Coughing up

Are we being priced out of specialty training? The seriously sick cost of being a doctor.

Network (1976), dir. Sidney Lumet

As the new year rolls over and we wake up to a new quarter century, many doctors-in-training (myself included) will be checking their coffers to make sure there’s enough to pay their respective College fees. Many will be disappointed to find that while their salary has risen very little in real terms compared with the cost of living, College training and membership fees have once again increased - some by as much as 12% within the last 2 years.

For a variety of reasons, 2024 was the year of increased awareness of the cost of practising as a doctor in Australia. There were myriad articles in AusDoc and the Medical Republic, as well as endless discourse on Reddit and other social media forums in regards to the newly raised AHPRA fees, which had just surpassed the $1,000 watershed. Doctors - irrespective of income, number of hours worked or stage in career - are now asked to cough up the princely sum of $1,027 per year to fund an organisation which provides a registration number (so useless to my everyday activities I routinely have to look myself up on the Register of Practitioners on their website when the occasion rarely demands) and the opportunity to be dragged through a Kafkaesque complaints process when patients (who do not, incidentally, fund this organisation) feel the need to. This sum, like many of the fees which will be mentioned later in this piece, has continued to rise in the last few years, despite lack of transparency as to where this revenue is being allocated and what tangible benefit this might have to the practitioners who single-handedly fund this organisation. This figure represents a 23% increase in the last 3 years (in 2021 the annual fee was $835) for doctors with general registration. Due to the essential nature of this registration and therefore universal vested interest among all doctors in Australia, this alarming inflation caused widespread outrage.

This increase was, however, just one more gut-punch for trainees across Australia, who are now copping a larger bill than ever.

Show me the money

In a survey conducted by the Medical Board of Australia last year, 62% of trainees found that the costs of their Colleges’ training programs caused them significant ‘stress’. ‘Stress’ is probably just one stage of grief the average trainee goes through when they try to calculate the portion of their hard-earned salary that will go into various fees - somewhere between ‘anger’, ‘bargaining’ and finally ‘PayPal’. But is there value for money? As one respondent’s testimonial states:

“I question what we pay for given that I am required to complete workshops outside of these fees that cost a significant amount of money, plus extra fees for exams. It is incredibly expensive to become and practise as a doctor.”