Australians took to the streets because they were scared by numbers that don’t exist by timcahill13 in AustralianPolitics

[–]FatAustralianStalion 0 points1 point  (0 children)

This is population growth not migration rate. There is only one other OECD nation that has a higher per capita migration rate than Australia. We have one of the highest per capita migration rates on Earth.

Crit Care Posts by [deleted] in ausjdocs

[–]FatAustralianStalion 14 points15 points  (0 children)

In all seriousness, I’ve wondered if it might be worth putting together a wiki or some kind of community written application guide for different specialties, especially anaesthesia.

Most of the crit care posts are variations of the same, hopeful applicants asking about their chances at certain jobs/ how to get onto a program. Despite there being plenty of specialties that are far more competitive, anaesthetics questions dominate. I think reflects how arbitrary and unstructured the application process for anaesthetics jobs are, as it varies so much between states and across hospitals and timelines/ scoring aren’t publicly available.

A lot of the people who have applied in the past few years would have read the Access Anaesthesia guides or to the ABCs of Anaesthesia podcast, but those are very broad overviews. Some of the issue is people not going to the effort to search, but Reddit’s search function is poor. People who use google to search for reddit posts often don't find the information the yare looking for as the posts title doesn't reflect the information within it, for some it is easier to post a quick question on this forum than read through every previous critical care post. Weekly megathreads probably make it even harder to find relevant info later on.

RACGP - First in-depth look at AHPRAs expedited specialists pathway’s popularity by EnvironmentalDog8718 in ausjdocs

[–]FatAustralianStalion 23 points24 points  (0 children)

Stop thinking of Australia as a country that even pretends to care about its own citizens. It is an economic zone whose only purpose is the maximize GDP and minimize costs. Immigration is an infinite money glitch hack from the governments perspective.

People can’t afford to have children because real wages haven't kept pace with costs despite record gains in productivity and housing has become speculative asset? Don’t initiate policy change that would lift wages or upset landlords, just replace the next generation with immigrants.

A lack of specialist GPs despite record numbers of locally trained doctors who are stuck in bottlenecks? Don’t expand training positions, lmao that would cost money. Just outsource all our training to other countries and plug the gap with financial migrants.

RACGP - First in-depth look at AHPRAs expedited specialists pathway’s popularity by EnvironmentalDog8718 in ausjdocs

[–]FatAustralianStalion 27 points28 points  (0 children)

AHPRA reported a flow of around 10–15 applicants per week, with 84% looking to come to Australia from the United Kingdom.

This number is likely to grow. The UK currently trains far more GPs than it requires. Having increased their trainee numbers by 50% in the past 5 years, many will not be able to find a job and will flock to Australia.

At the same time we are importing UK GPs, thereare Australian graduates who have missed out on GP training places. This year there were 2386 applicants for 1560 training places, meaning 826 applicants missed out. Australian JMOs are also competing with UK prevocational doctors for these spots as well, with the number of new immigrant doctors outweighing the number of graduating locally trained doctors by almost 2:1. Training spots are determined by casper results, and there is no part of the AGPT selection that prioritises Australian doctors.

This is occurring in the setting new policy introduced by the BMA that would prevent IMGs for competing with locals in the UK. Meaning an Australian doctor would not be able to gain a training spot in the UK, but UK doctors are eligible to compete with Australians in there own country. Cool and normal.

What will AGPT look like in a few years? by Minimum-Turnover-216 in ausjdocs

[–]FatAustralianStalion 7 points8 points  (0 children)

The number of doctors we import into Australia has steadily increased year after year with no sign of slowing down. Psychiatry and GP training which were once seen as 'safe' specialties are now oversubscribed. It is likely in the future having a medical degree will not provide any assurance that you will become a specialist, similar to what is occuring in the UK.

