New generation of medical graduates set out to address health disadvantage and disparity in WA

14/12/21. By Craig McKeough.

Curtin friends stand in front of the Curtin Medical School.

Thursday, November 26, 2021, was an auspicious day in Curtin’s history. On this date, Professor Sandra Eades presided over a Medical School Graduands Ceremony where the first cohort of 51 graduates took the oath to become medical doctors, committing themselves to practice their profession with conscience and dignity in the service of humanity, and to put their patients’ health first amongst all considerations.

Curtin’s position that equitable access to healthcare should be universal, irrespective of geographical location, has been embraced by the students, who rated Curtin’s medical school the best in Australia for the past three years in the Good Universities Guide, with five-star scores in the latest guide for learner engagement, learning resources, skills development, teaching quality and overall experience.

But the path to this point for the students and the University has been long and eventful, starting when the Council for Curtin University approved a proposal for the medical school in February 2009, based on a submission by Professors Jane den Hollander (Deputy Vice-Chancellor Academic) and Jill Downie (Pro Vice-Chancellor Health Sciences).

While establishing a third medical school in Western Australia has long been on Curtin’s agenda as a way to tackle a serious shortage of doctors in the State, the proposal drew considerable opposition from WA’s medical fraternity. However, after a long gestation, numerous revisions to the curriculum, and hard graft to put student support in place, the proposal won the support of State and Federal Governments, with the Commonwealth giving the final go-ahead in 2015.

A short two years later, Curtin Medical School opened to students, with 60 budding doctors stepping into the gleaming new building at Curtin Perth for the first time.

The new graduates of Curtin Medical School at last month’s ceremony.

Curtin Medical School has an obvious point of difference in that it is the only undergraduate medicine degree in Western Australia, complementing postgraduate medical courses at The University of Western Australia (UWA) and Notre Dame University.

Curtin also takes a different path in putting a high priority on enrolling rural and Indigenous students in the Bachelor of Medicine and Bachelor of Surgery course, and has a special emphasis on General Practice in all areas of the curriculum. These priorities are reflected in the leaders appointed as Dean and Head of School.

Professor William Hart was the Foundation Dean and an expert in rural health. His successor as Dean, Professor Sandra Eades, is a national leader in Indigenous health and one of the country’s first Indigenous medical graduates. Along with Associate Dean of Medicine, Professor Graeme Maguire, a clinician with a lifelong interest in health service delivery in rural and remote settings, the school has been in good hands.

Professor Sandra Eades speaking at the Curtin Medical School Graduands Ceremony.

Professor Sandra Eades said it is the deliberate focus on opportunities for students from rural and Indigenous backgrounds and preparing all students for careers in regional and remote areas that sets Curtin apart from other Australian medical schools. The School also aims to address the undersupply of doctors entering General Practice in both rural and outer metropolitan areas.

Professor Graeme Maguire said there was never a question that the Curtin course would result in an oversupply of doctors in WA.

“There certainly is not a problem with too many doctors in WA. The problem is in distribution and that is what we are trying to address with the Curtin Medical School,” Graeme says.

“We have big gaps in regional and remote areas – the Kimberley and Pilbara in particular.”

Curtin’s ambition to address this gap started with a decision to reserve 25% of student places for people from regional and remote backgrounds.

Curtin Association of Medical Students (CAMS) committee members, Christopher Chi and Chloe Lai.

Aligned with this approach is the concept of giving all students broad exposure to what it is like to live and work in rural areas.

“We set out to ensure that we gave kids from the bush every opportunity to study medicine,” Graeme says.

“And we aim to ensure that students have a positive experience of studying in the bush. We want them to see it as a viable and appealing option as a career path.”

All students get an early rural experience through a program in their second year where they spend one week in the WA Wheatbelt region, gaining exposure to local healthcare and clinical services, and also finding out something about the rural lifestyle by living with a local family.

One-quarter of Curtin students get to spend a year in the country as part of the Rural Clinical School – a combined program with the medical schools at UWA and Notre Dame University – and there is the opportunity in their final year to do placements with Aboriginal Controlled Community Health Services in regional areas. Several Aboriginal communities in Perth and around WA have joined with Curtin to tailor the training so all students gain strong skills and understanding of Aboriginal health.

