Introduction by Croakey: One year ago, Australia’s peak medical radiation science organisations called for the Federal Government to include their students in its newly proposed ‘placement payment’ initiative.
As Croakey reported at the time, the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT) and Australian and New Zealand Society of Nuclear Medicine (ANZSNM) sent a joint letter to Federal Ministers, saying it was critical that medical radiation science students be supported.
Their call was rejected, ensuring that the ‘poverty placement’ experienced by many medical radiation sciences students is now an important election issue for the profession, reports Marie McInerney.
This is the latest Croakey Conference News Service report from ASMIRT’s 19th National Conference, held in conjunction with the New Zealand Institute of Medical Radiation Technology (NZIMRT) from 27-30 March in Adelaide, on Kaurna Country.
Marie McInerney writes:
The next Federal Government is being urged to address the individual and professional cost of ‘placement poverty’ for medical imaging and radiation therapy students, amid reports that many have had to resort to living in tents, cars or unsafe areas while doing mandatory clinical placements.
Students of the medical radiation sciences professions, including radiographers, sonographers, radiation therapists and nuclear medicine practitioners, have been refused the national placement support set to be granted to nursing, midwifery, social work and teaching students.
Carolyn Heyes, past president of the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT), said the profession had faced “total apathy” from the Federal Labor Government on an issue that was critical not just to individual wellbeing and success but to recruitment and retention for an essential workforce.
Speaking to Croakey at ASMIRT’s recent 19th national conference in Adelaide last month, Heyes said the upcoming federal election was “time to recognise there are other people who work in health that are not doctors and nurses”.
Placement poverty was also top of mind for others at the conference, held in conjunction with the New Zealand Institute of Medical Radiation Technology (NZIMRT), as the medical radiation science workforce in both countries continues to face big shortages.
Rejection
The Federal Government last year announced a new Commonwealth Prac Payment to support some students undertaking mandatory workplace placements required for university and vocational education and training qualifications.
The payment, which takes effect on 1 July 2025, will apply to eligible students who are studying to be a teacher, a nurse, a midwife or a social worker. They will receive $319.50 per week during clinical and professional placement periods.
In a joint letter, ASMIRT and the Australian and New Zealand Society of Nuclear Medicine (ANZSNM) last May urged the Federal Government to expand the scheme to include medical radiation science students, who are required to undertake around 52 weeks of clinical placements across their four year undergraduate degree course.
“Unlike medical students, they are not provided with free accommodation, and they often have to relinquish their part-time, paid jobs to undertake these unpaid placements, particularly if the placements are in rural/regional locations or interstate,” their letter said.
“We have examples of students having to sleep in their cars, or in tents.”
Heyes said it took eight months to get a response: an unapologetic rejection letter from the office of Education Minister Jason Clare, which she described as a “slap in the face”.
The Minister’s letter said:
“While recognising other qualifications require mandatory placements, the (Australian Universities) Accord recommended the Government focus on nursing, care and teaching professions. Almost every Australian will interact with a nurse, midwife or teacher throughout their life, and social workers are critical to the wellbeing of vulnerable people in the Australian community.”
This was a red rag response for Heyes, who said studies had shown that 97 percent of people who go into Australia’s public hospitals have some interaction with the medical radiation sciences profession, including diagnostic imaging for x-ray, CT and MRI scans, theranostics for cancer treatment and radiation therapy.
The demand for these services has expanded exponentially in recent years which, combined with the increase in centres delivering the services, has resulted in a chronic national workforce shortage, she said.
Heyes said it was time for governments to take other health professions seriously, with allied health making up the second largest group of health practitioners behind nurses.
“Yes, we [allied health] are a collective group of collective professions, but we are all as vital for the patient’s health and wellbeing as our doctors and nurses,” she said.
ASMIRT has tried to step in to support students, but can currently only afford to offer bursaries to 10 percent of fourth year students towards their placements, she said.
Out of pocket and burning out
It’s certainly an issue that’s having a big workforce impact. Placement costs are, without doubt, a defining issue for many students, said Ruby Holman, a recent nuclear medicine technology graduate who helped develop a dedicated student program at the conference.
With degrees requiring “intense clinical hours”, many students who were not able to live at home or get financial support from their parents were “burning themselves out on weekends so they can make ends meet during the week”, Holman told Croakey.
“Social workers and teachers are getting supported, which is fantastic, but we’re also frontline, and we’re backline, and we’re everywhere else in between, and we need that support as well,” she said.
Alana Brkic, a fourth year student in medical radiation science (medical imaging) at the University of South Australia, told Croakey that a lack of local placement places meant she had had to go interstate for two sets of placements last year.
