They didn’t do anything about the shortfall until late in the game. No one did.
I’ve no doubt they’d been saying there’d be one for years, but it’s apparent it wasn’t taken seriously to point of action until that audit - because it showed that there were actually more applicants than there spots.
You missed my point there. That there was action was IMO a direct result of the audit, which was the culmination of lobbying, not that the audit showed something unique and absolute. In other words, there was no critical point at the coincidental time of the audit, but the audit did help to effect action at the federal level. States had generally been saying that they were experiencing shortages of spots -- the finding of shortages was non-unique -- while states had been able to fix those known shortages for the years leading up to CMI. Your own state, Qld, repeatedly, over years, claimed there were not enough spots. And yet, they created the necessary spots. Every year before CMI.
$10 million - I wouldn’t downplay what that’s worth in a public healthcare system.
UQ school of medicine got a couple of million cut from their budget and it resulted in a loss of services to students. Directly. It is still a resource. Maybe it’s a drop in the bucket to you (or me), but it’s not necessarily to everyone else.
$10mill is trivial in the federal budget picture. It was decided at the COAG level, not as part of some sequestered, indebted state health budget. But the context of the qualification of $10mill was in comparison to the federal political headache of not spending it -- in that sense, it's a bargain.
Okay, so you reckon politicians and officials at other levels are going to be better informed and wiser? I give up on this point. By the way. I've tried providing support to my points and countering it with tanya plibersek's an idiot, doesn't really convince me of anything.
Pollies are informed about what lobbyists make them informed. At all levels.
2006 is 6 years before 2012. 2008 is 4 years before 2012. I’m not sure how this is meant to negate my statement that they had been trying to discuss the point with the government for years. I’m not going to hang them on something they used to think years ago under different leadership. At least they did change in their perspective as an organization under different leadership. Finally, 2006 - it’s 11 years ago now. How does that still hold relevance now that things have changed? Sure it could shift again. But I would like to give current leaders credit where it’s due.
I'm not sure what your point is. Yes, there have been many years since the tsunami began. As pressures have increased to find spots, spots have been found. At some point in all that, the feds were pressured to pitch in with $10million. Now they can say they've done something, and push back to the states and schools to do what they had been doing up until CMI -- finding/creating spots to meet their grad numbers. If they pull back the $10mill, the feds get politically screwed, and they know it. $10mill is really, essentially, nothing at the fed level compared to the political hit the feds will take making REAL savings in the budget. Is it possible they will score an own goal and think saving $10mill matters in the scheme of things compared to the political headache? Sure. But I claim it's unlikely, put my best number to it, and that's essentially all I've done.
Finally got off it ass.
Indeed. Because someone in AMSA & CDT in this present day (not 10 years ago) asked them to. By anecdote? How about hospitals telling this directly to candidates over their losses as a warning for future applicants to be serious. That was a regular occurrence for me when I went to apply. On the side - we’re off side by the way, but at any rate. I still know fo students who actively do not apply for the CMI because they want to avoid the $140k payback clause. They’ll only apply for state internships. It’s seedy. And it remains a difficult situation for everyone to contend with.
Well, AMSA and CDT were calling for action a lot earlier than the Audit. But as said, the lobbying increased as it would be expected to, as the situation gradually got worse. Your anecdote seems to me to be a good argument for continuing CMI -- the feds cutting it would be contributing to an increase in int'ls cutting out mid-year.
When have I ever said it’s a dire situation?
I never claimed you did. I said that things were more dire past years. Point being, the largest hurdles for getting grads internship have been overcome. CMI has played a part (though as said, without it, empirically, there wouldn't be an additional shortage of 80-100 spots).
The entire time I’ve been saying that it’s uncertain.
And the entire time I've been saying it's not certain, but I'm not *particularly* concerned (compared to any other year, and as my 3:1 odds reflect).
How much am I willing to tell someone spending $250k and 4-6 years of their life to bet on something with 60 or 75% certainty? I can’t. How do we even begin put a number on this? I’m willing to say sure it’s over 50% certain that the CMI will be renewed again. But there’s no guarantee. There never has been. I’m not fear mongering here, I’ll say that again. What I am saying and have been saying is that I don’t know either and I don’t think it’s fair to be overly optimistic about it.
