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New School of Rural Health not the solution to New Zealand’s health workforce crisis

New Zealand’s health workforce crisis cannot be solved through the creation of the proposed new national School of Rural Health says University of Waikato Vice-Chancellor Professor Neil Quigley.

The idea floated today by the University of Auckland and the University of Otago for a new rural health initiative recognises that their current medical training model is not producing the distribution of doctors across specialties and locations outside the main metropolitan areas that New Zealand needs.

However, Professor Quigley says minor changes to the two existing medical education programmes cannot provide the step change in health workforce outcomes that New Zealand needs.

“Rural and high-needs communities have suffered decades of neglect from the two existing medical schools, so the solution needs to be a fundamental change in the way that we select and prepare medical students for community service. Internationally, the countries that have successfully addressed these problems have done it by introducing a new medical education model rather than adjusting existing programmes, we owe it to New Zealand’s communities to get this right,” says Professor Quigley.

“The Waikato Graduate Entry Medical School proposal currently being considered by government is the only proposal that offers the government fundamental change in medical education that directly addresses the problems of health workforce distribution and overall health workforce shortages.  The Waikato proposal recognises that New Zealand is not training enough doctors to meet its health workforce needs and is too reliant on recruitment of trained doctors from overseas, an issue that the proposed new School of Rural Health does not address at all.”

At present, rural and provincial centres depend on the approximately 1100 overseas doctors recruited to New Zealand each year. In addition to needing supervisory support to work in a New Zealand medical context, more than 60 per cent leave their employment within two years[1]. The health needs of New Zealand’s aging and rapidly expanding population are also becoming more complex.

Waikato DHB Chief Executive Dr Nigel Murray says following international best practice the Waikato Graduate Entry Medical School will produce doctors who will be more representative of the communities they serve, who will focus on the health of high-needs communities and be able to use the latest advances in technology.

“Our proposal opens the door for a new generation of community-focused doctors. The proposal by Auckland and Otago universities does not result in more doctors,” Dr Murray says. “They are telling us that we don’t need to train more doctors but this simply isn’t true – our population is growing, doctors are retiring at record numbers and many are working part-time. The Waikato Graduate Entry Medical School will address this problem.”

Dr Murray says existing medical programmes at the University of Auckland and the University of Otago have had significant funding over the years for rural initiatives but have not fundamentally changed the type of student they take, or the workforce outcomes that result. “The solution to our current workforce shortages in general medicine and rural medicine is therefore unlikely to be met with adjustments to their existing programmes.”

The University of Waikato and the Waikato District Health Board (Waikato DHB) submitted their proposal for a new medical school to government in October 2016, as part of a strategic alliance to address medical workforce shortages and community health needs.

[1] Source: The New Zealand Medical Workforce in 2013 and 2014, Medical Council of New Zealand

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