Name: Expanding access to health professional education
Uploaded: 2023-11-15T04:42:55.582Z
Duration: 542.24

Prof.mp4

Prof.vtt

Subtitles

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So we've had to be very

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careful to make sure that

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all of the changes we've made

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are robust and defensible

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and serve our deliberate

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strategy, which is widening

{{00:00:15}}
access to health professional

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education and making our

{{00:00:19}}
medical cohort look more like

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the communities it serves.

{{00:00:38}}
So Deakin University School

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of Medicine was, formulated

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about 17, 18 years ago,

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and it was deliberately

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not placed in Melbourne.

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the headquarters is

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in Geelong, which at

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that time was actually

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quite a regional town.

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it's become a bit

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more urban since.

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But right from the very

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beginning, the Deakin School

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of Medicine was meant to

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be something different

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from the other medical

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schools in Melbourne.

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We had a commitment to  rural

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and regional healthcare

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and the communities

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of Melbourne, western

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Victoria in particular.

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And also as the school

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has come to formulate its

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mission, we've had a focus

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on  serving,  diverse and

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marginalized communities

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across Victoria and especially

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across Western Victoria.

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What we've been working

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on  especially in the last

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three or four years is giving

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back to the communities in

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Western Victoria where our

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students train and trying our

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very best to make sure that

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we can provide  healthcare

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workers and doctors in

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particular who will work in

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and serve those communities.

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We had a look at the school's

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performance  from its first

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eight years of graduates

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and what we found was that

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in fact something, only

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something like about 16

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percent of our graduates

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were  working rurally,  an

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average of about five years

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after they left our program

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and that was clearly not what

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we were trying to achieve.

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So what we've been focusing

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on lately  was, trying

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to make sure that we can

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recruit our graduates or our

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students  from the communities

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that we want them to serve.

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so we introduced a thing

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called a rural training

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stream a couple of years ago.

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What that means is that

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we've  set aside,  30 of

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our 120 or so Commonwealth

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supported medical places

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only for students from

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a rural background.

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initially,  those students

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had to meet the same entry

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requirements as  the rest of

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the cohort  but they were only

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competing with each other in

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a little pool of their own.

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we, we developed three tiers.

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The first tier was defined

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geographical footprint in

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rural Western Victoria.

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The second tier was the rest

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of rural Victoria, and then

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the third tier would have been

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the rest of rural Australia,

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but we've never actually

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had to go to the third tier.

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In the first  year that

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we  ran the rural training

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stream, we found that we

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got 20 of the 30 places

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filled from rural Western

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Victoria from the first year.

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And the remaining 10 came

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from the rest of  the

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rural parts of our state.

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In the second year, though, we

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clearly found the low hanging

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fruit already because we only

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had 10 students coming from

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Western Victoria, the other

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20 from the rest of Victoria.

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And so we went to the

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communities and we

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tried to find out...

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what the barriers were to

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people from rural Western

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Victoria joining our Graduate

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Entry Medical Program.

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And the communities we talked

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to told us that the GAMSAT

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exam, the Entry Exam for

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Medicine, was a barrier, and

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that the so called 10 year

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rule, which means that we,

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people have to prove that

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they've done some university

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study in the last 10 years

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was also a barrier, but

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perhaps the most important

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one was the fact that people

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had to move to Geelong for the

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first two years of the medical

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program before then doing

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their clinical training years

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three and four in a rural

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clinical school and for people

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who had lives and families in

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the rural part of the state

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that was a big barrier.

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So this year, we've

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implemented some further

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changes for, just for our

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rural footprint in rural

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Western Victoria, the

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communities that we serve.

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We've removed that

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GAMSAT requirement.

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We've also removed

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the so called 10 year

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rule requirement.

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And most importantly, We're

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going to be offering  those

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first two years of our

{{00:04:27}}
medical program without people

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needing to move to Geelong.

{{00:04:31}}
we used to think that you

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could only run the first

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part of a medical program

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in an urban setting.

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but then COVID showed us

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that wasn't true at all,

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that you don't have to do

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everything face to face,

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that students can actually

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learn a lot of their medical

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program, by no means all

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of it, but a lot of it,

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from home, online.

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so what we've done is set

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up  some rural training

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campuses, one in Ararat

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and one in Warrnambool.

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And 15 of those 30 rural

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training stream students next

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year will do their face to

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face learning in Ararat, and

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the other 15 in Warrnambool.

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This is part of a larger

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thrust  by our school to try

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to widen access to health

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professional education

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for people from non

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traditional backgrounds.

{{00:05:17}}
We've got a strong belief

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that if our medical graduate

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cohort looks more like the

{{00:05:22}}
communities it's going to

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serve  then those communities

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will get better service.

{{00:05:26}}
And there is some evidence

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to suggest that that's the

{{00:05:29}}
case, that if you recruit

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for diversity, then you're

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actually more likely to get

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people with a real sense of

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vocation for medicine, and

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people who will choose the

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specialties that our community

{{00:05:39}}
actually needs, like general

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practice or rural generalism.

