Australian Medical Education -Is it Good for Our Health?

Australian Medical Education -Is it Good for Our Health?

Helen C BehCEO, Australian Orthopaedic Association

Helen C BehCEO, Australian Orthopaedic Association

The changesThe changes

Selection Process Course Structure and Content Teaching Methods

Selection Process Course Structure and Content Teaching Methods

Changes to selectionChanges to selection

From virtually unrestricted entry to: Entry on basis of HSC performance Entry on basis of performance on multiple

selection tools HSC Performance Graduate status Interview GAMSAT Score

From virtually unrestricted entry to: Entry on basis of HSC performance Entry on basis of performance on multiple

selection tools HSC Performance Graduate status Interview GAMSAT Score

Reasons for ChangeReasons for Change

Restriction on number of medical places

Students entering medicine with:

Wrong motivation Poor communication skills Poor social skills Poor medical skills

Restriction on number of medical places

Students entering medicine with:

Wrong motivation Poor communication skills Poor social skills Poor medical skills

Changes to Course Content and Structure

Changes to Course Content and Structure

Change from undergraduate to graduate course in some Universities

Change from focus on pure science medical science to focus on medical practice

Change from subject-based to theme-based course content

Change from undergraduate to graduate course in some Universities

Change from focus on pure science medical science to focus on medical practice

Change from subject-based to theme-based course content

Reasons for Change to GMPReasons for Change to GMP

GMPs aimed at Greater student maturity Wider student life experience

GMPs aimed at Greater student maturity Wider student life experience

Reasons for Course Content ChangesReasons for Course Content Changes

Greater integration of medical science and medical practice

Greater focus on medicine as a community concern

Greater focus on patient-doctor interaction

Greater integration of medical science and medical practice

Greater focus on medicine as a community concern

Greater focus on patient-doctor interaction

University of Sydney Pre GMP University of Sydney Pre GMP Year 1

Biology, Chemistry, Physics, Mathematics

Year 2 Pharmacology, Human Biology. Biochemistry

Year 3 Microbiology & Immunology, Anatomy, Human Biology (Cell & Molecular), Biochemistry,

Clinical Statistics, Behavioural Sciences in Medicine, History & Philosophy of Medicine

Year 4 Anatomy, Histology & Embryology, Behavioural Sciences in Medicine, Medical

Communication, Physiology, Medical Biochemistry

Year 5 Infectious Diseases & Pharmacology, Medical Communication, Clinical Diagnosis,

Immunology, Pathology, Clinical Physiology, Neuroscience, Clinical Epidemiology

Year 6 Infectious Diseases, Pathology, Pharmacology,Public Health, Medicine, Surgery

Year 1 Biology, Chemistry, Physics, Mathematics

Year 2 Pharmacology, Human Biology. Biochemistry

Year 3 Microbiology & Immunology, Anatomy, Human Biology (Cell & Molecular), Biochemistry,

Clinical Statistics, Behavioural Sciences in Medicine, History & Philosophy of Medicine

Year 4 Anatomy, Histology & Embryology, Behavioural Sciences in Medicine, Medical

Communication, Physiology, Medical Biochemistry

Year 5 Infectious Diseases & Pharmacology, Medical Communication, Clinical Diagnosis,

Immunology, Pathology, Clinical Physiology, Neuroscience, Clinical Epidemiology

Year 6 Infectious Diseases, Pathology, Pharmacology,Public Health, Medicine, Surgery

University of SydneyUniversity of Sydney

Years 1-3 Basic and Clinical Sciences Patient & Doctor Patient and Community Personal and Professional Development

Year 4 Child & Adolescent Health Perinatal & Women’s Health Community Practice Psychological Medicine - Drugs & Alcohol Option

Years 1-3 Basic and Clinical Sciences Patient & Doctor Patient and Community Personal and Professional Development

Year 4 Child & Adolescent Health Perinatal & Women’s Health Community Practice Psychological Medicine - Drugs & Alcohol Option

Course Description: Learning in the University of Sydney Medical Program is integrated across disciplines and between years. Learning is based on clinical problems presented in tutorial settings.

Principal areas of study: Throughout its four years, the program is organised around four major themes rather than around specific subjects or disciplines. The emphasis is on progressive development across all four themes in the knowledge, skills and behaviour appropriate for a graduate. The themes form the basis both for the design of the curriculum, and for the assessment of student learning.

