Introduction by Croakey: Amid national workforce shortages, Australia’s peak medical radiation science organisations have called for the Federal Government to include their students in its newly proposed ‘placement payment’ initiative.
With concerns over ‘placement poverty’, the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT) and Australian and New Zealand Society of Nuclear Medicine (ANZSNM) have written a joint letter to Federal Ministers, saying it is critical that medical radiation science students are supported.
Below, Marie McInerney reports on workforce issues discussed at the annual ASMIRT conference held on Larrakia Country in Darwin from 9-12 May.
Marie McInerney writes:
Australia’s peak medical radiation science bodies are urging the Federal Government to include radiation therapy, diagnostic imaging and nuclear medicine students in its proposed new paid placements scheme, warning that some are having to sleep in cars or tents while undergoing placements.
Carolyn Heyes, president of the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT), said that ‘placement poverty’ was a real and distressing issue for medical radiation students and a factor in critical and chronic workforce shortages that were exacerbated by the COVID-19 pandemic.
“Placement poverty is a very big deal for [our students] and we actually have students quit because they can’t afford to do a six month or 12-week placement,” she told Croakey at the annual ASMIRT conference in Darwin on Larrakia Country on the weekend.
The three-day conference brought together more than 600 medical radiation science professionals from across the country and internationally for a program under the themes: Community. Resilience. Innovation.
As well as a big focus on clinical and patient centred care, the conference discussed significant workforce pressures, with chronic shortages in workplaces across Australia and globally.
Heyes said ASMIRT is “very, very disappointed” for its students not to be included in the new Commonwealth Prac Payment – set up to support teaching, nursing, midwife and social work students undertaking mandatory workplace placements required for university and vocational education and training qualifications.
Under the scheme, eligible students will be provided $319.50 per week – which is benchmarked to the single Austudy rate – from 1 July 2025.
Financial burden
ASMIRT and the Australian and New Zealand Society of Nuclear Medicine (ANZSNM) have written this week to Federal Ministers, noting that the combined medical radiation sciences are “key professional areas instrumental in delivering diagnoses and treatment across a range of health conditions, in particular cancer”.
They say the demand for diagnostic imaging (DI) for x-ray, CT and MRI scans, nuclear medicine (NM), including theranostics, and radiation therapy (RT) has expanded exponentially in recent years resulting in a chronic national workforce shortage.
“This has now become critical,” their joint letter says.
Both organisations’ respective national conferences have identified contributing issues around training – in particular, the financial burden of rural, regional and interstate clinical placements.
The organisations say their students are required to undertake more than 52 weeks of clinical placements throughout 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,” they write. “We have examples of students having to sleep in their cars, or in tents.”
While they applaud the scheme for its recognition of the shortage of healthcare professionals, they are “most concerned” that medical radiation science students are not included, despite widespread workforce shortages and the professions being listed as priorities for Australia.
“With the rapidly increasing number of medical radiation services performed, it is critical that we continue to support and supply a viable graduate workforce,” they said, urging the Government to think beyond just doctors and nurses when it comes to investment in the health workforce.
Workforce under pressure
In an interview with Croakey at the conference, Heyes said ASMIRT is also in negotiations with unions to try to equalise professional awards across Australia, to stop an ongoing “exodus” to the better paying states like Queensland.
As Croakey reported last year, workforce shortages in the medical radiation sciences in Australia and globally have put the profession in a “state of stress” which risks further depleting numbers and is pitting jurisdictions against each other.
“We firmly believe Australia-wide we have the same qualifications and we do the same work, with slight variations obviously, depending on the patient population, but we think everyone should get the same remuneration and same conditions,” Heyes said.
“It’s trying to get all those things even so people can choose to work in the state because they love the state or they come from there, they’re not having to leave to go elsewhere to get the better conditions.”
At the conference, a session on the future of medical radiation sciences heard that its workforce makes up 2.2 percent of all health professionals – nearly 80 percent are diagnostic radiographers, 14 percent are radiation therapists, and seven percent are nuclear medicine technologists.
Seventy percent of the professions are female, while Aboriginal and Torres Strait Islander people make up less than one percent, with just 131 practitioners out of a total workforce of just under 20,000.
Heyes told the session that the profession is in some ways a victim of its own success, with university requirements for access now “really high”, above 95 percent.
“I would have had a snowball’s chance in hell of getting into the course now,” she said, noting that career pathways, including that advanced practice is still in its early days in Australia, then become major issues.
Students “are super bright, they want to be in charge in five years…which all of us know doesn’t necessarily happen so they move on to other professions, we are of course a stepping stone to medicine”, she said, citing a 25 percent drop out rate by five years after qualification.
Heyes, who is based at the Royal Children’s Hospital in Melbourne, said demand on medical radiation services is also reflecting financial distress in the community.
“A lot more people are using our ED [Emergency Department] as a GP clinic,” she said.
Earn while you learn
Medical radiation sciences in the United Kingdom also have a “massive retention and recruitment problem”, with the National Health Service “on its knees”, said Dr Rachel Harris, Head of Professional Practice and Education at the Society and College of Radiographers in the UK.
“Even the ones we manage to recruit we’re losing because they’re now in a system where they’re in absolute burnout,” she said.
UK students have also struggled to afford placements, with the result that universities are having to move into more simulation, which she said was another controversial issue.
To help address recruitment, the UK has moved towards an apprenticeship model of study in hospital departments — “a nice way to grow a local workforce” — which is being watched carefully by the Australian profession amid plans for a trial program in nuclear medicine.
Harris said the biggest benefit is the capacity to “earn while you learn”, which is particularly attractive to more mature students who might have a young family or other commitments and cannot afford to go without a wage.
“Therefore we believe we’re widening access to people who might otherwise not come into the profession,” she said, though acknowledging there are also many challenges to an apprentice system, not least capacity in hospital departments to support it.
Apprenticeship benefits and challenges
Noting that 98 percent of people in hospitals now undergo some form of imaging, Harris said the profession is in part “a victim of its own success”. “No clinician is going to risk not doing imaging now so I can’t see that changing,” she said.
Nonetheless the session heard that Australia’s Medical Radiation Practice Board is developing a statement on low value care, with a survey showing most professionals report having to do low value care at times, with many not feeling empowered to say no.
Watch this interview with Carolyn Heyes on placement poverty, equitable awards, apprenticeship training and highlights from #ASMIRT2024.
Last night’s Federal Budget restored indexation of nuclear medicine items on the Medical Benefits Schedule, a step long urged by the Rural Alliance In Nuclear Scintigraphy (RAINS), which works in partnership with ASMIRT.
RAINS committee member Professor Geoff Currie tweeted that the move would “support practices, particularly in regional and remote areas, to remain viable and will improve patient affordability for nuclear medicine imaging services”.
“Now for [the] workforce crisis!,” he said.
Further reading
What about me? Paid placements for some university students, but not others, by Kate Mansfield at Charles Sturt University
What does the new Commonwealth Prac Payment mean for students? Will it do enough to end ‘placement poverty’? by Professor
From X/Twitter
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