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The biggest worry about plans to train more doctors is finding quality clinical placements for them while they are studying, a medical school professor says.
Acting dean of Otago Medical School Professor Tim Wilkinson told Morning Report for almost half their degree, students are not actually training at the medical schools, but are based in a professional setting.
He said capacity would have to be increased so the trainee doctors continue to receive appropriate training in the right places.
He is also questioning National's plan for a third medical school at the University of Waikato, saying it might mean competition for Otago to find suitable placements while trainees are working towards becoming qualified.
Labour leader Chris Hipkins said on Wednesday if re-elected the party would increase placements at Otago and Auckland medical schools by a further 95 every year, beginning in 2024 and ending in 2027.
National announced plans to set up a third medical school last month, saying it would add another 50 placements in Otago and Auckland from 2025.
Professor Tim Wilkinson Photo: supplied
Professor Wilkinson said that the school had already been planning on increasing the number of trainees.
There were two limiting factors - the cap on the number of trainees which was about to be lifted by both main parties, and clinical placements which involved students having workplace experiences for roughly half their degree.
"Not just the right experiences but also the right places - so that's something we've been doing for many years."
The Otago medical school does this by operating campuses in Dunedin, Christchurch and Wellington and then sending students out to regional and rural settings throughout the lower North Island and all of the South Island.
"We've got good relationships there but that would be the bit we would need to work on to increase our capacity ... theoretically it's a win-win for them, they give us good experiences and then if they give our students good experiences they know they get those people back as doctors."
For those who do some of their medical training in rural areas, it was four times more likely they would return once fully qualified, Prof Wilkinson said.
"So I'm hoping they will be really supportive as well."
Otago medical school enjoys a good working working relationship with its Auckland counterpart, including making the best use of placements across the entire country, he said.
"Adding a new player into the field [alluding to the third medical school] doesn't magically increase those placements. That would be the issue we would have to work through."
National's health policy regarding training more doctors has committed to placing them in regional jobs.
Prof Wilkinson said Otago also offered post-graduate training for doctors and placed them in regional and rural roles.
"The thing that would worry us is if suddenly some of our rural and regional placements were not available to us anymore because they were taken by another party. What's the net gain for the country on that?"
He did not doubt Otago would form good relationships with a new medical school if it was set up at Waikato.
"But the issue would be if we've all got a problem finding good quality placements having another medical school doesn't solve that."
"... if they give our students good experiences they know they get those people back as doctors" - Professor Tim Wilkinson
Asked about any concerns he might have about National's health spokesperson Dr Shane Reti working closely with Waikato University on the prospect of setting up the new school, he said anything that improves the health workforce was a good thing.
"It's not so much do we have a problem with it but do we need it really."
On competition between universities, he said work had already done with the University of Auckland and the rural doctor workforce on improving the doctor pipeline.
Relationships with Auckland, Te Whatu Ora and other networks needed to be good to ensure the whole system worked well.
"We need a joined up approach."
Auckland medical school keen on Labour's plan
Meanwhile, the University of Auckland's medical school dean John Fraser is backing Labour's proposal, saying it would provide more doctors than the 285 more per year recommended by a recent review of the health workforce.
He said Labour's plan would deliver more doctors faster than National's policy of increasing medical school intakes and creating a third medical school at the University of Waikato.
However, National leader Christopher Luxon said Labour's policy was not the better option.
He insists his party's plan for a new medical school will provide more doctors for regional New Zealand than Labour's would.
Senior hospital doctors and dentists say Labour's promise is good as far as it goes - but it will be years before it can make a difference to the chronic workforce shortages.
More than 5000 members of the Association of Salaried Medical Specialists held a two-hour strike on Wednesday, their second in a month, over their deadlocked pay negotiations.
Its president, Julian Vyas, who was on the picketline at Wellington Hospital, said action was needed immediately to recruit and retain clinicians.