THE AUSTRALIAN PUBLIC MEDICINE MELTDOWN CONTINUES

Three more reports below on government control of medicine:

Universities producing doctors trained as social workers

University medical schools have filled their curriculums with "soft" subjects to such an extent they are now busy turning out a generation of "medical social workers and medical psychologists" instead of doctors. One of the country's top neurosurgeons warned that the decline of anatomy teaching was "a growing cause of concern, to the point of panic" among many surgeons, who felt powerless to stop the universities cutting traditional science subjects.

Leigh Atkinson, associate professor of neurosurgery at the University of Queensland, said the downgrading of science in favour of soft topics such as communication skills meant young doctors "haven't got the basics they have to build their medical thinking on". Professor Atkinson said junior doctors' understanding of anatomy was "very poor". "I think the people running the medical schools have to justify to the profession why they are changing direction, and what are the benefits of changing direction," he said. "It would seem they are trying to turn our medical students into glorified social workers... we are going to be producing medical social workers and medical psychologists."

Professor Atkinson said senior doctors "do not feel the universities are listening to the clinical colleges" about what skills medical students needed. "There's this big rush to see how much money they can get ... I think they are forgetting the basic principles."

The Weekend Australian on Saturday revealed widespread alarm among senior doctors over the decline in anatomy training to make way for "touchy-feely" subjects such as "cultural sensitivity". One group, the Australian Doctors' Fund, sent a dossier to the federal Government last week detailing its concerns.

Final-year Monash University medical student Michael Gardner said up to 25 per cent of his course was now focused on cultural sensitivity and other subjects such as ethics, law and "personal development". Sensitivity training taught students that some ethnic groups had "different expectations" of doctors, and that they should "be aware that things you say may be viewed in a different way than how you intend". A smaller module on personal development focused on "relaxation techniques" and "how to manage stress".

Education Minister Julie Bishop said she was "concerned by the issues raised" in the ADF submission, which will be considered in a current review of medical education.

Source




Medical schools in new alert on anatomy teaching

Three more doctors' colleges have raised concerns about the standard of teaching in medical schools, with one warning that doctors' skills risk being taken "back to the Middle Ages" by cutbacks to the basic sciences. Amid a continuing row over the downgrading of anatomy teaching, the Royal College of Pathologists of Australasia has opened a new front, warning that the problem extends to other basic sciences such as pharmacology and pathology, the study of the disease process. Anaesthetists, obstetricians and gynaecologists have added their voices to the concerns, saying the gaps now evident in junior doctors' knowledge raise questions over the extent to which they could practise safely if they did not do further training after university.

RCPA president Stewart Bryant said universities had slashed pathology tuition so much that many newly graduated doctors were "often quite unsure" what pathology tests they should order to confirm or exclude a diagnosis. "That's another fallout of this - it's something we are observing routinely," Dr Bryant said. "If you go back to the origins of the names of diseases, malaria means 'bad air'. Do we want to go back to believing malaria is caused by bad air, when modern medicine shows us it's caused by a parasite in the blood? "Pathology started 250 years ago and has taught us this basic information about the disease process - and we risk losing that, we risk going back to the Middle Ages."

The Weekend Australian last week revealed a coalition of senior doctors and academics had called on the federal Government to step in to sort out the "appalling" state of medical education. But the deans of the nation's 17 medical schools have strenuously denied their courses are failing to equip medical students with essential knowledge, and have accused critics of resisting necessary change. The Royal Australasian College of Surgeons is in talks to arrange remedial training courses in anatomy for junior doctors entering its own specialist training program, saying their anatomical knowledge was "unacceptably low".

The president of the Australian and New Zealand College of Anaesthetists, Michael Cousins, said the teaching of communication skills was important, but that graduates "need to have a fundamental knowledge of the major structures in the human body". "We are finding we have to do more work with students, especially those coming out of four-year programs, in bringing them up to speed," Professor Cousins said. "It raises some concern, I suppose, with us that the people who aren't coming to us for further education, but go out practising as doctors or GPs, may not necessarily have as much knowledge as they should have."

John Svigos, chairman of the training and accreditation committee of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, said almost all the colleges shared the concerns and would discuss them when college presidents meet later this month. John Carmody, who taught physiology and pharmacology at the University of NSW for more than 40 years, said many medical courses had now changed the sequence of education in a way that made it harder for students to apply the knowledge.

Source




Health bureaucrats at last get some blame

The Queensland Government has suspended three senior health bureaucrats, pending the outcome of an investigation by the Crime and Misconduct Commission (CMC). The Director-General of Queensland Health Uschi Schreiber referred the matters to the CMC last week after receiving new information from a doctor that raised concerns about possible misconduct. The Queensland Government was forced yesterday to apologise to Dr Chris Davis after he was disciplined for raising concerns about a nurse hired on fake qualifications and recommendations of her boyfriend. Health Minister Stephen Robertson said he had personally apologised to Dr Davis, who heads the rehabilitation and geriatric unit at Brisbane's Prince Charles Hospital. Mr Robertson said based on new information, Dr Davis had been given whistleblower status and his disciplinary record cleared.

A decision today by a delegate of the Public Service Commissioner found that Queensland Health had denied natural justice to the senior doctor as he was not given an opportunity to respond to a charge against him. Dr Davis was disciplined last September after raising concerns about the abilities of a nurse employed in a senior role in his unit. The nurse's competence also was questioned in a written document by 18 other staff members in the unit. The Opposition revealed yesterday the nurse had been hired despite presenting fake qualifications of a masters degree from a university in Tasmania where she had nursed in an old age home. It also said Queensland Health had failed to question the nurse's previous employer, interviewing only one referee who turned out to be her boyfriend.

Opposition health spokesman Dr Bruce Flegg said Dr Davis was "very distressed". "All his hard work to build the rehabilitation unit has been blown out of the water," Dr Flegg said. "Three-quarters of the staff has left and the unit is in disarray." The future of the nurse in question, who has been on leave without pay since last August, will be determined following the CMC report.

The case raises fresh concerns of bullying in Queensland Health, following the case of Bundaberg nurse Toni Hoffman whose complaints about rogue surgeon Jayant Patel were initially ignored....

More here

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