Health workforce maldistribution and shortages, and the oncoming tsunami of medical graduates are generating widespread discussions about the future of health and medical training in the context of moves towards health reform.
Professor Bruce Robinson, dean of medicine at the University of Sydney, has recently suggested that one solution may be to broaden the range of services involved in providing postgraduate medical education. The University of Melbourne’s Emeritus Professor David Penington recently urged the Feds to incorporate university hospitals into health reform.
Now Professor Peter Brooks, who has been a strong advocate of workforce reform and innovation, says it’s time to take the debate a step further.
“Recent contributions by Bruce Robinson and David Penington have highlighted some of the issues in relation to medical training and the importance of research and learning to our health system.
This should be strongly supported but the debate should go further . This is about health professional training – not just the training of doctors. Probably the most important thing that a health professional of today learns is to be able to work as part of a team.
This is how health care is delivered – not by individuals but by teams – and it is almost unethical for any practitioner to hold themselves forth as the ‘sole/independent ‘ health provider in a given situation.’Team’ learning needs to start early before the ‘siloed ‘ mentality develops – it should be an integral part of any health learning program be it nursing, medicine or allied health professional.
These program teach not only about the role that other health practitioners play in a patient journey but they should also develop a sense of respect for the other professions in the eyes of the learner. Interprofessional education can be taught anywhere but particularly in primary care and in the rural sector.
Bruce Robinson is correct, we need to move beyond the public teaching hospital and focus on the primary care and private sectors to provide health learning experiences. These will need to be resourced appropriately with both teaching space and personnel, but this investment will have huge benefits in terms of providing excellent learning opportunities at both an undergraduate and post graduate level.
It is also likely to promote a culture change in the approach of health professionals from ‘illth ‘ to health – learning how to promote health and prevent illness rather than learning entirely on a ‘ sick ‘ population.
The Government has recently established Health Workforce Australia with a significant funding stream for clinical placements and it would be unfortunate if these monies are used to continue the status quo in terms of learning opportunities.
This is exactly the sort of project that might gain from a consortium approach as partly outlined by David Pennington in his plea for University Teaching Hospitals. The model recently established in the UK – Academic Health Centres of Excellence – is a prototype and could be used to create health learning ‘communities’.
In this model the Government could put out a tender for provision of health education with clear guidelines to the bidders.
Consortia would need to demonstrate that they included public and private health facilities, universities, TAFEs, primary care organizations and general practices, post graduate colleges and professional organization and other health and education industry partners.
An important addition would be patients who would act as advocates for community learning.
Consortia would also need to demonstrate a governance structure that would deliver the required outcomes.
Contestability often provokes innovation and I would suggest that this type of approach would generate some very interesting ideas to move this whole learning agenda forwards. It is also likely to see the emergence of different models of health education across the country but all of course aspiring to excellence and the registration requirements of the various national registration authorities.
Underpinning all this is a need for all Australians to accept that every clinical interaction they have with a health professional is a learning opportunity and that if we are to continue to train some of the best qualified health professionals on the planet then they (the community) need to accept that teaching role and assist in training the health professionals of the future.”
• Peter Brooks has recently stepped down as Executive Dean Faculty of Health Sciences at the University of Queensland and is Professorial Fellow in the Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne