Deans of medicine in Australia are in conflict with the Australian Medical Association and young doctors over federal government plans to cut the number of general practitioners.
University deans have endorsed a government proposal that will allow only a third of the 1,220 medical students who graduate each year to work as GPs, imposing an almost immediate cut in their numbers. The radical plan is estimated to save Aus$570 million (Pounds 284 million) over the next four years.
The government first revealed the scheme in the August budget, saying there were too many doctors and that each one cost the taxpayer almost Aus$200,000 a year.
Under the scheme, medical graduates hoping to work as GPs will have to complete vocational training through the Royal College of General Practitioners. But the government will then issue just 400 Medicare provider numbers that allow doctors to offer patients Commonwealth rebates on services.
Although graduates will still be able to gain registration through state medical associations, and can then work as GPs without a Medicare provider number, they cannot offer patients any rebates. Critics claim this will discriminate against women undergraduates who will lose the certainty that they can take time off work to raise a family and still return to practice.
The AMA, junior doctors and medical undergraduates say that if the government goes ahead with its plans jobs will not be available for hundreds of new graduates - despite years of study, hospital internships and training.
The association has backed protests by the doctors who warn they will take strike action if the government does not back down.
An AMA spokesman said doctors would impose rolling stoppages and work bans, and also hold stop work meetings as part of the campaign by the nation's 10,000 medical registrars, residents, interns and students. The council supported the doctors' campaign, including calls for a national strike.
But John Young, chair of the committee of deans of the medical schools, said his committee had endorsed the government's policy. Professor Young, dean of medicine at Sydney University, said the committee had proposed measures to the government that would ensure every student currently at university would have access to training when they had completed their internships.
Apart from the GPs' college, Australia has another ten colleges that cover the specialist branches of medicine: surgery, obstetrics, pathology and so on. These also run training courses that provide up to 600 places a year. The medical schools produce more than 1,200 graduates each year and another 200 overseas-trained doctors are admitted after completing Australian Medical Council examinations.
That means more than 1,400 new doctors want to enter the system each year although only 1,000 training places will be available.
"There is a risk of more students graduating than there are training places, but we have time to study that," said Professor Young.
"The point is we do not want young graduates completing an internship in a hospital and then going into general practice with no training. That was all right 40 years ago but not today."