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* Julia Medew
* Health Editor
* Sydney Morning Herald
* August 21, 2012
THE number of Aboriginal and Torres Strait Islander medical students has increased dramatically in the past decade and now matches the ratio of indigenous to non-indigenous people in Australia for the first time.
Last year, 80 of Australia’s 3241 domestic first year medical students were indigenous – 2.5 per cent, up from 0.8 per cent in 2004.
The milestone is being celebrated by medical deans and the Australian Indigenous Doctors’ Association because 2.5 per cent of Australia’s population is Aboriginal and Torres Strait Islander.
”This is a huge step forward,” said the president of the Australian Indigenous Doctors’ Association, Peter O’Mara.
However, Associate Professor O’Mara – a Wiradjuri man, GP and Aboriginal health specialist – said the biggest task was getting students through their medical degrees because about 30 per cent of indigenous students had not completed the course in the past compared with about 2 per cent of other students.
Family and cultural commitments, financial difficulties and, in some cases, racism contributed to the high attrition rate, he said.
A new agreement being signed today between the association and the Medical Deans of Australia and New Zealand aimed to monitor and support these students more so they could graduate and become successful doctors, he said.
The agreement comes after a report, published this year by the Medical Deans of Australia and New Zealand, found a huge variation in how well universities were teaching indigenous health and recruiting and retaining indigenous students.
While all universities were teaching some indigenous health, the report said about 66 per cent of indigenous medical students had experienced racism and discrimination from other students, residents, professors or physicians during their course, with 64 per cent feeling inadequately supported.
Associate Professor O’Mara said he hoped the new agreement would help better educate all medical students about indigenous people, including their history and special needs, so they can help close the gap in health outcomes between indigenous and non-indigenous Australians.
While indigenous people generally felt more comfortable with indigenous doctors, there were only about 160 of them, making up 0.2 per cent of the total medical workforce, he said.
”To get parity, we need another 1200 Aboriginal and Torres Strait Islander doctors,” he said.
A fourth year medical student, Dana Slape, a Larrakia woman, said she was thrilled about the recent milestone because it showed universities were getting better at recruiting indigenous students. Having been told during high school that she was unlikely to get into medicine, Ms Slape, 28, said it was important for young indigenous people to see people overcoming hurdles to achieve their goals.
”Aboriginal and Torres Strait Islander people have just as much ability and right to become doctors as everyone else,” said Ms Slape, who mentors younger indigenous students at the University of Western Sydney.
”We’re aware that as we grow our numbers of doctors, lawyers and teachers, more kids will be inspired to do the same.”
The intake of first-year Aboriginal and Torres Strait Islander medical students in Australian universities has reached a new high of 2.5 per cent, matching the percentage of Australia’s Aboriginal and Torres Strait Islander population.
The increase, up from 0.8 per cent in 2004, comes as a new is signed today between the Australian Indigenous Doctors’ Association (AIDA) and the Medical Deans of Australian and New Zealand (Medical Deans) to further promote Aboriginal and Torres Strait Islander medical education and help close the gap in health disparities between Indigenous and non-Indigenous Australians.
“What makes our work with the Medical Deans important is we have made positive, sustainable and long term change over the life of our previous Collaboration Agreements,” said AIDA President Associate Professor Peter O’Mara. “The new agreement will build on this success.”
“Importantly, this Collaboration Agreement gives us the continuing capacity to jointly influence broader structural reform and policy and program agendas in health and education,” said Medical Deans President Professor Justin Beilby. “From this basis we are better able to work towards recruiting and graduating Aboriginal and Torres Strait Islander students.”
While positive progress has occurred in recruiting first-year Aboriginal and Torres Strait Islander medical students, the total enrolment rate stands at 1.6 per cent of total domestic medical student enrolments and graduations currently account for approximately 0.5 per cent of total domestic graduations.
“The rise in the number of Aboriginal and Torres Strait Islander medical students is a great way we can build the numbers of Aboriginal and Torres Strait Islander doctors. It’s important to ensure that these students can access appropriate cultural and academic support to graduate,” said AIDA Student Director, Ms Dana Slape.