Then how can you decide what 'overly optimistic' is? If you can't put a number to it, then you can't possibly know how to advise people. Nothing is certainty. There are no guarantees. CMI could double, it could go away, a state could decide "no jobs for int'ls". We have the status quo, and a history with patterns of behavior from the states and the feds. Last decade int'l students in Qld and NSW were pessimistic, many assuming there was less than a 50% chance they'd be able to stay. Based on state projections and claims of a shortage of spots. Well, as a worst case scenario, if 75% of those wanting to stay can stay, that's pretty damn good in the scheme of things. As it stands though, it's more like 90%+. Either way, it's obvious my attitude towards those numbers is mine. Everyone looking at those numbers, if they believe them, will make their own judgment of what that means to them, and their own situation.
Bogus - what evidence do you have to suggest it’s bogus exactly? How is a national report bogus? I’ll agree that each year many people apply without ever really being serious about staying in country. You can’t say that there was never a shortage - I’m really confused on what evidence you’re going off of.
I said claims of a particular shortage are bogus, JUST AS states' past claims over and over that they can only create x spots has been bogus. Empirically, any claim of a static number is bogus.
The number of people who accept a CMI each year is 75-80, and it’s probably going up now, but that alone tells you that that’s the shortage occurring. And it’s real. If it wasn’t we would need a CMI program, because everyone has received a state internship.
Aside from the fallacy of assuming federal policy is all about 'need', you're assuming these are independent events. CMI not existing would (as history demonstrates, over many sample years and multiple states) result in more spots created by the states. This really should be a no-brainer.
You have stated that the states will create internships out of thin air - but it's the hospitals that have to create the spaces for more trainees, the state pays for those spots. they flatly refused to create spaces in 2012 saying it was the responsibility of the feds, who then created the CMIs. The last person who said to myself in others that someone will create jobs for future students somewhere were the hopeful deans to be of yet another school that is trying to get itself open - this time the NSW latrobe university, for the Murray-valley region.
...Also, how do you know the hospitals have ample space for interns? They're not residents. they need a lot more space to grow and to be trained. That's not easy. They also have very strict rotations they have to fulfill to get full registration.
And yet...for EACH OF MANY YEARS, in Qld, the state you were schooled in (and just behind Qld, NSW), spots were indeed created when the very people in charge of allocating/creating them were saying they could not be created and accredited. How do I know? Because I was involved politically at the time. Spots got created when the exact same arguments were made against creating them. Indeed, they more than doubled, by putting in more money, by increasing the number of hospitals involved, by increasing the numbers at hospitals, by going more rural, by defining certain GP practices as time in ED, by bending the rules of due diligence and making the spots in 1-2 months when it was supposed to take 12, accreditation magically happening when clearly corners were cut. Every contingency was explored, even using private hospitals, and they were implemented from least difficult (politically, financially, by popularity, etc) to most. To finally get private hospitals involved (among other reasons), the feds got involved.
I don't know how you're arguing certainty of numbers, and absolutes wrt the 'rules', as though they're concrete and unyielding, when they never are, never were. The whole reason why the history going back 10+ years matters, why I referred to it, is because the goings on back then matter, and empirical evidence matters. Empirically, yes, spots were created "out of thin air". The politics made it so.
Where is your evidence for this seriously? where's the article that says from Royal brisabne saying it's going to go from 80 interns a year to 100 and that other hospitals are going to do the same for internationals? The only places that ever do are the private hospitals like rural Mater hospitals or Greenslopes in the private sector that get free interns.
How are empirical evidence and demonstrated trends not evidence? How do you suppose the states dealt with the tsunami before CMI? Hospitals across Qld doubled their intern numbers in just a few years when most people claimed it shouldn't and couldn't happen. There is nothing unique about Time X, and no precedence, for where suddenly, out of nowhere, all the variables somehow suddenly become fixed and now there's no room for more spots, or without CMI there'd be that many fewer spots, or that somehow the system is linear and events are independent. That's not reality.
You didn’t really make that explicit in that initial statement and I was careful in saying - “implication” in a counterargument. I expected clarification. Not to my benefit - but to those who know nothing about the context.
...While it’s very interesting trivia - about Flinders, i didn’t know about. That said it was 1995. Undergrad programs like JCU currently has matriculating medical students who were born in 1995. It was 22 years ago...
It's only trivia if taken out of context. Yes you claimed I was implying something that I was not. Ok, you withdrew your claim, so the Flinders point is no longer relevant.
I’m sure they used to attract internatioanl students that way, what I’m saying by the point of this post in entirety - is that I don’t think it’s ethical that any medical school in Australia continues using this. Yes it’s difficult to change, and what I find with faculty (present day) is that they’re out of touch with job markets. They used to actively tell me that it’s not their problem, it’s the responsibility of the students. Fine, then I’m going to make it easier for students by being here to make them more cautious about their choices. There's enough people including the schools telling students they'll all get jobs and not to worry. In spite of all the uncertainty out there.
