MEDICAL EDUCATION The new Australian medical schools: daring to be different Kerrie A Lawson, Mabel Chew and Martin B Van Der Weyden This is an extraordinary opportunity and very exciting, say the Deans of the new medical schools ith so many changes in medical education in the past “entirely free of government subsidy and influence”, said Chris Del decade in Australia and overseas, we might have Mar, Bond). The new schools are also bringing an academic Wexpected a period of consolidation and stability. Not so, presence to the medical community in regions where this has for seven new Australian medical schools are now at various stages previously been lacking. of development. Except for the James Cook University medical The schools are small, with intakes about, or even slightly below, school in north Queensland, which opened in 2000, these are the 80 students per year — sometimes deemed to be the “critical mass” first new medical schools in Australia in 30 years. We talked to the to sustain a medical school (Box). But small size may have DeansThe of theMedical five schools Journal which of Australia are closest ISSN: to 0025- opening to find what advantages (“the Dean might even know your name”, said Paul has been729X happening 6/20 December and what 2004 they 181 hope11/12 to 662-666 achieve. Gatenby [ANU]). All the new schools lack the traditional depart- The©The schools Medical are marked Journal by theirof Australia differences, 2004 not only from most mental structure. They emphasise collaboration, and are harness- of ourwww.mja.com.au established medical schools, but also from each other. These ing teaching and learning resources in innovative ways from within differencesMedical lie Education not in their curricula and courses, which incorpo- their universities, their local communities, around Australia and rate many recent reforms in medical education, but in the ways the internationally. new schools are structuring themselves and harnessing resources “The emergence of the new schools is clearly being driven by for delivering the curricula, as well as in their priorities and the workforce issues”, said Judy Searle (Griffith). They have a commit- specific qualities they wish to foster in their graduates. ment to fill particular workforce needs, local or national. Because of their responsiveness to local needs and dependence on local resources, each school is unique. What are the new schools and why are they needed? First to open was the Australian National University (ANU) in Canberra, which enrolled its first students in 2004 and is taking Courses and curricula: no need to reinvent the wheel over the Canberra Clinical School facilities from the University of The new schools are incorporating the recent reforms in medical Sydney. Griffith University and Bond University on Queensland’s education. All will provide curricula with problem-based, self- Gold Coast, and the University of Notre Dame Australia in directed learning; horizontal integration between disciplines; verti- Fremantle, Western Australia, plan to take their first students in cal integration between basic and clinical sciences; early exposure 2005, the University of Wollongong in 2006, and the University of to patients; and increased emphasis on communication skills, Western Sydney in 2007. A medical school at the proposed Sydney ethics, and personal and professional development. campus of the University of Notre Dame has been announced, but However, the new schools “are not reinventing the wheel”, said its exact status is unclear. Iverson (Wollongong). All are obtaining a curriculum from an We interviewed the Deans of Medicine at ANU, Griffith, Bond established medical school and modifying it for local conditions: and Notre Dame. At Wollongong, the Dean of Medicine, John Griffith from Flinders University, Notre Dame from the University Hogg, was yet to assume full-time duties, and we spoke instead to of Queensland, the ANU and Bond from the University of Sydney, Don Iverson, Dean of the School of Health and Behavioural and Wollongong from a UK medical school. Iverson explained that Sciences, who has overseen the planning of the new medical Wollongong has turned overseas as it plans a model he believes is school, and to key faculty members. As the Western Sydney school new to Australia — a community-based medical school, which appointed its Dean, Neville Yeomans, in October 2004, and had conducts most of its clinical teaching in the community rather yet to develop the details of curriculum, location and student than in hospitals. This model is most developed in the United numbers, it was not included in our survey. Kingdom. The new schools are fostering diversity, bringing their programs Four of the new schools will also follow the lead of