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Australia’s leading national Aboriginal health organisation and Australia’s peak medical education body have signed a landmark agreement aimed at increasing medical student placements in Indigenous primary health care settings.
The Memorandum of Understanding between the National Aboriginal Community Controlled Health Organisation (NACCHO) and Medical Deans Australia and New Zealand will also support NACCHO’s potential to build the capacity to recruit more Aboriginal and Torres Strait Islander medical students.
The agreement was signed in Canberra during National Reconciliation Week by NACCHO Chair Mr Justin Mohamed and Medical Deans President Professor Justin Beilby.
‘This is a valuable and important agreement that will build the capacity for medical student placements in Aboriginal Community Controlled Health Organisations, which increases students’ understanding of Aboriginal and Torres Strait Islander peoples’ diverse and distinct cultures and their health issues,’ Professor Beilby said.
‘These settings are the most effective places to learn about Aboriginal health, and this agreement will help formalise and strengthen some of the understandings that are already in place.’
‘It also has the potential to recruit more Aboriginal and Torres Strait Islander students to medicine and build the capacity of NACCHO health services across the country.’
Professor Beilby said Medical Deans, in conjunction with its partnering Aboriginal organisations and networks, was committed to reducing the gap in health outcomes between Indigenous and non-Indigenous people.
‘Our formal collaboration with the Australian Indigenous Doctors Association (AIDA), the Deans’
Leaders in Medical Education (LIME) Network and our Indigenous Health Expert Advisory Group have contributed to this, and we look forward to our agreement with NACCHO taking this to the next level,’ he said.
Mr Mohamed said ‘we welcome the formal collaboration with the Deans and individuals within their organisation who have contributed to this. We’re looking forward to working together towards developing capacity within the Aboriginal Community Controlled Health Sector to increase the effectiveness of clinical training and the Australian medical workforce.’
NACCHO is the peak national body in Aboriginal health and represents more than 150 Aboriginal Community Controlled Health Services in State and Territories across Australia.
Medical Deans represents professional entry-level medical education, training and research in Australia and New Zealand. The organisation comprises the Deans of Australia’s 18 medical schools and the two New Zealand schools.
More information, Justin Beilby: (08) 8303 5193 or 0403 017 457
PRIVATE hospitals are well placed to play an increasing role in medical student training, according to Professor Justin Beilby, president of Medical Deans Australia and New Zealand.
Professor Beilby, commenting on research published in the MJA that found overwhelmingly positive attitudes to medical student training at a Sydney private hospital, said the value of training medical students in both public and private environments was becoming obvious to all. (1)
“There is a growing momentum in Australia that we have this lovely option of training in private hospitals — it’s fantastic”, he said, adding that a training facility that opened last year at St Andrew’s Hospital in Adelaide had been a great success.
“As long as there is appropriate information provided to the patients who attend, the hospitals are very keen to be involved. I think that’s a reflection of realising the value for all society of training in both public and private environments.”
The research letter published in the MJA found that both patients and staff at the Sydney Adventist Hospital (SAH) were accepting of medical student involvement in care. It was the first private hospital in NSW to include a clinical school, opened by the Sydney Medical School in 2011.
A cross-sectional survey of 143 staff and 283 patients found 90% of patients would allow a student to be present during a consultation with a doctor, and 94% of staff would allow a student to watch their patient care. About half of patients and staff said they would like to have a medical student present.
The study authors said the results supported medical student teaching in private hospitals and noted that the privilege of having private health insurance did not reduce the responsibility to contribute to the training of future doctors. “Despite the limitations of this study, we have shown that patients and staff of a private hospital largely accept this responsibility.”
Professor Beilby said many clinicians in private hospitals loved to teach and there was a growing realisation that both the public and private hospital systems need to be involved in teaching.
“For years we have been teaching medical students in general practice — which has a private structure — so with the appropriate balance and the appropriate approvals, it can be done”, he said.
Michael Roff, CEO of the Australian Private Hospitals Association, said the research findings reinforced feedback to the association about other private sector training already occurring, such as registrar training. He noted that the private sector already provided more than 500 000 training days a year to both undergraduate and postgraduate health professionals.
Mr Roff said the sector had also demonstrated a willingness to become more involved in medical training last year when private hospitals agreed at short notice to take about 100 interns who were not able to be accommodated in the public system.
“There is probably capacity to increase that number. The issue is — and always has been —access to appropriate levels of funding”, he said. “If that funding is made available, we’ve seen that the private sector can step up to the mark.”