Yes, and your concerns -- the ethics, the over-selling of jobs, and so on -- have all been the exact same concerns going back more than a decade. Given the success of the last decade, that itself IMO is a reason for optimism.
None of what you’re saying here changes the fact that it is getting harder to remain in Australia for work. That’s not a belief it’s a trend. 1995 is 22 years ago. The existence of the CMIs alone means that it’s not as easy as it used to be (I mean, why does a government have to create extra jobs? And have private hospitals help run them?)
Is it? I haven't seen official numbers for this past year, but certainly it hasn't gotten harder (in terms of odds) up until then -- essentially anyone graduating from an Australian school had been able to stay if they wanted to. For the trend to get worse, which it may, either grad numbers have to increase faster than spots, or spots would have to be cut. The former I've been arguing isn't supported by history, since increases in numbers are trivial and states can continue to create the spots that they've always contended couldn't be created. The latter could happen if CMI were cut, which is what this discussion was originally about (where I'd bet 3:1 that it wouldn't be).
Again, CMI existing does not imply how many spots would exist without it. Because of history. And because actions taken at the various levels are not independent. CMI most certainly does take pressure off of states to create spots.
I still disagree with the notion that somehow extra internships would still come from somewhere. It’s also downplaying a situation by saying it’s the product of political pressure.
Ok. Then throw empiricism out of the window. Logically, what you're saying is that the burden is on showing that the empirical trend (of states creating spots) would continue, while assuming that it would not. What reason do you have to support the notion that suddently, at Time X, right when the audit came out saying what states had been saying incorrectly for years, there was this critical threshold reached? I contend there is no reason to believe there was any such threshold reached, because the audit simply stated in a tangible, 'official' manner the same thing that states had been erroneously saying multiple times over years. CMI resulted, and it should be obvious that those 80+ spots means the states didn't have to create them themselves by state action. As to where the spots would have come from...the same place they came from for CMI, for starts.
Scaremongering? I’m going to let this part drop. I’m really getting tired of this particular perception.
Um. Yeah, scaremongering. I wasn't referring to you. Claims that grads would (were) driving taxis in Sydney, that for any given year for about five in a row, claims made in the media by the likes of AMSA or the AMA that 50, 60, 80 students "are without jobs" -- when the announcements were made earlier in the year than state ballots were settled, or CMI spots were decided, let alone before the start of the internship year. Scaremongering was when people on these forums, going back to 2003, were asserting, confidently, "Don't go to Australia, there will be no job for you". Some of the scaremongering was calculated, and I agree with, for political purposes, but what do you call such erroneous alarmist assertions if not scaremongering?
going back to 2012 again. The state government were pressed, for months. They said it was the responsibility of the feds. Sure blame game occurred, but in the end it was the not the states that created ‘extra’ jobs due to ‘shortage of jobs’.
In what 'end'? They sure did create those 'extra' jobs up until CMI. And pressure on the states had been building over years, not months. What changed was the tactics of the lobbying groups (most notably AMSA and the AMA, whose media releases and planted stories over the ~2 years in the leadup I'm sure you can find) to increase pressure and put responsibility on the feds. And in response, the feds reacted. As designed.
And why do would you think the states would create extra positions it didn’t need? The CMIs created jobs in the private sector. That in itself should suggest that there’s no need for ‘extra’ interns.
I'm not sure what you think I was claiming here. States created spots when they claimed they couldn't precisely because if they didn't, they'd be shooting their market good-bye with a PR disaster, and because universities are themselves lobbyists.
Using private hospitals was first brought up in Qld, when it was the first state to experience the tsunami. The idea was put on the back burner because it was not popular -- there was the misconception that training in private hospitals would be ****. The idea came back when positives outweighed the negatives, in part because it was politically more palatable to send int'l students to the private hospitals -- the argument being, if you didn't get a job through you ballot and really want to stay, then you shouldn't have an issue with going private. They couldn't say that to domestic students, who'd point out that there would be no need to go private if there weren't int'l students. Politically, the pieces came together when they needed to, pretty much by design.
Why should a state government with a public healthcare system be expected to spend more money on top of 700-800 million on internships alone? How do you justify that? Sure, education market creates politic pressure or economic interest. Eventually it’s not going to balance out anymore. It used when there was a workforce shortage. It was win-win, international students being cash cows and also becoming doctors in a country had (in the past - not anymore) widespread workforce shortages.