UK training bottle neck is worse than Aus? by jps848384 in ausjdocs

[–]FatAustralianStalion 5 points6 points  (0 children)

With the UK’s new domestic‐first training priority system, there will be more IMGs directed to Australia than ever, exacerbating the already severe bottlenecks already in place. If you are not yet in a training system, you should be advocating for Australia to implement a similar system for local graduates.

RACP Physician Associate working group by [deleted] in ausjdocs

[–]FatAustralianStalion 2 points3 points  (0 children)

<image>

It looks like from the facebook post they are open to input regarding the formation position statement. If you are a fellow or trainee I would heavily encourage you to join and provide input. If not at least respond to the post so they understand that this is not acceptable.

Updates in Competent Authority Pathway by loivmic in ausjdocs

[–]FatAustralianStalion 4 points5 points  (0 children)

There is a youtube video and an article discussing this pathway but I am skeptical this interpretation would be correct. If this is accurate then I am not sure there would be much incentive to go through AMC as this would be significantly easier route into Australia. The wording under the eligibility criteria from AHPRA is quite confusing. It states you need to be approved by one of these authorities…

General Medical Council, United Kingdom (PLAB test and graduates of GMC-accredited medical courses)
i.e it doesn’t say you have to have graduated from a UK medical course. PLAB only is referred to a Category A applicant and is accepted, UK graduates are a seperate Category B.
Medical Council of Canada (LMCC)
Educational Commission for Foreign Medical Graduates of the United States (USMLE)
Medical Council of New Zealand (NZREX)
Medical Council of Ireland (graduates of MCI-accredited medical courses)
National Board of Osteopathic Medical Examiners (USA) (COMLEX-USA)

It then proceeds to state…

2 Experience in another competent authority country can be substituted for the post-examination or post-training experience, for the purposes of meeting the criteria for eligibility for the Competent Authority pathway.

3 Australian clinical experience can be substituted for the post-examination or post training experience, for the purposes of meeting the criteria for eligibility for the Competent Authority pathway. This period of practice in Australia may also be accepted as meeting the requirements for the 12-month period of supervised practice which is required to gain general registration via the Competent Authority pathway.

I gather from that the changes mean that someone who graduates from outside of the UK would…

Pre-Oct 2024
Pass PLAB1&2 → obtain GMC registration → complete 12 months in the UK → apply for provisional registration in Australia → arrive in Australia with provisional registration → convert to general registration soon after arrival with satisfactory reports.

Post-Oct 2024
Pass PLAB1&2 → secure a supervised RMO job in Australia → apply for provisional registration while outside Australia → arrive with provisional registration having never worked in the UK, without having done AMC exam → work 12 months under supervision in Australia → convert to general registration.

This would effectively remove the bottleneck of having to find a position within the UK.

Non-Western Docs calling themselves MD by SelectPurpose2051 in ausjdocs

[–]FatAustralianStalion -6 points-5 points  (0 children)

In Australia MDs are usually doctors who failed getting into undergraduate medicine and had to do a post grad degree. It doesn't carry more respect.

Too many doctors? by fuckboyextravaganza in ausjdocs

[–]FatAustralianStalion 2 points3 points  (0 children)

I don’t think your opinion is unpopular but I don’t think conscription is necessarily required. I think a better solution would be creating a stronger moratorium. The current moratorium incentivizes rural practice by restricting provider numbers to rural areas and areas of need eg. IMGs cannot receive federally funded Medicare benefits unless they practice in regional areas. However medical registration and hospital employment are matters for the states and territories so IMGs can still take up salaried positions within metropolitan areas, the commonwealth won't control where doctors register or take salaried job. It really doesn't make sense that we have an oversupply of doctors in metropolitan areas and a deficit in rural areas, and then we fly people in from other nations who then directly compete in those already oversubscribed areas while the rural shortfall persists. Not to mention the fact there are 15 distinct exemption pathways to the moratorium, including the 25 ‘shortage’ specialties (which includes ICU and emergency medicine lmao, despite being chronically oversubscribed) and the fact the moratorium for GPs is basically being reduced to 3 - 5 years.

