MSCV: Working to ensure quality clinical education

Australia’s doctor shortage has developed into a sizeable issue over past years. Many solutions have been proposed to tackle this growing problem. Strong advocacy on the issue has been successful with a large increase in medical student places across Australia; however, this has left Victoria, like many other states, with the enormous challenge of accommodating the increasing numbers of medical students while maintaining quality clinical placements and medical education.

Medical students from the University of Melbourne and Monash University have been acutely aware of this issue since the increased numbers were announced and seek reassurance through demonstrated action that the increasing numbers of medical students can be accommodated without compromising the high quality medical education and training that our future patients deserve. With the opening of the Deakin Medical School this year, leadership groups from the three Victorian Medical Student Societies have formed the Medical Student Council of Victoria (MSCV) to advocate for medical students at the State level. The MSCV works closely with the Australian Medical Students’ Association (AMSA) which campaigns for quality medical education and clinical training at the Federal level. The Medical Student Society President and AMSA Representative from each University sit on both the AMSA Council and the MSCV.

Representatives from MSCV currently sit on several committees including working parties of the Department of Human Services, the Postgraduate Medical Council of Victoria, Junior Medical Officer Forum and focus groups considering medical student welfare, medical education and clinical training. The MSCV greatly appreciates the support from AMA Victoria and has representation at AMA Victoria Council meetings and at the AMA Doctors-in-Training subdivision meetings.

The beginning of 2008 has been extremely busy on the advocacy front for MSCV. The Ministerial Review on Victorian Public Health Medical Staff was disappointing, with less focus on education and training and preparation of Victoria’s workforce for increasing medical students than expected. MSCV responded to the Minister with encouragement to take up recommendations in the Review relevant to education and training but emphasised that more has to be done to tackle these issues.

In addition, with the Australian Health Care Agreements (AHCA) being negotiated, MSCV wrote to the Minister urging education and training to be a priority issue. Action is crucial for outcomes to be achieved and MSCV believes that education and training indicators should be included in the AHCAs. Similar sentiments will be echoed in our submission to the National Health and Hospital Reform Commission which will include measures MSCV believes are required to provide a safe and competent workforce in the short and long term.

While the increased number of trainees coming through the system requires much consideration to provide sustainable and quality education in the short and long term, MSCV would strongly support moves to:

• Provide high-quality clinical training places for all Victorian undergraduate medical students, regardless of their enrolment status as CSP, fee-paying or international.
• Recognise dedicated teaching time for employees of Victorian public hospitals and provide training and increased remuneration for clinical teachers in order to facilitate positive attitudes towards teaching and to encourage the teaching culture in the profession.
• Guarantee a number of medical intern positions that is at least commensurate with the number of graduating Australian CSP and fee-paying students from Victorian medical schools. Intern places for International students training in Australia would also be welcomed.
• Expand into alternative settings or alternative modes of learning (e.g. simulation) dependent on adequate supervision and support for students and required infrastructure. Experience in the acute hospital setting is still a crucial part of clinical placements.
• Recognise the increased number of doctors training through the system with a sufficient number of Hospital Medical Officer (HMO) 2 and HMO 3 positions to absorb the increase in intern numbers. An increase in vocational training positions (i.e. registrar level appointments) in Victorian public and private hospitals so to avoid bottle-necks at the HMO3/HMO4 level. 

While many stakeholders have recognised the need to accommodate increasing numbers of medical students and provide quality clinical training, further action is required. Practical ideas such as training in alternative clinical settings are acknowledged but lack funding or drivers to be implemented across the State. Other aspects, including defining quality clinical placements, need to be considered in more depth.

There is much work to be done to prepare for our incoming medical students, indeed, the ‘flood-waters’ are already rising. Increased funding, implementation of projects, teamwork with clarity, and working in division of responsibility with various stakeholders for the different aspects of clinical training are key to moving forward.

The MSCV will continue to work with stakeholders to progress these issues. Victoria must provide quality clinical training for our medical students and ensure that our graduating students are safe and competent to care for our patients.

http://mscv.ummss.org.au/

Christine Mandrawa, Chair, MSCV
Lachlan Batty, Monash AMSA/MSCV Representative