Creating new medical schools in new universities won't cure doctor shortages

The Prime Minister’s announcement of a new private medical school in the centre of Sydney has more to do with ideology and cementing the prestige of the Vice Chancellor of Notre Dame University than any meaningful plan to address chronic doctor shortages.

The Western Australian-based Catholic University of Notre Dame will start up a new campus in inner-city Sydney. It will offer places in medicine, nursing, law, business and education.

The medical faculty is part of a wider misguided campaign to fund several new medical schools when extra places in established faculties would be far cheaper and produce the same outcome.

The relative rapidity of the development has much to do with the charisma of Notre Dame’s Vice Chancellor, Peter Tannock, who education expert Andrew Norton claims is “the most effective lobbyist in the country”.

The federal government is expected to provide the initial funding for the university at a time when public universities have suffered serious cutbacks to their own budgets. In particular, Sydney University’s nursing faculty will be closed due to its low income.

It follows earlier announcements by the Minister of Education, Dr Brendan Nelson, that the Universities of Western Sydney and Wollongong will both have their own medical schools.

The trend is clear and worrying.

While there is certainly a shortage and maldistribution of doctors, particularly in rural areas, I suspect the Vice Chancellors who are pushing for their own medical faculties care little for whether a small country town is adequately served with medical practitioners or not.

Professor Bower, the Dean of Notre Dame’s medical school, was quoted after the PM’s announcement saying “what this has shown is that a small place like Notre Dame can actually dream of having a medical school”.  No mention of plugging doctor shortages, just a reflection on his university’s standing.

The fact is that there are few things more prestigious to a university than a plush new medical school. It offers the promise of the brightest students in the land strutting the lawns and lecture halls of its campus. There is the prospect of research grants - the highest academic status symbol. For new universities trying to gain a name, or those struggling to improve their image, it’s gold.

Prior to his current appointment Professor Bower was Dean of James Cook University’s medical school. James Cook is the newest medical school in the country, based primarily in Townsville. It remains to be seen whether it can play a role in plugging doctor shortages, but when it opened in the year 2000, it was the subject of widespread criticism. James Cook was accused of taking student places from the established universities in Queensland. Some of those schools already had regional programs running in Northern Queensland that were damaged by the new body.

Furthermore, there are no guarantees that a student who goes to a medical school in a regional area will continue to practise in that area. The prime reason that students from regional or rural areas are poorly represented among medical students is that there are not many of them as they struggle with inadequate facilities to gain the entrance marks required.

Dr Nelson has complained that medical schools need to be populated by students other than those from the North Shore or the Eastern Suburbs. But how can a medical school change the geography of its intake? Assuming selection remains based on merit and an interview, geography is not a factor that can be weighed. Furthermore, the entire intake of Notre Dame will be full-fee paying students. This is not likely to widen the net of opportunity, let alone solve the rural health crisis.

A study published in the Medical Journal of Australia this year gave three major factors most likely to contribute to a doctor practising in a rural area. They were that the doctor came from a rural area, had a spouse from a rural area or had post-graduate experience working in a rural hospital. The location of the medical school was not a factor.

Another consideration with Notre Dame is that it is a Catholic university. There is no course like medicine to test the ethical and moral dilemmas of our time. What will the university teach on the myriad of controversial topics like abortion, homosexuality and AIDS, stem cells and genetic engineering?  Will it be science or theology?

The move is consistent with the PM’s preference for value-based education and suggests the Notre Dame facility is based in ideology, not practicality.

The major universities already have significant programs in regional areas. The doctor shortage will be much better served with new places in the established medical schools, perhaps with a preference for students from rural areas, rather than expensive new faculties built for the enhancement of ideology and prestige.