Too many graduates, not enough jobs: universities, profits and clinical need

Universities could be oversupplying graduates in a number of key health fields. Graduate image from www.shutterstock.com

What if, after several years of studying in an intense degree program, you graduate only to find no jobs within your field?

Since 2012, public universities have been allowed to determine the number of students they enrol in bachelor level courses (excluding medicine). They receive commonwealth funding for these places – this is commonly referred to as the demand-driven system.

Many universities have moved on this legislative change to increase student numbers. La Trobe University, for example, aims to increase its student places by 30% from 2013 to 2017.

Now some professions, particularly in a number of the health disciplines, are talking about an oversupply of qualified graduates. So how do we judge if there’s an oversupply? And are universities profiteering?

Increasing numbers

There are two good examples of disciplines which, under the new system, have produced an increasing number of graduates – dentistry and speech pathology.

The increases in both fields have come from an abundance of new courses and ever lower entry requirements. Speech pathology courses are popping up all over the country. From 2011 to 2014 there will be seven new courses across the east coast of Australia, where only a total of ten existed before.

In Melbourne we now have three courses training about 230 speech pathologists every year. But this explosion of new graduates has not been followed by new job openings in Victoria. We know from our most recent cohorts in Victoria that finding a job has proven difficult for some.

This situation will only get worse with more and more courses on offer. At the current rate, Australia will soon be training more than 1,000 speech pathologists annually, with the majority attempting to enter the workforce upon graduation. The lack of jobs means that some new graduates are heading straight to private practice where continuing professional education may be more challenging to access.

For dentistry graduates, there have also been ongoing calls from the Australian Dental Association to place a cap on university student numbers. The ADA expects around 580 students to graduate in Australia this year while only 250 graduates enter the workforce each year.

Clinical need?

It’s clear universities are driving this expansion, capitalising on students desire to take more vocational courses with the promise of a high paying job at the end.

But can we judge an oversupply just through workforce numbers? Many argue that there remains a clinical need for these services. Australian experts, professors Peter Brookes and Mike Morgan suggested that an increase in dental graduates is a valid response to a real clinical need for greater dental services in the community.

With a conservative estimate of around 5% of Australians presenting with a communication or swallowing impairment of some form at any one time, it could be argued that the community would also benefit from more speech pathology services.

This means over one million Australians require the services of a speech pathologist. Or put another way, one in five people will need to see a speech pathologist in their lifetime. With an ageing population, the need for clinical services will grow. There are about 7,500 clinicians in Australia, however not all of those are practising clinicians and many fulfil part time positions.

That number makes an optimistic ratio of one speech pathologist per 150 individuals requiring their services at any one time. An inadequate figure if we as a society aim to minimise the health and social cost of communication disability.

These fears are being echoed in the United Kingdom with cuts to speech therapy leading to extended waiting times for much-needed services.

Winners and losers

The expansion of new speech pathology courses in recent years may leave the industry and others like it with several problems. One issue is an oversupply of trained clinicians seeking employment.

The second relates to quality of new graduates. The standard of graduates may vary based on the quality of education and the entry scores required to enrol in a course. If a course is popular with few places, the entry requirement goes up. The opposite applies when places are easily found.

In the case of speech pathology, these issues are exacerbated by the absence of a legal requirement for clinicians to register with any health professional board. An accreditation requirement stipulated by the National Registration and Accreditation Scheme (NRAS) which covers most other health professions including medical (physicians) and allied health (physiotherapists) and even complementary therapies (osteopathy).

The NRAS considers its primary role as protecting the public in relation to health profession conduct. The lack of formal regulation means individuals are able to practice in many workplaces without registration or accreditation.

Limited numbers

Those training the new graduates – the universities – clearly stand to gain with increased revenue from higher student numbers. Universities may well argue that it is not their responsibility to regulate graduate numbers based on health industry job opportunities. The government, too, has shown reluctance to cap student numbers except in the case of medicine on the grounds that there are limited hospital training placements available.

The same could be said for any health based profession where clinical placements are an essential component of training.

Students may end up making the decision by recognising those courses and universities which offer the best opportunity for employment. Hopefully they will limit graduate numbers by choosing courses and professions that maximise their employment opportunities.

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