the idea of saving peoples life but I wouldnt say Im really committed to it.
Do you think its bring decision to drop out and focus on chicken industry which needs more attention as the goverments ETP would suggest http://www.youtube.com/watch?v=DoqRHdeHRoE&feature=plcp
Whenever I bring up these issues about some dubious medical schools overseas and in Malaysia, I get a lot of remarks. But I am very sure a lot of people know the truth.
BTW, food business is a very profitable business. Have you seen anyone going bankrupt unless they did not plan properly? Forget about NFC!!
just a side story. i guess LTL probably spend more time thinking about these kind of things instead of how to improve our health care system.
http://www.malaysiakini.com/news/199894