TB or not TB: treat to see.

This year, some 2400 young Australians entered our medical schools, and in the coming years their numbers will increase further. The Prime Minister recently announced yet another new medical school and continues to top up medical school places. With these developments one thing is obvious — policy announcement is easy, but policy implementation is not. Already, there is talk that the existing health system might find it difficult to meet the educational needs of increased numbers of students. Already, medical students are voicing concern about the effect of increased student numbers on the quality of their education in the clinical years, especially the high student-to-teacher ratios and projected bottlenecks in future vocational training. And this pressurecooker environment can only worsen. In short, we are heading to a crisis in medical education. There is talk in academic circles of “new ways” — sharing teaching hospitals among medical schools, simulation centres, increased involvement of private hospitals, specialist and general practices, and community health services in teaching. But the realisation of these new ways requires time, as does the development of skilled clinical teachers. Undoubtedly, the issue is complex. Crucial to effective medical education is the capacity of an already stretched public hospital system to sustain both service delivery and quality clinical training. It’s time for the federal and state governments to take stock and ensure that medical education and training are not jeopardised by overburdened, under-resourced and suboptimal clinical environments. Funding for capacity building is necessary, but undoubtedly will fall victim to the federal–state political game of who pays. No matter that both are responsible for the health rights of all Australians. The last thing we want is a future generation of medical students disillusioned through questionable quality of clinical exposure and experience.