Expected to? I don't see your point here. The point is, they DID spend the money. And there is no evidence of there being some magical threshold passed that said, "ok, no more spots now".
You’re going on theory here too. What’s the evidence that the state would create jobs out of thin air if the CMIs didn’t exist to give pressure? I’m genuinely asking for proof that the states somehow created extra jobs for internationals. I have not seen any suggestion of this.
Evidence or proof? There is no proof here. But why would you dismiss empirical evidence? You bring up trends, one being a hypothesized future trend, and I've brought up empirically demonstrated trends of behavior and politicking and contingency planning. For the umpteempth time, the states have been creating spots all along while claiming they could not create them. Again, what was so magical about the time around the audit that finally made those previously, demonstrably false claims, suddenly true? It should be obvious that the only thing that changed was the existence of the audit itself, as a culmination of and consistent with how the lobbying and the politics and the contingency planning had all been playing out.
Alright, I’ll give you that. It doesn’t change my overall point.
There’s still a massive pool of internatioanl students in Australia. Even if it plateaued, what does that change? We’re still at bottleneck, we as junior doctors are still feel that pressure. I still felt that previously as a final year and I would say it’s still being fetl by current final years. How does knowing that truly help someone going to apply for medical school or internship? It doesn’t make things any less hard.
Either you accept the trend of essentially no increase in grads or you don't. At any rate, we've been discussing internship and CMI, not junior docs. Yes, there is now what's been coined the 'junior doctor tsunami', as the bulk of the medical student tsunami (of getting internship) has been solved. Not that it can't be broken, but the status quo looks pretty damned good for int'ls staying.
Watch I what I claim...lol.
That’s rich because Wilko isn’t Dean anymore. There’s been 2 deans since Wilko.
I’m perfectly aware of what Wilko’s plans were before he left UQ. That doesn’t mean the deans that followed shared his view or were obligated to follow through if they didn’t think it fit their idea of how to run the school.
Huh? You made an incorrect claim about how Ochsner was set up "from the start":
...the Ochsner cohort was never ramped up on purpose to be ethical about their traditional cohorts. That's completely separate. UQO's numbers were planned that way from the start with Ochsner. It was always going to be gradual increases each year over 4 years with the ultimate number predetermined from the day it was set up. I know that because I was directly told this by UQ admin.
So naturally, it matters what Wilko et al planned, "from the start", as you clearly didn't know what was. And just as it was planned "from the start", int'l student numbers (those who'd be graduating in Australia, as per the context of these claims) decreased significantly as Ochsner students increased. The net effect was, is, and as was planned, significantly fewer int'l students to find internship for in Australi.
Additionally, what was *not* held to was the original plan to have 100 students per year, which was increased later contrary to what you've just claimed. If "admin" told you that the plan was "100 to 120" students from the beginning, then they were fudging numbers (technically, yes, the plan was in that range, it was 100, as per Wilko and the head of Ochsner).
Also in the time that Wilko left, the SoM went into a 5% annual deficit. They couldn't actually afford to decrease the overall international student class size further...
I don't know what you're trying to argue for or against here. Int'l student numbers seeking internship in Australia went down by 50+ per year as claimed. For someone who thinks $10mill is a lot to the feds, surely you see that 50 fewer UQ grads to find internship for is significant.
..but Pitman you graduated 10 years ago. My point is that you have to concede that a few of the things you say are perhaps a bit out of date. I left school 1-2 years ago. If there wasn’t such a void in recent grads and final years in this area of SDN, I wouldn’t bother being here.
Which things? (as if post-grad years spent in the midst of the politics somehow don't count). Rather than generalizing, show me some things I've claimed that are false because of how long it's been since I was a student. On the contrary, I haven't really stopped being involved along the way, while someone who has graduated recently doesn't have the same hindsight to see the larger trends and patterns of state and school and federal and AMSA and AMA politicking and planning and scaremongering...
Your point is what? Doesn’t make the pressures felt by current students any easier. Not unless it goes down further. Doesn’t change my point in suggesting that current premeds and medical students need to be careful. What are you then suggesting? That they continue to go through medical school and not worry about the future? That there’s a job for them if they apply? How are you going to guarantee that?
What strawman argument are you trying to make here? I have been discussing chances at internship and the future of CMI, from the beginning of this discussion. "Pressures felt" by current students generally is another matter, and I've never said that prospective students don't "need to be careful". You seem to be projecting here.
Likewise, what was your point about saying UQ is too large? Yes, it is. Unfortunately, that has no bearing on anything we've been debating. Meanwhile, I pointed out that UQ has decreased the number of int'l students requiring Australian internship, in a discussion about chances of getting internship, and you ask what my point is? Really?