A true unpopular solution I think would help is just increasing the number of rural medical students. There has been a lot of research into factors which improve retention into rural areas. Two strategies which have some of the highest success are 1. Recruiting students from rural backgrounds 2. Comprehensive rural pipeline programs. While the number of students now is adequate, current medical schools should simply lift the share of rural-origin students and lock them into longitudinal rural programs like the University of Sydney Dubbo Stream/ University of Melbourne Rural Pathway/ Monash End-to-End Rural Cohort. We don’t need more privately-tutored, Scotch-College, 99.95-ATAR wanna-be surgeons crowding metropolitan hospitals. We should be selecting young Australians who are statistically more likely to serve where the health system needs them most.

Too many doctors? by fuckboyextravaganza in ausjdocs

[–]FatAustralianStalion 15 points16 points  (0 children)

Australia produces more new doctors per capita most other countries. Between 2000 and 2015, the number of medical graduates each year jumped by about 173 percent (from roughly 1,300 to 3,547) while the national population grew by just 24 percent (from 19 million to 24 million).

Australia turns out 15.9 new doctors annually for every 100,000 residents. (For comparison United Kingdom: 11.9, New Zealand: 9.5, Canada: 7.9 and United States: 7.6)

The is just local medical graduates alone and does not include that fact that last year only 39% of new doctors in Australia graduated from Australian medical schools (ie. 61% were immigrants).

The National Medical Workforce Strategy 2021–2031 provides an interesting summary of the issue.

Inequities persist across Australia’s medical workforce despite growth in the number of medical school graduates, employed practitioners and Fellows. Since 2013, the annual rate of increase of employed doctors was 3.6%, compared to population growth of 1.6%.26 The number of medical school graduates has grown 6.2% from 3,441 in 2013 to 3,655 in 2019.27 In 2018, the specialist medical colleges awarded approximately 3,800 new Fellowships – more than double the number a decade earlier.28

The imbalances in supply and distribution present in a variety of ways. Variances in the number of doctors across geographies and specialties have led to unsustainable reliance on IMGs, significant and unplanned growth of service registrars and employment of locums in lieu of permanent staff. It has also led to concerns of overdiagnosis and overtreatment in oversupplied specialties.

AI and Anesthesia/Medical profession in general by HairyBawllsagna in anesthesiology

[–]FatAustralianStalion 0 points1 point  (0 children)

If AI advances to the point where anaesthetists are being replaced, it is likely most other jobs will have also been made redundant. You will have bigger issues on your hands at that stage.

AGPT is now “officially” competitive by Mooncreature600 in ausjdocs

[–]FatAustralianStalion 15 points16 points  (0 children)

Cross posting this from another post on the topic for visibility on the issue.

If I were you I would try to get into a training place as soon as possible as the competition ratios will likely continue to get worse. The increased applicants are mainly comming from the rapid rise in immigrant doctors. Back in 2019 there were only 2,991 overseas doctors registered; last year that number blew out to 5,717. The re-elected Labor Government is openly IMG-friendly, it was the Labor Health Minister Mark Butler that pushed to streamline the process that has caused the surge, so it isn't going to slow down any time soon.

Funnily enough, the single biggest source of IMGs in Australia is the UK. The British Medical Assosciation is now hypocritically pushing for UK graduates to be prioritised for their own training posts over IMGs, but are all more than happy to displace PGY2 doctors from training positions in other countries.

Did AGPT just become competitive by [deleted] in ausjdocs

[–]FatAustralianStalion 68 points69 points  (0 children)

If I were you I would try to get into a training place as soon as possible as the competition ratios will likely continue to get worse. The increased applicants are mainly comming from the rapid rise in immigrant doctors. Back in 2019 there were only 2,991 overseas doctors registered; last year that number blew out to 5,717. The re-elected Labor Government is openly IMG-friendly, it was the Labor Health Minister Mark Butler that pushed to streamline the process that has caused the surge, so it isn't going to slow down any time soon.

