GP shortage bites despite rising IMG numbers

Michelle Wisbey

22/08/2023 4:08:35 PM

A record influx of doctors has not put an end to ongoing GP shortages in many Australian communities.

Patients in clinic wait room
Despite rising practitioner numbers, Australia is predicted to be short 10,600 GPs by 2031, with demand for GP services increasing by 58%.

Healthcare practitioner numbers have skyrocketed by 18% since Australia was crippled by the COVID-19 pandemic, so why the chronic shortage of GPs?
There are now 877,119 practitioners registered in Australia across all professions, with more than 5000 people applying every month, according to new AHPRA data.
Specifically, doctor numbers have grown 15% since June 2019, rising from 118,996 up to 136,742 in June this year.
Despite the surge, it is predicted Australia will still be short 10,600 GPs by 2031, with demand for GP services expected to increase by 58% over 10 years.
‘Many of the most critical pandemic-fuelled health workforce shortages are progressively being addressed; however, continued work is needed to address key areas of need,’ AHPRA said.
Today’s general practice workforce is reporting an ongoing battle against rising costs, tax grabs, international recruitment, doctor retirement, and burnout.
Former RACGP Rural Chair Associate Professor Ayman Shenouda, who came to Australia as an international medical graduate (IMG) in 1992, said significant changes are needed to attract doctors into general practice before the crisis worsens.
He told newsGP that task begins in the classroom.   
‘[Doctors] do most of their training within the hospital system and it’s controlled by other specialties and then all they can see and be inspired by is other specialists,’ Associate Professor Shenouda said.
‘It does influence their decision in the end because they want to have a role model to look at, and we want to increase the exposure of students to their practice where they can understand the art of general practice and how good a profession it is.’
AHPRA found in the past year alone, more than 27,000 internationally trained practitioners have been registered to work in Australia, including 5918 medical practitioners.
But the regulator’s chief executive Martin Fletcher says more needs to be done to help streamline the employment process for those IMGs.
‘There is always more than can be done to ensure Australia has an adequate supply of safe health professionals,’ Mr Fletcher said.
‘We are working closely with governments and employers to identify areas of specific need, which allows us to escalate applications for registration where critical health workforce vacancies need to be addressed.’
He wants to see changes made to English language requirements to help further increase the attractiveness of Australia for experienced overseas practitioners.
The RACGP has already committed to making changes to its accreditation processes in the wake of the interim Kruk Report, investigating how to simplify applications for IMGs and help fill crippling rural workforce gaps.
Associate Professor Shenouda said changes are needed not just to the accreditation of IMGs, but also to support them when they arrive in Australia. 
‘We need to really look after those doctors and support them in every way we can so they can get oriented with our system and get adequate training for them,’ he said.
‘You’re dealing with patients, you’re dealing with their lives. You change lives, you change outcomes of health, outcomes for our country, that’s what general practice does.
‘It’s not only the health of rural communities, but the GPs looking after them are on the verge of burnout.’
That shortfall is hitting particularly hard in rural areas according to the RACGP’s latest Health of the Nation report.
Regional patients are likely to wait longer than they felt acceptable for a GP appointment, and more likely to wait 24 hours or more for a GP appointment for urgent care.
Associate Professor Shenouda said the need for a strong and well-equipped rural general practice workforce is more important than ever before, and government needs to create meaningful change to keep practices afloat.
‘It’s a problem because patients deserve to have access to quality care no matter what their postcode is,’ he said.
‘One of the things that we’re struggling with is to advocate for general practice so that governments can understand how important it is.
‘We’re dealing with chronic disease, we’re dealing with palliative care with an ageing population, we’re dealing with a huge mental health surge especially after COVID, and who’s doing the majority of this work?
‘It’s general practice.’
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Dr MD Shah Fakhruddin   23/08/2023 3:55:58 PM

Hi I am not sure how can RACGP not understands that concept
GP shortage since last 20 years
But in one seminar in Liverpool hospital l have had attended and the speaker gave us a grim
pictures about how to control the influx of Overseas GP and how to make their journey
harder and made so many barriers so that get difficult to achieve fellowship
Just an example some Gp has history of 22 years working in Australian medical system
After 7 years of Gp rural area experience and trained by RVTS and he was failed by .06 marks which was not even 1 marks
Anyway when he wanted to reseat exam
New rules came out and not counting previous yrs of experience
Not only that he was resubmitting every thing documents to restart again
Despite poor doctor lost his time/ money and even on personal sickness not gain any sympathy to earn .06 marks
He could have been get fellowship as he passed other exams
After repeated attempts and requests nothing gain.w
I beg only provide.06 mark to be fellowship

A.Prof Christopher David Hogan   24/08/2023 10:16:06 AM

I agree with my colleague.
Medical students need exposure to high quality General Practice to see what it can do & how well it can do it.
I remember some of my students telling me that GP was wonderful , but it was so complicated & so hard that they would prefer an easier choice. Others were impressed & inspired and have become great GPs.
So there were 2 groups- those who wished to be GPs & those who respected General Practice.
It was reinforced when PGY2s had the opportunity to work supervised in General Practice in the post graduate prevocational placement programs.
Medical students have a choice. They can choose any specialty, but if they choose General Practice they are not remunerated as well as the other specialties. Even as students they bear enormous debts.
The difference in remuneration is an accident of history because when I graduated, the lifetime incomes of GPs & other doctors was similar. That difference arose because of naivety, poor coordination & cynical exploitation. It must be amended.
It is ridiculous that one of the most difficult medical disciplines is remunerated the least.

A.Prof Christopher David Hogan   24/08/2023 10:34:25 AM

IMGs are not treated fairly.
Instead of being appreciated for the enormous contribution they make to our country they are sent to areas local graduates do not like & pressured to undertake tasks that our local graduates will not accept.
Why can’t they be better informed of Australian expectations & circumstances before they come?
In these days of remote learning, why can’t they undertake bridging courses before they arrive?
The delays between arriving in Australia & undertaking practice are too long and too financially draining.
If you ask them, IMGs mostly come here for freedom & opportunities for themselves & for their family not a bigger pay check.

Dr Nahyan Asif   25/08/2023 12:02:42 PM

Why not place a 10 year moratorium on local graduates ?