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March 30, 2016
By Professor Nicholas Glasgow
President Medical Deans
A recent Productivity Commission report reinforced what many in country towns and rural regions already know — it’s tough finding a GP or specialist, and the lack of medical services is having an impact on the health of rural and regional Australians.
People who live in regional and rural Australia are more likely to die of cancer, will die earlier and have higher rates of cardiovascular disease, diabetes and suicide than their city cousins. In a developed country such as Australia this is simply unacceptable.
Will a new medical school lead to more rural doctors? There is renewed interest in a proposal to create a new medical school with Orange, Wagga Wagga and Bendigo campuses, called the Murray Darling Medical School Initiative — with the sole aim to train doctors in rural areas on the assumption they will stay there.
This misses the crucial issue behind our rural doctor shortage: it’s not more medical schools that are needed, it’s more rural and regional general practice and specialty training places.
Simply building a rural-based medical school that will train students in locations where there are already rural clinical schools is not the answer.
We are awash in medical schools already. Australia has more than doubled the output of its medical schools over the past 15 years, largely to address the shortage of doctors in the late 1990s and early 2000s. Per capita, we graduate more doctors than almost all OECD countries.
This, combined with a huge increase in the importation of doctors from overseas, means we have what could be considered a high water mark for our medical workforce. It’s just that most don’t work in the bush.
A lot has already been done to encourage medical graduates to work in regional and rural Australia. Many universities have rural clinical schools and students can experience placements in country areas. Federal government funding for these universities requires 25 per cent of medical students to be from a rural background, and these are the students more likely to want to practice in a rural area. Since 2003, the number of students from a rural background has increased from 20 per cent of commencing students to nearly 26 per cent.
There are more medical students and internships per capita in regional and rural Australia than in metropolitan Australia.
There is not a lack of willingness or interest among graduates to practise outside cities. Students from the city who undertake a rural placement also report high levels of satisfaction with the experience. However, the path to becoming a fully fledged doctor is a long one. Four to six years at medical school, followed by a year of internship and then typically four to 10 years spent training to be a specialist.
Competition for specialist training positions is fierce and even young doctors with the best intentions end up back in our cities to secure a training position.
This also tends to coincide with the time when young people are settling down with families, complicating the issue even further.
The small number of regional specialist training posts available are generally filled by trainees on short-term rotations from the city. It would be much more effective to create self-contained regional training programs, which would reserve these posts for trainees who want a career in rural medicine.
So what is needed is more general practice and other specialist training opportunities in the bush. As long as young doctors have to return to big metropolitan hospitals to complete their training, we will struggle to address the inequity in distribution of the medical workforce in Australia.
Understandably the idea of another new medical school that is rurally based appears an attractive option to governments and communities alike, who want to see the problem solved.
The federal government has already outlined a solution to the disconnect in the rural training system.
The regional training hubs and rural junior doctor innovation fund and new rural specialist training places will all provide opportunities for graduates interested in rural careers to stay in rural communities while they complete their postgraduate training.
There is much evidence to suggest doctors who train in remote and rural areas stay there.
These new initiatives recognise that our limited rural health resources and training capacity need to be directed to the training positions that follow medical school, not the medical schools themselves.
Rural communities will be much better served by an investment in regional postgraduate training.
Professor Nicholas Glasgow, President of Medical Deans Australia and New Zealand.
8 March 2016
Medical Deans is celebrating International Women’s Day by highlighting women leaders in medical education and research.
Professor Nicholas Glasgow, President of Medical Deans, said that International Women’s Day was an opportunity to celebrate the enormous contribution women have made to medicine and medical education and research.
“There are now six Deans and five Deputy Deans at the 21 medical schools and faculties across Australia and New Zealand. This is a significant increase since 2004 when the first woman Dean of Medicine, Professor Judy Searle was appointed at Griffith University.
“Over the last three decades there has also been a significant increase in the number of women studying medicine. We have come a long way since the University of Melbourne graduated Australia’s first women doctors, Clara Stone and Margaret Whyte, in 1891. In 2014, 51 percent of Australian medical graduates were women and there were 1 666 women (51.9 percent) commencing medical studies in 2015.”
Professor Glasgow acknowledged there are still challenges to address. “While we have seen substantial progress, it remains a challenge to see the increase in medical school students translate into a similar increase of women in leadership positions and specialist roles and we will continue to work towards this end.”