The themes are; basic and clinical science; community and doctor; patient and doctor; personal and professional development

University of Melbourne University of Melbourne

Semesters 1-5 (Years 1 - 3) Body Systems:

Basic Sciences in Medicine Human Mind & Behaviour in Health & Illness:

Health & Society Introduction to Clinical Medicine

Semesters 6 & 7 (Years 3-4) Choice of an option from: aboriginal health, adolescent health, medical ethics and the

law, laboratory research, international health, women’s health

Semesters 1-5 (Years 1 - 3) Body Systems:

Basic Sciences in Medicine Human Mind & Behaviour in Health & Illness:

Health & Society Introduction to Clinical Medicine

Semesters 6 & 7 (Years 3-4) Choice of an option from: aboriginal health, adolescent health, medical ethics and the

law, laboratory research, international health, women’s health

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CoursesCourses

University of Queensland Year 1

Foundations of Medical Practice + Elective

Year 2 Systematic preparation for Clinical Practice

Year 3 Core Clinical Rotations + Literature Review

Year 4 Core Clinical Rotations + Internship

University of Queensland Year 1

Foundations of Medical Practice + Elective

Year 2 Systematic preparation for Clinical Practice

Year 3 Core Clinical Rotations + Literature Review

Year 4 Core Clinical Rotations + Internship

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Phase 1 Foundations Society and Health Beginnings, Growth & Development Health Maintenance Ageing and Endings

Phase 2 Society and Health Beginnings growth and Development Health Maintenance Ageing and Endings Independent Learning Project

Phase 3 Clinical Modules

Phase 1 Foundations Society and Health Beginnings, Growth & Development Health Maintenance Ageing and Endings

Phase 2 Society and Health Beginnings growth and Development Health Maintenance Ageing and Endings Independent Learning Project

Phase 3 Clinical Modules

University of New South Wales

Change in Teaching MethodChange in Teaching Method

Change from didactic teaching to problem-based learning

Change from lecture based teaching to tutorial based teaching

Change from didactic teaching to problem-based learning

Change from lecture based teaching to tutorial based teaching

Reasons for Changes to Teaching Techniques

Reasons for Changes to Teaching Techniques

Shift in education philosophy from teaching as a passive process to learning as an active process

Evidence on effectiveness of problem-based learning

PBL became fashionable as an educational tool

Shift in education philosophy from teaching as a passive process to learning as an active process

Evidence on effectiveness of problem-based learning

PBL became fashionable as an educational tool

Summary of ChangesSummary of Changes

Selection change to target those with motivation, aptitude and interactive skills

Course change to cut back science units to increase focus on medical practice

Change in course delivery from didactic teaching to PBL to improve learning

Change in level of entry to increase maturity and experience

Selection change to target those with motivation, aptitude and interactive skills

Course change to cut back science units to increase focus on medical practice

Change in course delivery from didactic teaching to PBL to improve learning

Change in level of entry to increase maturity and experience

New System GraduatesNew System Graduates

Have the changes worked? Better communication skills Change in social skills? Change in clinical skills? Poorer clinical skills at AST level Greater confidence Lower career commitment

Have the changes worked? Better communication skills Change in social skills? Change in clinical skills? Poorer clinical skills at AST level Greater confidence Lower career commitment

Room for improvement - 1Room for improvement - 1

Pendulum has swung too far away from sciences Balance between science, social science needs

adjustment Argument that former level of scientific knowledge not

necessary is invalid Doctors are researchers and they can never have too

much evidence Emphasis on social sciences may be misplaced

because of the role of personality in human interaction

Pendulum has swung too far away from sciences Balance between science, social science needs

adjustment Argument that former level of scientific knowledge not

necessary is invalid Doctors are researchers and they can never have too

much evidence Emphasis on social sciences may be misplaced

because of the role of personality in human interaction

Room for improvement -2Room for improvement -2

Effectiveness of training in communication

and social skills poorly established

Selection procedures need improvement to target those with the social and communication skills required for medical practice

Effectiveness of training in communication

and social skills poorly established

Selection procedures need improvement to target those with the social and communication skills required for medical practice

Room for improvement -3Room for improvement -3

Better balance of theory and practice in medical sciences

Better balance of didactic and PBL teaching

Better balance of theory and practice in medical sciences

Better balance of didactic and PBL teaching

What the AOA is doingWhat the AOA is doing

Current: Orthopaedic Principles and Basic Science Exam as part of AST programme

Examined in Anatomy, Pharmacology, Bacteriology, Pathology, Biomechanics

Future: UG Committee working on national standard for curriculum in musculo-skeletal medicine which includes an increase in didactic teaching and practical sessions in

anatomy, biochemistry and physiology

Current: Orthopaedic Principles and Basic Science Exam as part of AST programme

Examined in Anatomy, Pharmacology, Bacteriology, Pathology, Biomechanics

Future: UG Committee working on national standard for curriculum in musculo-skeletal medicine which includes an increase in didactic teaching and practical sessions in

anatomy, biochemistry and physiology