This left her “out of pocket both times…by a lot”.
Financial constraints meant she had to stay in an area where she didn’t feel safe, where she’d been warned “if you want to go out…don’t go after dark”.
Both Holman and Brkic spoke about the particular toll on mature age students, who had to juggle the hours and cost of placements with family and other financial responsibilities, particularly for the 24 weeks of placement in their final year.
“There’s no time for anything else,” Holman said.
This week Croakey asked Minister Clare whether he would reconsider expanding the scheme for medical radiation science students. He emailed a brief statement, echoing most of the points in his previous rejection letter.
He said: “The Government will continue to work with tertiary education providers, state and territory governments, industry, business and unions to consider further support for those experiencing financial hardship and placement poverty caused by mandatory unpaid placements in other courses in due course.”
Croakey has also asked the office of Shadow Health Minister Senator Anne Ruston about any Coalition commitment to expanded placement support. We will include her response if provided.
Workforce issues
A senior panel discussion at the conference on workforce issues heard that there’s hope from initiatives like the Nuclear Medicine Scientist Embedded Student Program which has been launched this year by Queensland Health with partner university RMIT.
The panel discussed other evolving issues for the medical radiation professions over the next 10-15 years, including addressing equity (particularly for Indigenous people in both Australia and Aotearoa/New Zealand), advanced practice/scope of practice, and the emerging assistant workforce and what level of training and governance that will involve.
On the need to address burnout in the profession, Cara Miller, chair of the Medical Radiation Practice Board of Australia, and CEO of North East Community Hospital in Adelaide, said practitioners in larger workplaces can be helped with a team approach, where colleagues can support each other.
But that doesn’t help the sole practitioner in a regional or remote location who has absolute loyalty to community and patients and an ‘if not me, then who’ approach to work, she said.
The panel also touched on the promise and risks of artificial intelligence (AI) — including quoting another speaker that “AI without human oversight is malpractice”. Croakey will report in more detail on AI and medical radiation in an upcoming story.
In her interview with Croakey, Heyes also expressed frustration at national moves towards broadening scope of practice in the workforce, saying it is about so much more than having radiographers commenting on imaging – an issue of contention with radiologists.
Radiographers had the ability to be working in Emergency Departments, like physiotherapists now do, and could step up in rural and regional areas, she said.
“There is some work afoot but we have to work very hard to get past other professions that are protecting their turf,” she said.
Advanced practice matters
Advanced practice skills are more embedded in the United Kingdom, said Dr Nick Woznitza, an Australian reporting radiographer and clinical academic now at University College London Hospitals and Canterbury Christ Church University in the UK.
With most imaging in the UK done in public hospitals versus private practice here in Australia, a recent survey of UK hospitals with imaging departments found that 95 percent had some form of x-ray image reporting by radiographers — yet to be approved practice in Australia.
“All are supported by accredited postgraduate training within a multidisciplinary team,” he said. “No one’s going off and flying solo…”
Woznitza said the evidence of benefits is also in, including 2023 research that he led showing that immediate reporting of chest x-rays from primary care reduces time to diagnosis of lung cancer by half, and that radiographer reports are comparable to local radiologist reports for accuracy.
However, he said the UK is not yet a “utopia” for advanced practice, which he noted goes beyond reporting of imaging.
There is significant variation in roles across the country, not only between hospitals providing advanced practice, but even within hospitals. See his slides below.
Gender parity
The conference also heard concerns about gender wage parity in the female-dominated profession from Sally Bellchambers, who last year sounded a powerful alert about inequity and discrimination experienced after taking time off to have children.
Bellchambers, who is a Lecturer in Medical Imaging at the University of Canberra, is hoping to launch a national survey on the medical radiation science (MRS) workforce this year, saying there is currently “absolutely no MRS specific data re the gender pay gap at present”.
Quantifying that gap is, she told Croakey, “a necessary step if any meaningful change is going to occur”.
Watch these interviews
Alana Brkic and Ruby Holman discuss student perspectives.
Carolyn Heyes, immediate past president of ASMIRT, discusses placement poverty, scope of practice issues and the importance of professional recognition and equity.
Naomi Gibson, incoming president of ASMIRT, a
Sophie Shephard, a pain physiotherapist in Wagga Wagga (who presented with her sister Kate Dahlenburg, a diagnostic radiographer from Brisbane – see our story here) with a call for the social determinants of health to be at the top of the 3 May federal election agenda.
Bookmark this link to follow ongoing Croakey Conference News Service coverage.
