New system for medical internships required

13 March, 2013

Hospitals have become a battleground where state of origin is the decisive factor in a fight over hospital internships.

Researchers have argued that the system for allocating medical internships, where states prioritise graduates from their own medical schools, is inequitable and potentially unconstitutional.

In a paper published in the Medical Journal of Australia, Monash University researchers Dr Dev Kevat and Dr Fiona Lander, both of whom have legal qualifications, argued that Section 117 of the Australian Constitution could be used to invalidate the current "priority" system of medical internships.

Section 117 prohibits discrimination between Australian citizens on the basis of residence in a particular state.

Currently, allocation of internship places takes place at the state level and priority is given to Australian medical students who have studied, and therefore are living, in that state.

Dr Lander, from the Department of Epidemiology and Preventive Medicine, said the authors had examined relevant High Court decisions and concluded that the intern system was discriminatory under Section 117.

"The current system has considerable implications. The 27 per cent of students who travelled interstate to study medicine now find it extremely difficult  to be able to undertake their internship in their home state," Dr Lander said.

"In some cases, it also limits the potential of graduates to work in an interstate hospital that offers their potential specialty.”

The internship allocation system contrasts with the selection procedures of medical schools, which recruit students nation-wide, and medical registration rules, which allow medical professionals to practice throughout the country.

Dr Kevat, of the Department of Epidemiology and Preventive Medicine, said the authors had contacted the relevant state and federal ministers asking them to defend the current system.

"After analysis, we do not believe that any of the justifications provided by the health ministers would stand up to a legal challenge," Dr Kevat said. 

“The current system is an odd and unfortunate departure from the principle that all Australian citizens should be treated equally.  Most people would not consider it acceptable for an employer to say they consider your job application a low priority because you studied in an interstate high school or university.

"We believe the system is unconstitutional and discriminatory. A system that treated all Australians equally and was nationally-coordinated would not only be fairer, but beneficial for the national medical workforce."