Although total Aboriginal and Torres Strait Islander student enrolment and graduation percentages are expected to increase over the coming years, an important joint priority of AIDA and Medical Deans under their new Collaboration Agreement will be to advocate for reform within medical schools to ensure appropriate support processes are in place to increase the numbers of Aboriginal and Torres Strait Islander doctors. Medical Deans’ Leaders in Indigenous Medical Education (LIME) Network will continue to provide significant leadership within the schools to achieve this reform.
“Australia’s first Aboriginal doctor graduated in 1983,” said AIDA CEO Mr Romlie Mokak. “In 2009, Aboriginal and Torres Strait Islander doctors comprised approximately 0.2 per cent of the total number of medical practitioners in Australia. To come close to population parity, there would need to be an additional 1,200 Aboriginal and Torres Strait Islander doctors today.”
To achieve this requires sustained and accelerated support from governments, education and health sectors to increase the recruitment, retention and completion rates of students, as well as work environments that encourage medical graduates to practice and specialise in their chosen field.
Aboriginal and Torres Strait Islander medical practitioners currently fulfil a range of leadership roles across policy, service delivery, research and academia, contributing not only to improving Aboriginal and Torres Strait Islander health outcomes but to positive health reform for all Australians. For example, six Aboriginal and Torres Strait Islander doctors were recently announced as members of the new National Health and Medical Research Council’s Principal Committees. A priority under the new agreement, AIDA and Medical Deans have committed to develop stronger pathways for Indigenous medical academic leaders.
AIDA Contact: Romlie Mokak 0427 786 153
Medical Deans Contact: Justin Beilby 0403 017 457
*By Mark Metherell
*Sydney Morning Herald
*August 6, 2012
Trainee doctors face a struggle to get enough ”hands-on” time with patients as the boom in student numbers outpaces the availability of medical educators in many public hospitals.
Ward rounds, where students learn the craft of diagnosis, are becoming increasingly crowded. Senior doctors have to teach the finer points of medicine to eight or more students clustered around a single patient.
Medical students typically learn much of the craft of diagnosis from watching a specialist in action with patients at teaching hospitals.
The training crush has been aggravated by a scarcity of specialist educators in hospitals. What is worse, the Australian Medical Association says, is that the national health funding reforms will deepen the problem because the focus on service costs has failed so far to take account of the cost of training to public hospitals.
In the past decade, medical student numbers have more than doubled to about 17,000 in Australia, but medical schools have complained that hospital training resources have failed to keep up – a problem at risk of worsening under the funding reforms, the AMA and medical school deans have warned.
Geoff Dobb, the AMA’s vice-president, said it was now common for hospital consultants and registrars to have eight or more students accompany them on a ward round when previously there would have been two or three at such sessions.
”There are lots of signs of pressure on training quality,” said Professor Dobb, an intensive care specialist. ”I don’t think it is yet affecting the quality of medical graduates but I don’t think we are far from the point at which it will potentially do so.”
Learning to identify patients’ conditions was obviously best learnt on living patients, he said.
The AMA has sent a submission to the Independent Hospital Pricing Authority calling on it to give greater priority to formulating a policy on the pricing of hospital medical training on which the federal government will base its funding to hospitals.
Delays in funding arrangements created ”a significant risk” that training and research would not be sufficiently recognised, the AMA told the authority.
The president of Medical Deans Australia and New Zealand, Justin Beilby, said medical schools were experiencing problems with the supply of medical educators, partly because younger consultants were less likely to take on the training role.
It was important for the pricing authority to deal with the issue this year to ensure the health funding reforms did not further complicate the training problems, Professor Beilby said.
James Churchill, the president of the Australian Medical Students Association, said students were concerned at the strains affecting training sessions.
Apart from the diminution in training quality, ”being faced with increasing numbers of students may be a challenge for patients”, he said. ”We need to ensure the increasing numbers of students don’t impact [on patient care].”