Dancers from the Bindjareb Middars Indigenous Australian dance group perform a welcome dance for the Curtin Medical School graduates.

Curtin Kalgoorlie’s Rural Health Campus, which opened in August 2021, is earmarked to be a key part of Curtin Medical School’s regional learning opportunities, providing a Goldfields base for students to gain rural experience, and a training base for a range of allied health professions. Kalgoorlie is home to the Aboriginal Wongutha community, and the medical students are honoured to be connecting with them in a primary care setting.

Graeme hopes his own outreach work in the Kimberley, and on Christmas and Cocos Islands sets an example for students.

“It’s important that as leaders, we show students that we walk the talk, so they can see remote service is enjoyable. It is core and central to what we do.”

Curtin Medical School has also had an emphasis on taking tertiary education to parts of the Perth metropolitan area which lacked easy access to university.

Curtin opened its Midland campus adjacent to St John of God Hospital in November 2019, where some medical students are based for their fourth and fifth years.

The campus is a landmark development for Midland, as the first university facility in the eastern region which is home to communities experiencing high levels of socioeconomic disadvantage. Engagement in the region allows students to understand the impact of poverty on health.

Graduating students Jayde Frank and Raphin Hossain say Curtin has done a good job of incorporating regional and remote experiences into the curriculum, to the extent that the students accepted it as an integral part of their training and came to love the opportunities it provided.

Left to right: Vice Chancellor Harlene Hayne ONZM, 2021 Curtin Medical School Valedictorian Raphin Hossain and Dean of Curtin Medical School, Professor Sandra Eades.

Curtin University Midland Campus.

For Raphin, this included a year living in Port Hedland as part of the Rural Clinical School, which he describes as “an incredible experience”.

“I never really thought about regional and remote medicine until I came here,” Raphin says.

“In Sydney it is seen as a barrier, something that you might have to do to get your qualification, but there is a different mindset at Curtin. Students are really encouraged to look at regional and remote experiences as an integral part of their course.”

He says the approach changed his ideas around working in remote areas.

“Curtin built that foundation, and my experience in Port Hedland solidified it for me. I know now that I want to include working in regional and remote areas in my future career.”

He said it was an eye-opening experience in many ways, in particular the disparity between city and remote areas in terms of access to GPs.

“It helped me realise why health outcomes in some remote areas are the way they are. A lot of it comes down to a shortage of health professionals in these areas.”

Jayde Frank did her fourth-year residency at Royal Perth Hospital, but the period included a cumulative 12 weeks in regional and remote locations, including a week in Broome, and five weeks each at Margaret River and Laverton in the Goldfields.

“It gave me a great breadth of experience in different types of rural communities,” Jayde says.

“In Laverton I learnt how so much of the healthcare services are carried by passionate health professionals, especially GPs, who carry the weight of the community with them. It was really inspiring to see that level of commitment.”

Jayde Frank. Photo supplied by Jayde Frank.

The COVID-19 pandemic presented its own challenges for the students, disrupting their schedules during the final two years of on-site clinical experience. They were temporarily taken out of their hospital placements and the Rural Clinical School of WA was shut down for almost two months.

“We’ve been lucky that we haven’t been affected to the extent of other states,” Raphin says.

But he said the pandemic restrictions, including closed borders, did have an effect on mental health and provided additional stresses for students.

Even so, Jayde did see some upside in the COVID experience.

“It was actually exciting in an intellectual way to be a medical student during a pandemic,” she says.

“It was a great learning experience to be exposed to the COVID response in areas such as infectious diseases, public health messaging and the logistics around infection control.”

Professor Sandra Eades summed up the importance of the School, the students and the task ahead, in her opening address at the Medical School Graduands Ceremony.

“Every medical graduate in the room will remember the heady days of completing our medical degrees as a great milestone after years of sustained effort. Students, I wish you well as you take forward the foundation of your professional careers in medicine formed here at Curtin.

“Our graduates are our legacy and through future decades here in Western Australia and elsewhere, your work reflects the priority and urgency the University has placed on education to increase the pipeline of future doctors graduating here in Perth.”

With this foundation, the health of the WA community will be in good hands.

Inside the Curtin Medical School.

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