Surgical workforce under pressure as regulator calls for major reform

Surgical workforce under pressure as regulator calls for major reform

04 May 2026

Speaking in Perth at the Royal Australasian College of Surgeons annual meeting, Ahpra chief executive Justin Untersteiner said the health system is dealing with “complex, ongoing pressures” that are affecting both doctors and patients.

He said not enough surgeons are available to meet demand, leading to longer wait times and reduced access to care. He warned that shortages in healthcare ultimately result in patient harm.

He pointed to national reviews showing problems such as burnout, ageing specialists, training bottlenecks and doctors leaving the profession early. He also highlighted the low proportion of women in surgical specialties compared to the wider medical workforce, calling it a missed opportunity for the system.

Training pathways under review

Mr Untersteiner said younger doctors are increasingly discouraged by long and rigid training pathways. He said reforms are needed to make surgical training more flexible and sustainable.

He also said better use of internationally trained doctors could help ease pressure on the workforce, but warned that delays and barriers in the system have slowed progress.

Concerns over workplace culture

A major focus of his address was behaviour within the profession. He said data shows nearly one in three surgical trainees experience or witness bullying, harassment, discrimination or racism.

Most incidents, he said, go unreported, and senior clinicians are often identified as the source of harmful behaviour.

He warned that poor culture is driving training disruption and affecting patient safety, and said it must be addressed directly by the profession.

Costs and public confidence

Mr Untersteiner also raised concerns about rising out-of-pocket costs for specialist care. He said some patients are delaying or avoiding treatment because of expense.

He said there is growing public confusion about why fees vary, and warned that lack of transparency is weakening trust in the system.

He noted that government is now seeking access to billing data from Medicare and private insurers to better understand specialist charging.

Call for cultural change

He said racism and discrimination in healthcare must not be tolerated, and patients must feel safe accessing care regardless of background.

While doctors have the right to express opinions, he said this does not extend to behaviour that harms patients or undermines trust in the profession.

Final message

Mr Untersteiner said no single organisation can solve these challenges alone. He urged surgeons, colleges and regulators to work together to strengthen training, improve culture and ensure fair access to care.

He said surgeons remain central to the health system, but must also take a leading role in shaping its future.

https://www.ahpra.gov.au/

Source: Speech by Ahpra CEO Justin Untersteiner at RACS Annual Scientific Congress, Perth

 
 

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