The capacity of Australian ED to absorb the projected increase in intern numbers

Abstract

As a reaction to the medical workforce shortage in Australia, a large expansion of undergraduate medical education has occurred through the provision of funding of additional medical student places. As a consequence, the number of medical graduates is anticipated to increase by as much as 90% with a peak in numbers anticipated in 2012. With ED already under pressure, this increase has serious implications for ED, particularly the delivery of intern and student teaching. This integrated review describes potential challenges that might arise from the predicted increase in intern numbers working in ED. A structured literature search was conducted from which 44 directly relevant articles were identified. We discuss the possible impact of an increased number of medical graduates on emergency medical staff, education, supervision and feedback to interns, and given the potential impacts on the education of junior doctors; we review the purpose and implementation of the Australian Curriculum framework for Junior Doctors in relation to their learning requirements. Although there is consensus by most postgraduate bodies that the core emergency term in emergency medicine should be retained, the impact of increased intern numbers might dramatically affect the clinical experiences, supervision and educational resources in the ED. This might necessitate cultural changes in medical education and ED function.

The Medical Boomerang: Will it come back?

“…Increasing medical graduate numbers in Australia from the mid-2000s17 and national health workforce reforms since 2010 aim to facilitate a more self-sufficient and sustainable medical workforce 18. A subsequent consequence of the increasing medical student, intern and registrar numbers is now a growing demand for ED training, revealing key issues for the future of medical training in Australia19; namely practical constraints to supervisory capacity and availability of placements in existing teaching hospitals. In the very near future, more early-career doctors than ever will be competing for junior medical officer and vocational training positions 20.…”

Focusing on the learner: Introducing Emergency Medicine Australasia's new trainee section

“…The Australasian College for Emergency Medicine (ACEM) now has the third highest number of specialty trainees of all Australasian medical colleges, with over 2200 currently enrolled in the training programme . At the prevocational level, structured EM teaching programmes have proliferated, and completion of a term in ‘emergency medical care’ is now a requirement for all Australian interns . In line with an increasing number of ACEM fellows, demand for continuing professional development has risen as well.…”

Interns in the ED: The real challenges of increasing numbers

“…The articles by Weiland et al 4 . and Chong et al 5 . in this issue of the journal are thus welcome additions to the challenge of defining the problem and identifying the solutions.…”

“…The article from the same group by Chong et al 5 . provided a semistructured literature review on the capacity question for interns in emergency.…”