{{00:05:42}}
It has been challenging

{{00:05:43}}
to start to implement

{{00:05:44}}
these changes.

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I think, medicine in

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particular is a fairly

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conservative profession

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and is people of privilege,

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largely, and whenever you

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seek to  unsettle privilege,

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privilege fights back.

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And I think,  it is the

{{00:06:02}}
case that entry to medicine

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is incredibly competitive.

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And when people  miss

{{00:06:08}}
out on a position in the

{{00:06:09}}
medical program  they can

{{00:06:11}}
become quite litigious.

{{00:06:12}}
So we've had to be very

{{00:06:13}}
careful to make sure that

{{00:06:14}}
all of the changes we've made

{{00:06:16}}
are robust and defensible

{{00:06:18}}
and serve our deliberate

{{00:06:20}}
strategy, which is widening

{{00:06:22}}
access  to health professional

{{00:06:24}}
education and making our

{{00:06:25}}
medical cohort look more like

{{00:06:26}}
the communities it serves.

{{00:06:28}}
Partnerships have been really

{{00:06:30}}
important  in bringing about

{{00:06:32}}
this, widening of access

{{00:06:34}}
to health professional

{{00:06:35}}
education and our medical

{{00:06:36}}
program in particular.

{{00:06:38}}
we partner with rural health

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services, with general

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practices and also with the

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communities, the towns, the

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small towns, the regional

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towns that we work in.

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We've done community

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development workshops.

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We have a community advisory

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board with members from

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each of the small towns

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where our students study.

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and we have lots of

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discussions and negotiations

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with the health services

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that our students study in.

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it's really important

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to develop that

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sense of partnership

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for the health services,

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of course, we're looking to

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provide the healthcare workers

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that they so desperately need.

{{00:07:14}}
So they're keen to partner

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with us, but we need to go

{{00:07:16}}
about it carefully and talk

{{00:07:18}}
things through, make sure

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that we have those training

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positions available for the

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students that we recruit.

{{00:07:24}}
We're fairly early in  in

{{00:07:26}}
developing these programs, so

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it's too early for us to have

{{00:07:29}}
seen  outcomes in relation

{{00:07:32}}
to patient care just yet.

{{00:07:33}}
But the evidence

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internationally is growing

{{00:07:36}}
that if you do recruit  a

{{00:07:38}}
more diverse cohort into

{{00:07:41}}
health professional and

{{00:07:42}}
medical training  you

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gain a group of  students

{{00:07:46}}
who have a real vocation for

{{00:07:48}}
medicine, who are interested

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in the good that they can

{{00:07:51}}
do in the world  rather than

{{00:07:54}}
perhaps enriching themselves,

{{00:07:56}}
and there's some emerging

{{00:07:57}}
evidence to suggest that if

{{00:07:58}}
you do recruit for diversity,

{{00:08:00}}
then the people who graduate

{{00:08:02}}
from your program  are more

{{00:08:04}}
likely to have a strong sense

{{00:08:06}}
of vocation, that want to

{{00:08:07}}
do good in the world, and

{{00:08:08}}
will therefore choose the

{{00:08:09}}
specialties that the community

{{00:08:11}}
actually needs, like general

{{00:08:12}}
practice and psychiatry

{{00:08:14}}
rather than perhaps the

{{00:08:16}}
specialty that will do them

{{00:08:17}}
the most, the most good.

{{00:08:19}}
And I think that, that

{{00:08:20}}
principle, that  approach to

{{00:08:22}}
recruiting for diversity is

{{00:08:24}}
something that many health

{{00:08:26}}
professional education

{{00:08:27}}
institutions around the

{{00:08:28}}
world could  could focus on.

{{00:08:31}}
we're in a, in a unique

{{00:08:32}}
position because we're one of

{{00:08:33}}
three universities in Victoria

{{00:08:35}}
to offer medical training.

{{00:08:37}}
The other two are based in the

{{00:08:38}}
capital city, so the people

{{00:08:40}}
who traditionally  gone into

{{00:08:43}}
medical training, do have

{{00:08:44}}
those other options, which

{{00:08:45}}
gives us a little freedom

{{00:08:46}}
to be rather different

{{00:08:47}}
and to, unsettle the usual

{{00:08:50}}
way of doing things and

{{00:08:53}}
aim at a wider cohort

{{00:08:54}}
into our medical program.

Expert Insight

In this insightful interview, Professor Gary D. Rogers, Dean of the School of Medicine at Deakin University, discusses the deliberate strategies and initiatives undertaken to widen access to health professional education. 

From the unique position of Deakin's School of Medicine, deliberately situated in Geelong to serve rural and regional healthcare needs, Prof. Rogers sheds light on the evolution of their mission and the challenges faced in achieving their goals.


Healthcare

Health Systems

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GaryRogersHeadshot2.jpg

Gary D. Rogers

Professor & Dean

 Strategies and initiatives implemented by Deakin University's School of Medicine