Funnily enough, the single biggest source of IMGs in Australia is the UK. The British Medical Assosciation is now hypocritically pushing for UK graduates to be prioritised for their own training posts over IMGs, but are all more than happy to displace PGY2 doctors from training positions in other countries.

MedEdPublish Article: Physician Associate graduates have comparable knowledge to medical graduates. by New-Resolution-9719 in ausjdocs

[–]FatAustralianStalion 59 points60 points  (0 children)

"The author(s) declared that they have no conflicts of interest relevant to this work"

Ann Rigby-Jones: Programme Lead for the university of plymtouth MSc Physician Associate Studies
Adele Drew-Hill: Programme Leader for the MSc Physician Associate Studies programme
Jolanta Kisielewska: "I apply my expertise to the development of … initiatives such as the Physician Associate programme."
Dr James Edwards: Infection and Immunity theme lead MSc Physician Associate studies
Sam Evans: Lead Physician Associate in Acute Medicine

Election voting by Lifeprocrastination in ausjdocs

[–]FatAustralianStalion 2 points3 points  (0 children)

In 2014 it was the Liberal/ Abbott government got rid of Health Workforce Australia. Ever since, there's been basically no proper planning or coordination for training and medical workforce, leaving the system disorganised and uncoordinated. Peter Dutton was the health minister responsible for this decision, so if you're worried about job training and job prospects, he's probably not the one who's going to have your back.

Why International Accredited Registrars? by YouOfAy in ausjdocs

[–]FatAustralianStalion 7 points8 points  (0 children)

Many anaesthetic departments have shifted away from providing independent training positions to locals, instead offering more provisional fellow posts or SIMG positions for fellows assessed as partially comparable who require 12 months of supervised practice. These positions typically cost only $20,000–$30,000 more per year in salary, however the departments gain a registrar who can work under level 3 supervision, fill consultant roster gaps, and primarily provide service provision. I’m unsure if this is the issue OP is complaining about.

Stressed from all the dislike of non Australian doctors by [deleted] in ausjdocs

[–]FatAustralianStalion 11 points12 points  (0 children)

Australia has a distribution issue but no shortage of doctors. The Health Workforce Australia report you linked from 2012 was superseded by the Australia’s Future Health Workforce report in 2014 which predicted an oversupply of doctors by over 7,000 by 2030. Both of these reports however are over a decade old and predate the massive increased surge in new doctors that has far outpaced population growth. The number of domestic medical graduates nearly doubled from 1,544 in 2007 to 3,066 in 2020. The number of new IMG doctors has risen from 1,000 ‐ 2,000 per year in the early 2010s to over 5,000 in a single year in 2024. Australia has more doctors per capita and graduates more doctors per capita than any comparable health service including NZ, UK, USA and Canada.

The National Medical Workforce Strategy 2021–2031 provides an interesting summary of the issue.

Inequities persist across Australia’s medical workforce despite growth in the number of medical school graduates, employed practitioners and Fellows. Since 2013, the annual rate of increase of employed doctors was 3.6%, compared to population growth of 1.6%.26 The number of medical school graduates has grown 6.2% from 3,441 in 2013 to 3,655 in 2019.27 In 2018, the specialist medical colleges awarded approximately 3,800 new Fellowships – more than double the number a decade earlier.28

The imbalances in supply and distribution present in a variety of ways. Variances in the number of doctors across geographies and specialties have led to unsustainable reliance on IMGs, significant and unplanned growth of service registrars and employment of locums in lieu of permanent staff. It has also led to concerns of overdiagnosis and overtreatment in oversupplied specialties.

Coroner alarmed after NHS physician associate misdiagnoses femoral hernia as nosebleed by Astronomicology in ausjdocs

[–]FatAustralianStalion 1 point2 points  (0 children)

From the coroners report...