Late last month, the final report of the Review of Australian Government health workforce programs recommended that Health Workforce Australia engage more closely with the private health sector in developing and implementing health education training initiatives. (2)
Mr Roff welcomed the report’s recommendations. “The lack of coordination and the lack of funding are the two biggest barriers to the training role in the private sector expanding, as it will need to do if we are to maintain an adequate supply of health workforce into the future.”
1. MJA 2013; 198: 532-533
2. Australian Government 2013: Review of Australian Government health workforce programs
Monday, 3 June, 2013
A FIGHT over a plan to create a new regional medical school could become a political issue after the Nationals signalled strong support for the proposal from Charles Sturt and La Trobe universities.
The established medical schools believe they have headed off the proposal, with Tony Abbott reportedly assuring the medical deans that, like Labor’s Health Minister Tanya Plibersek, he has no plans to back the idea.
But the Liberals’ Coalition partners, the Nationals, are backing the plan as a way to solve the chronic shortage of doctors in regional areas after strong growth in graduate numbers resulted only in more city-based doctors.
Coalition health spokesman Peter Dutton was non-committal, his office saying the opposition’s health policy would be announced closer to the election. But Medical Deans Australia and New Zealand president Peter Smith told the HES that one of his members had been told that the Opposition Leader was not interested in approving a new school. Mr Abbott’s office did not respond in time to queries from the HES.
“The model (proposed by CSU and La Trobe) is based on national and international evidence that supports rural training and is cost-effective by combining existing infrastructure and resources. In my view it deserves the government’s strong consideration,” Nationals senator and opposition regional education spokeswoman Fiona Nash said in a statement.
The Australian Medical Association opposes any new schools, given the near-term oversupply of graduates and shortage of internships.
Training spokesman Will Milford said he could yet have an open mind if a new school did not result in a net expansion of domestic places, but that would mean taking places away from existing schools and lead to them making up the shortfall by recruiting more international students.
Last week, Ms Plibersek said the government first wanted to ensure there was sufficient training capacity for internships before considering a new school.
La Trobe and Charles Sturt are arguing that a medical school located in the Murray-Darling area would effectively retain graduates in regional areas.
Many students have to travel to cities to do their initial study and proponents of the new school argue that they too often end up staying there.
Professor Smith said the problem was not at the undergraduate level, adding that the lack of internship places and specialist training opportunities in regional areas was driving doctors to the cities.
Last month, an independent review of health workforce programs by former NSW director general of human services Jennifer Mason said regional training pathways for doctors needed to be boosted urgently.
But she was agnostic on the merits of a new regional school, noting that while there were merits in keeping students in regional areas, the shortage of training places following the expansion of existing schools appeared a major issue.
“Further time and evaluation is needed to determine the true strength of arguments from both sides,” the review said.
5 June 2013
1. ‘Evidence-based medical workforce planning and education: the MSOD project’ – an editorial in MJA
2. ‘Utilisation of the healthcare system for authentic early experience placements’
3. ’International medical electives undertaken by Australian medical students: current trends and future directions’
4. Article –
The newly elected President of Medical Deans Australia and New Zealand has warned against politicians supporting a new rural medical school in the upcoming federal election campaign.
‘What Australia does not need are more rural medical schools in an attempt to increase the number of doctors working in rural Australia,’ said Professor Peter Smith, who is Dean of the Faculty of Medicine at the University of New South Wales.
‘What we do need are better training opportunities for doctors based in rural and regional areas, which would encourage them to stay in those areas where there are acknowledged doctor shortages.’
This included improved regional vocational training opportunities and more intern places in regional hospitals, Professor Smith said.
‘We are strongly supportive of continuity of medical training in regional areas and we are keen to work with medical colleges to progress this so that people living outside the metropolitan centres have better access to general physicians, psychiatrists, surgeons and the like.’
Professor Smith said Australia now had a plentiful supply of new medical graduates, with numbers jumping sharply in recent years.
‘More than 3,400 new students are set to graduate as doctors at the end of this year. To create a new medical school of any sort, even if done with the best of intentions, would be a mistake.’
Professor Smith, who was elected as President yesterday, said a priority of his two-year appointment was to continue Medical Deans’ work in Indigenous health. ‘We can be proud of what we are doing in this space, not only in training Indigenous doctors but in ensuring non-Indigenous doctors have a cultural understanding of the needs of the Indigenous community.’
‘It is vital we continue this work and strengthen the partnerships we have built with the Indigenous doctors’ organisations (AIDA and TeORA) and our own leaders in Indigenous medical education.’
Professor Smith also said Medical Deans wanted to ensure that governments provided adequate funding for medical research, particularly research in hospital settings.
Medical Deans is made up of the Deans of Australia’s 18 university medical schools and the two New Zealand schools.
More information: Peter Smith, (02) 9385 2451
4 June 2013