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26 March 2018

The Australian Society of Otolaryngology, Head and Neck Surgery (ASOHNS) represents the interests of surgeons practicing in the specialty of Ear, Nose and Throat, Head & Neck Surgery and the interests of their patients. ASOHNS works with the Royal Australasian College of Surgeons to administer the training program in this specialty.


The issues of workforce requirements, training and practice in surgery and its specialties are not new and were extensively investigated by the ACCC in 2000 with the conclusions made then, as now, that the rate limiting step is funding from the State, Territory and Federal governments for public hospitals.


The Society acknowledges concerns regarding training and workforce requirements in Ear, Nose and Throat, Head & Neck Surgery, public hospital waiting lists and out of pocket expenses.


The Australian article reported a reduction of 10.8% in the number of new surgeons from 2011 to 2015. This is a difficult comparison, as numbers who qualify for fellowship each year is subject to fluctuation for a variety of reasons. It does not reflect the real increase in the number of Active Ear, Nose and Throat surgeons from 405 in 2011 to 460 in 2016, an increase of over 13%.


A medical workforce report used by the Department of Health stated a looming oversupply of ENT surgeons with an excess of 25% by 2030. The Federal Government removed a funded Specialty Training Post (STP) in 2018 for ENT because of this projected oversupply.


The Society invests significantly in encouraging excellence in training and maintenance of professional standards. Increasing the numbers of medical students does not mean an automatic increase in specialist numbers. The young surgeon takes about 15 years to train from the beginning of medical school. Many will then undertake further years of international training before they set up practice. This arduous course is not for all to aspire to.


Reporting that 81.5% of Ear, Nose and Throat surgeons work in the private sector and that 85% are in the major cities as demonstration of maldistribution within the workforce doesn't provide the full picture. The 2016 Workforce census reports that 78% of surgeons work in both public and private hospitals. There has been a reduction in public hospital appointments and closure of country health services by State governments. The issues will not be resolved by the increase in medical graduates but requires good planning and careful distribution of resources by governments.


In summary, I think it is important that the public understands:

(i)  that the provision of training posts is largely limited by the resources of State and Territory public hospitals

(ii) even if more surgeons were trained, the same lack of resourcing of State public hospitals would mean that there would likely be no impact on waiting lists


The Australian Society of Otolaryngology, Head and Neck Surgery welcomes the increase in medical graduates and the great pool of talent that brings to the specialty to serve the people of Australia.


The public can be assured that the professional surgical societies and the College continually strive to ensure that they receive a safe, high quality, timely and affordable service.

Dr Phil Fisher, President