Flinders, to an even broader range of institutions than the traditional Queensland and Sydney in offering a 4-year graduate-entry pro- “sandstone” universities. The ANU is one of Australia’s “group of gram, creating a more equal balance between graduate and eight” research-oriented, capital-city-based universities (and the undergraduate medical programs in Australia. Bond will offer a 5- last of these to open a medical school), whereas the other four year undergraduate course, but this will be similar to the graduate- universities are regional, and two are private — the Catholic entry program, preceded by a “science-heavy, case-based first year” University of Notre Dame and Bond University (the former having to bring school-leavers up to the necessary level, said Del Mar. some Commonwealth-subsidised places, but the latter being The new graduate schools are also adopting the now almost universal criteria for graduate entry — grade-point average in a The Medical Journal of Australia, Sydney, NSW. first degree, performance in the GAMSAT (Graduate Australian Kerrie A Lawson, PhD, Assistant Editor; Mabel Chew, FRACGP, Medical School Admissions Test) and interview. The differences FAChPM, Deputy Editor; Martin B Van Der Weyden, MD, FRACP, from established graduate schools will be in the details: for FRCPA, Editor. example, whether all criteria must be satisfied individually or may Correspondence: Dr Kerrie A Lawson, The Medical Journal of Australia, be combined, and, in particular, the content and weighting of the Locked Bag 3030, Strawberry Hills, NSW 2012. interview. For instance, at Wollongong, the planned weighting [email protected] reflects the school’s aim that 30% of its students should come from 662 MJA • Volume 181 Number 11/12 • 6/20 December 2004 MEDICAL EDUCATION structures. In keeping with the principle of integrating the disci- plines, the schools are not setting up traditional discrete depart- ments. Nor do they expect to derive all their expertise and resources from within the medical school. Instead, they are drawing on the resources of the parent university and, where necessary, forming collaborations with other institutions, locally THE AUSTRALIAN NATIONAL UNIVERSITY and further afield. Canberra, ACT For example, at Griffith, which already has many health stu- 10-year goals: dents (especially in physiotherapy), the medical school will be one of 11 schools, including dentistry and pharmacy, consolidated into • For the school to hold its own in teaching and a new Health Group. Within this group, academics will be research at the ANU. organised into “discipline clusters”, said Searle. The medical school will draw on clusters in the Health Group and the Science Group • To be seen as the Dean: Paul Gatenby principal source of for subjects such as biochemistry, physiology and microbiology. Alma mater: University of medical graduates for This has the added advantage of allowing cross-fertilisation, said Tasmania the region. Searle. Where more specialised expertise or resources are required, the school is appointing academics who report directly to the Dean Previously: Associate Dean of • To provide leadership Medicine, Canberra in medical education. (eg, in molecular pathology, anatomy and paediatrics). The univer- Clinical School, and sity has pre-existing excellent “wet” anatomy laboratories, and the Director of ACT school is setting up a pathology laboratory and museum. Pathology Bond, which lacks other health courses, is following the prin- Discipline: Clinical immunology ciple of obtaining expertise through appointments direct to the school — many part-time — and providing resources through collaborations with other institutions. For example, Bond will rent pathology resources from the Queensland University of Technol- a rural, regional or remote background. In addition, the ANU has a ogy, and, for anatomy, the University of Queensland laboratories pathway whereby high-achieving school-leavers enrolling at the for a week of intensive dissection to complement prosected university in other disciplines may be interviewed and guaranteed specimens, computer simulations and high-fidelity medical imag- a place in the medical school when they graduate, provided they ing. Bond is also keen to collaborate with nearby Griffith medical pass the GAMSAT. school. Entry criteria at Bond are similar to those at other undergraduate schools, comprising the UMAT (Undergraduate Medicine and Clinical teaching: doing more with less Health Sciences Admission Test), school academic achievement and interview. Fees are about $45 000 per annum, and Bond, like Availability of patients for clinical teaching is an increasing concern the other new medical schools, is actively seeking support for for medical schools in developed