The Executive Dean at the University of Wollongong, Professor Alison Jones, said profiling the achievements of women leaders can assist in reaching this goal.
“The importance of women leaders as role models and mentors cannot be underestimated. I hope being a female executive dean, medical practitioner and toxicologist will encourage girls to consider a science-based career and to aspire to a leadership position. We are nuts as a nation if we don’t use half of the smarts of the population.”
“Medical Deans is committed to diversity in medicine, supporting women and reducing barriers that may stand in the way of women continuing to rise to the top of the profession.”
Across university campuses, events such as Monash University’s Faculty of Medicine, Nursing and Health Sciences International Women’s Day lunch are being held to celebrate women’s achievements.
Contact: Carmel Tebbutt, CEO Medical Deans, 02 8084 6557, 0437 476 267 or firstname.lastname@example.org
Current Women Deans and Deputy Deans
Professor Christine Bennett AO is Dean of Medicine at the University of Notre Dame Australia in Sydney. Professor Bennett is a specialist paediatrician and has over 35 years of health industry experience in clinical care, strategic planning, and as a CEO in the public, private and not-for-profit sectors. She is also Chair of Research Australia, Sydney Children’s Hospitals Network and formerly the National Health and Hospitals Reform Commission.
Professor Shirley Bowen is Dean of Medicine at University of Notre Dame Australia, Fremantle. Professor Bowen holds Fellowships in Infectious Diseases and Sexual Health Medicine. Her research interests include strategic planning for the prevention of HIV and STIs; Chronic Disease Management Services; cost effectiveness and health outcomes; and Residential care and the Emergency Department interface.
Professor Wendy Erber is Dean of the Faculty of Medicine, Dentistry and Health Sciences at the University of Western Australia. Professor Erber, a Rhodes Scholar (the first female from NSW), worked as a haematologist in Sydney, Perth and Cambridge hospitals. Her specific areas of interest and expertise are cellular haematology, and particularly the integrated approach to the diagnosis and assessment of haematological malignancies. In 2015 she was named the Cancer Council WA’s Research of the Year and inducted as a Fellow by the Australian Academy of Health and Medical Sciences.
Professor Annemarie Hennessy AM is Dean of the School of Medicine, at Western Sydney University and Foundation Chair of Medicine (2006-2016). Professor Hennessy is a Renal and Obstetric Physician with a research interest in Hypertension and Hypertension in pregnancy.
Professor Alison Jones is Executive Dean of the Faculty of Science, Medicine and Health at the University of Wollongong. Professor Jones is a scientist and medical practitioner who has served as a high-level toxicology adviser to NSW Ministry of Health. Professor Jones maintains strong, collaborative research partnerships with health and medical researchers nationally and globally. Professor Jones is Secretary of Medical Deans Australia and New Zealand.
Professor Christina A. Mitchell is Academic Vice-President and Dean of the Faculty of Medicine, Nursing and Health Sciences at Monash University. Professor Mitchell has practiced as a general physician and as a specialist haematologist. Professor Mitchell major research is to investigate the role of lipid phosphatases in development and human disease.
Professor Cheryl Jones is Deputy Dean (Education), Sydney Medical School. Professor Jones is a clinician-scientist in paediatric infectious diseases who leads a bench-to-bedside research program covering laboratory-based research, population health epidemiology and surveillance of infectious diseases.
Professor Michelle Leech is Deputy Dean of the Faculty of Medicine, Nursing and Health Sciences at Monash University. Professor Leech has been a research fellow at Monash Centre for Inflammatory Diseases and continues as a consultant physician and deputy director of Rheumatology at Monash Health. Professor Leech is Treasurer of Medical Deans Australia and New Zealand.
Professor Imogen Mitchell is Deputy Dean of the Medical School, ANU College of Medicine, Biology & Environment. Professor Mitchell is an intensive care specialist and a senior medical advisor to the Australian Commission on Safety and Quality in Health Care. Professor Mitchell’s major research is development of sustainable processes for managing patient deterioration.
Professor Tania Sorrell is Deputy Dean (Clinical), Sydney Medical School. Professor Sorrell is Director of the Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI) and is an infectious diseases physician and medical mycologist whose research focuses on invasive fungal infections.
Professor Eileen Willis is Deputy Executive Dean of the Faculty of Medicine, Nursing & Health Sciences at Flinders University. Professor Willis has a research interest in the area of Indigenous public health policy and is currently engaged in two research projects examining the impact of rationalised care in the public hospital system and international nurses.