The real cost of training health professionals in Australia: it costs as much to build a dietician workforce as a dental workforce

Objectives: We explored the real cost of training the workforce in a range of primary health care professions in Australia with a focus on the impact of retention to contribute to the debate on how best to achieve the optimal health workforce mix. Methods: The cost to train an entry-level health professional across 12 disciplines was derived from university fees, payment for clinical placements and, where relevant, cost of internship, adjusted for student drop-out. Census data were used to identify the number of qualified professionals working in their profession over a working life and to model expected years of practice by discipline. Data were combined to estimate the mean cost of training a health professional per year of service in their occupation. Results: General medical graduates were the most expensive to train at $ 451,000 per completing student and a mean cost of $ 18,400 per year of practice (expected 24.5 years in general practice), while dentistry also had a high training cost of $ 352,180 but an estimated costs of $ 11,140 per year of practice (based on an expected 31.6 years in practice). Training costs are similar for dieticians and podiatrists, but because of differential workforce retention (mean 14.9 vs 31.5 years), the cost of training per year of clinical practice is twice as high for dieticians ($ 10,300 vs. $ 5200), only 8% lower than that for dentistry. Conclusions: Return on investment in training across professions is highly variable, with expected time in the profession as important as the direct training cost. These results can indicate where increased retention and/or attracting trained professionals to return to practice should be the focus of any supply expansion versus increasing the student cohort.