Daily BulletinHoliday Centre

The Conversation

  • Written by The Conversation
imageIf you need doctors to work in the country, you need a selection system that picks people with those values and commitments.University of Exeter/Flickr, CC BY

Prime minister Tony Abbott has justified his decision to help fund a new medical school in Perth by noting that Western Australia lacks locally-trained doctors.

But how can we know whether the new institution will help Western Australia’s shortfall of 1,000 doctors, many of whom will be needed in rural and remote areas?

Three features of a medical school help predict where medical students will eventually work as doctors. They are selection, the curriculum, and the professionalism of the newly-qualified doctors.

Selection procedures

The aim of selection procedures is to predict and select applicants who will go on and become good doctors, and reject those who are likely to perform poorly in medical school and future practice. This might be due to poor professional behaviour as well as a lack of clinical knowledge and skills.

If you get into medical school, there’s a 95% chance you should become a doctor. But there’s only a 10% chance of getting into many medical schools. So these schools can pick and choose from the cleverest, and still choose those who have the values and commitment to work where they’re needed.

Worldwide, doctors tend to like working in the city rather than in country. This means there are plenty of doctors in urban areas but too few working rurally everywhere; it’s not just an Australian problem.

The best predictor of whether a doctor will work in the countryside is whether she grew up in a rural town. And also, whether she has a good rural experience during her medical training.

So if you need doctors to work in the countryside, you need a selection system that picks people with those values and commitments.

The right curriculum

The second informative feature of a medical school is the curriculum. This sets out the knowledge, skills, and behaviours that newly-qualified doctors ought to have. And the methods used to teach them. A third curriculum feature is assessment methods, which help ensure students have achieved a high standard.

Modern curriculum design can produce doctors who are ready for work in hospitals and in general practice. They should also have sound knowledge and skills, and be good communicators.

Curricula come in different flavours, depending on the kind of doctor the medical school wants to produce. Using a medical education tool called SPICES, you can tell whether a medical school is based around the teacher, with all its training done in the hospital, and where all the students do the same thing. Or whether the curriculum is based around the needs of the student, teaching is done in the community, and there’s a degree of student choice around their interests.

An army of volunteer teachers in hospitals and general practices provides the backbone of clinical education, particularly for teaching how to manage chronic disease. But just because you are a doctor doesn’t mean you are a good teacher. So training this army to be effective clinical teachers is in itself a big job.

Assessment always makes students anxious, but medical school examinations are about protecting the public. A good medical school will have a clear system for following student progress, and managing and supporting students who are at risk of failing. This might be because of ill health, poor behaviour, a life crisis, or simply falling behind in their studies.

Training professionals

Around 85% of Australians visit a general practitioner at least once a year, and 7% will see a specialist. If you ask the public what they think are the characteristics of a good doctor, they will mention being caring, a good communicator, understanding their culture, being a good problem-solver, and working well with other professionals in a health-care team.

Some of these professionalism skills, for example, around empathy, are known to deteriorate during a traditional medical education. This is largely caused by the distress of the “hidden curriculum”, which is the hierarchical and competitive atmosphere in medical schools.

It can lead to haphazard instruction and teaching by humiliation, especially during the clinical training years. Senior students and newly qualified doctors can experience burnout on the front line of the public hospital system, which is underfunded and short-staffed when dealing every day with the increasing burden of chronic disease and emergency care.

But the good news is that some professionalism skills are thought to increase during the same phase in training. This happens when students are placed in rural communities for up to a year, for instance.

Their supervisors and hosting community freely contribute towards student education because they believe such students will return to work there. Medical school rural programs find that graduates of rural programs are not only likely to enter rural general practice but 70% remain in rural practice for decades.

There’s been much said in recent days about how this country doesn’t need another medical school. But what Australia actually doesn’t need is another traditional medical school feeding into a stressed public hospital system, and urban private practice. What this country could benefit from is an innovative medical school feeding into a reformed public health-care system.

But what comes first? This is where we need to challenge our politicians. We need innovative medical education and training, as much as we need health-care reform, with a focus on primary care.

If this new school doesn’t innovate, based on the evidence, it will do little to get doctors into areas of need.

Chris Roberts receives funding from the Department of Health to evaluate the national selection procedures into general practice specialty training

Authors: The Conversation

Read more http://theconversation.com/getting-doctors-to-the-bush-depends-on-more-than-just-uni-places-41972


The Conversation


Scott Morrison Virus Announcement

PRIME MINISTER: Good afternoon. Keeping Australians safe - that is the priority of our Government as we deal with what has been an emerging situation with the coronavirus. Each and every day there a...

Scott Morrison - avatar Scott Morrison

Closing the Gap Statement to Parliament

Mr Speaker, when we meet in this place, we are on Ngunnawal country. I give my thanks and pay my respects to our Ngunnawal elders, past, present and importantly emerging for our future. I honour...

Scott Morrison - avatar Scott Morrison

Prime Minister Interview with Alan Jones

ALAN JONES: Prime Minister, good morning.    PRIME MINISTER: Good morning, Alan.    JONES: I was just thinking last night when we're going to talk to you today, you must feel as though you've ...

News Company - avatar News Company

Business News

Having a mentor is a must to take your business to the next level

Kerstyn Walsh will have the chance to meet her business mentor, LA-based wedding planner to the stars, Lisa Vorce, which will be game-changing for growing Kerstyn’s business Kerstyn Walsh, a self-emp...

Media Release - avatar Media Release

Is Hiring a Corporate Lawyer for Your Company Necessary?

Alternative online legal services like LegalZoom, Incfile, and Rocket Lawyer provides young and budding entrepreneurs access to legal help at a much affordable price without having to hire or meet a l...

Joe Curmi - avatar Joe Curmi

Top 5 Green Marketing Ideas for Your Eco-Friendly Small Business

According to studies, about 33 percent of consumers prefer buying from brands that care about their impact on the environment. This is good news for anyone running an eco-friendly business. It’s a...

Diana Smith - avatar Diana Smith


Travelling With Pets? Here Is What You Should Know

Only a pet parent can understand the dilemma one experiences while planning a vacation. Do you leave your pets at home?  Will you get a pet sitter or someone to take care of them while you are away?...

News Company - avatar News Company

How to Be a Smart Frugal Traveller

You are looking through Instagram, watching story after story of your followers overseas at a beach in Santorini, walking through the piazza in Italy, and eating a baguette in front of the Eiffel ...

News Company - avatar News Company


Graduation is the stage of life when a student receives the rewards of hard work of years. It must have taken sleepless nights and tiring days to achieve the task. Now, as you have received your cov...

News Company - avatar News Company