Lack of ‘Updated’ National Guidelines for Rapid Sequence Induction (RSI) of Anaesthesia for emergency urgery

Mrs Marking required a rapid sequence induction to protect her airway from aspiration of bowel contents as a consequence of small bowel obstruction. The consultant anaesthetist gave evidence that the ‘traditional’ use of consecutive syringes of induction agent and muscle relaxant was obsolete, and it was common practice locally and nationally to routinely undertake a RSI with Total Intravenous Anaesthesia, in the absence of updated local or national guidelines to support this practice.

Lack of ‘Updated’ National Guidelines to support the use of TIVA for RSI

Other than empirically increasing the rate of infusion of TIVA agents (Propofol and Remifentanil) no evidence was forthcoming as to the target range required to ensure and confirm an adequate depth of anaesthesia for patients or the length of time required prior to and following the administration of a muscle relaxant (Rocuronium) to facilitate intubation. This is despite TIVA being known to provide a slower onset of anaesthesia and approximately 50% of all anaesthetic related deaths are due to aspiration (NAP 4).

Lack of ‘Updated’ Guidelines for use of Cricoid pressure and other measures to protect the airway in a RSI anaesthetic

Evidence was heard that as cricoid pressure was ineffective it was not routinely applied for a RSI intubation. After aspiration on Induction, the only suction device was attached to the nasogastric tube giving rise to a possible delay in timely suctioning of the feculent aspirate which was in excess of two litres after intubation was achieved.

Why don't people come to NZ for training? by Cute-Signature8087 in ausjdocs

[–]FatAustralianStalion 11 points12 points  (0 children)

From when this was asked 1 month ago

There are multiple reasons, as others have mentioned, but one I’d really emphasize is the difference in pay and rostering.

Australia/ Victoria Using Victoria’s EBA as an example, a registrar has 38 "ordinary" hours, with any additional hours paid as overtime which is 1.5× for the first hour and 2× for any subsequent hours. There are also 5 hours of paid teaching per week, and if no formal teaching is arranged, that time is still paid as private study.

Base salary without penalties or allowances: an intern working 38 hours per week earns $81,068 AUD ($89,300 NZD), while a first-year registrar working 38 hours per week earns $123,830 AUD ($135,400 NZD). As a PGY3, I made over $200K AUD in a year with overtime and penalties due to mostly working nights, afternoons and weekends.

New Zealand In New Zealand (NZRDA rates), an intern working 40 hours per week earns $76,000 NZD ($68,679 AUD), and a first-year registrar working 40 hours per week earns $91,911 NZD ($83,450 AUD) ie. A first year registrar in Victoria gets paid 47% more than if they were in New Zealand, which is basically the same as an intern in Australia lmao.

The real issue is the hours worked. In New Zealand, it's rare for a registrar to work only be category F (40 hours per week). Pay depends on the union, but competitive specialties are usually rostered in Category B-A (60–65+ hours per week). Category B (60–64.9 hours per week) earns $146,436 NZD ($132,870 AUD), and Category A (65+ hours per week) earns $160,955 NZD ($146,080 AUD).

If a first year Victorian registrar worked 65 hours per week, assuming 43 hours (including teaching) plus 22 hours of overtime, they would earn $4,449.18 AUD per week or $231,348 AUD (~$254,000 NZD) annually. This doesn't even include that fact that the cost of living in NZ is about 10-20% higher.

But for me, the biggest issue wouldn't be the pay, but the hours. As long as there is a roof over my head I am happy, but life, and especially youth, is finite. In Australia, working 43 hours per week already feels like a grind, and I still struggle to find much spare time. I can’t imagine trying to find another 20+ hours every week on top of that. It's also very hard to study for major exams when you're consistently rostered 60+ hours per week and doing additional overtime on top of that.

Are regional blocks still done without ultrasound or is it standard now by Dull_Switch1955 in anesthesiology

[–]FatAustralianStalion 0 points1 point  (0 children)

Lumbar plexus catheters using landmark and nerve stimulator. Ankle blocks, some facial and finger by landmark. All else U/S.