Also, with regards to the "ad nauseum", I don't know if was intended or not, but saying that devalues the notion that large class sizes are some less relevant today than it was in 2005. to the contrary, it is even more relevant in the now, 2017 (not 2005) since we're feeling the effects. (Or should i watch what i presume again? Happy to, on this front, just tell me i'm wrong). Not to mention, there's always new premeds coming to this forum, not everyone's been around SDN Australia for 10+ years like you have.
The points was, aside from being irrelevant to the debate at hand about internship chances, anyone could look at any number of in depth discussions on these forums about UQ class sizes. Yes, it's been discussed ad nauseum, and saying so doesn't undermine its importance. It means, particularly in a discussion of internship chances, it's extra-topical, adding nothing to this discussion and is easily accessible in its own right elsewhere.
I would love to be wrong in my stance.
But class sizes are larger now than when I graduated. You can say that the percentage of increase has plateau’d, but doesn’t really matter that much for applicants going to apply. Even if I knew that trend when i went to apply, that wouldn't have afforded me any practical use. Some small reassurance, but it wouldn't have changed my approach.
I don't know why you've been tending to shift to other topics, but you keep raising them as though there's some point of contention, that I've somehow implied, for example, UQ class size is not an issue that should be understood by prospective students. Essentially, you're making strawman arguments. UQ class sizes are too big, as I've simply said. So what? What does that have to do with whether an int'l student will get a state-based or a CMI internship spot?
I've stated this before in other threads. I'll say it again. because it's true (It's not my far fangled belief) I didn’t get to passively submit an application online then hope for the best. Many people in my class didn't either. May be you didn't have the same experience 10 years ago, maybe you did (I have no idea, I really know anything about you). Things change. I worked hard to get to where I am. As did many others did in my year. Some got lucky to be sure and didn't have to put in as much effort. But some of us had to go out of our way to contact hospitals.
The hospitals currently take commitment and loyal to them and this country seriously. There’s the expectation now in QLD alone that final year students visit rural hospitals to show intent and seriousness. This isn't some conspiracy theory I made up for fun, they actually said this to us. They told me and other applicants who took time to get to know them and visit them that they would give our applications more weight. They also pointedly ask what our intentions are and if we have taken board exams for other countries, and they admitted that this does factor into how they give offers.
And? What does this have to do with anything I've been arguing? Yeah, we've had to work hard to get to where we are, to get a job, to continue training...What topic are you discussing??
Again.. My platform here is that if say medical students are consumers, given what they pay for their degrees. They need to be careful, they need to prepare themselves for the next step. I don't think there's anything inherently wrong in my telling them to have a back up plan.
To what are you suggesting then? That they not?
Is what we should be telling them as grads is that they have nothing to worry about? (not trying to put words in your mouth - I actually have no idea, what your main point is).
What did I say, anywhere, that would lead anyone to believe that I would disagree with the notion that prospective students need a backup plan, or that they need to understand reality and not assume they'll have a job after med school (anywhere, in any country).
To re-iterate, I have no political agenda. I’ve graduated, I have a job I worked hard to get and keep. I’m here anonymously. I gain nothing from being on SDN. I can think of plenty of other things more fun to do with my spare time, as well as more productive to my own ends. I'm not here for an ego boost or to justify to anyone why I choose my way into medicine. But I care about what students go through and how they come out of this system...
Are you suggesting that I don't care? Because I've put a number to the odds I put on CMI being renewed? Weird ****, dude.
In the here and now, 2017, advice can go two different ways (for me as a recent grad) to current & prospective students:
A. Don't worry about a thing. There's a CMI program. It's not a guarantee. some of my colleagues believe there's a 75% chance they'll be renewed, which is great. Just apply and expect a job.
B. Worry a little. be prepared in the 25% chance the CMIs are not renewed. we cannot say what will happen in 4-5 years time when you get to graduation. Use that worry and anxiety as fuel to do what you need to do.
I don't know anyone who's claimed 'A'. Do you? Again, you're making strawman after strawman.
I would rather give advice following path B, and be wrong.
I would also rather advise B. And there would be no inconsistency with anything I have said, in this thread or for the past 10 years.
I can't predict what direction the future will actually go. However, I would rather undersell, than oversell a situation.
I would rather say what I believe to be factually correct rather than sell, over- or under-.
We talk about numbers, but they represent actual people.
Indeed. Actual people who can decide for themselves what numbers mean to them.
don't ask me anything too specific
