Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Time to establish comprehensive long-term monitoring of Australian medical graduates?

Christine Jorm A B , Jane Bleasel A and Inam Haq A
+ Author Affiliations
- Author Affiliations

A The University of Sydney, Edward Ford Building, NSW 2006, Australia. Email: jane.bleasel@sydney.edu.au; inam.haq@sydney.edu.au

B Corresponding author. Email: christine.jorm@sydney.edu.au

Australian Health Review - https://doi.org/10.1071/AH16292
Submitted: 20 December 2016  Accepted: 6 June 2017   Published online: 7 December 2017

Abstract

We believe that the well being of our medical students (and medical staff throughout the continuum of practice) matters too much not to ask, ‘How do they feel?’ Society, and students themselves, have invested too much in their education not to query ‘How well are they performing in the workplace?’. Our accountability to the community demands we ask, ‘How are their patients going?’ This article presents a schema for building long-term monitoring in Australia, using linked and reliable data, that will enable these questions to be answered. Although the answers will be of interest to many, medical schools will then be well placed to alter their programs and processes based on these three domains of graduate well being, workplace performance and patient outcomes.


References

[1]  Wilson A, Feyer A. Review of medical intern training – final report. Canberra: Council of Australian Governments; 2015. Available at: http://www.coaghealthcouncil.gov.au/portals/0/review of medical intern training final report publication version.pdf [verified 5 October 2016].

[2]  beyondblue. National mental health survey of doctors and medical students. October 2013. Melbourne: beyondblue; 2013. Available at: https://www.beyondblue.org.au/docs/default-source/research-project-files/bl1132-report---nmhdmss-full-report_web [verified 12 May 2016].

[3]  Rogers ME, Creed PA, Searle J. Emotional labour, training stress, burnout, and depressive symptoms in junior doctors. J Vocat Educ Train 2014; 66 232–48.
Emotional labour, training stress, burnout, and depressive symptoms in junior doctors.CrossRef |

[4]  Spittal MJ, Bismark MM, Studdert DM. The PRONE score: an algorithm for predicting doctors’ risks of formal patient complaints using routinely collected administrative data. BMJ Qual Saf 2015; 24 360–368.
The PRONE score: an algorithm for predicting doctors’ risks of formal patient complaints using routinely collected administrative data.CrossRef |

[5]  Duckett S, Breadon P, Romanes D. Questionable care: avoiding ineffective treatment. Melbourne: Grattan Institute; 2015.

[6]  Medibank Private and Royal Australasian College of Surgeons. Surgical variance report: general surgery. 2016. Available at: https://www.surgeons.org/media/24091469/Surgical-Variance-Report-General-Surgery.pdf [verified 22 June 2016].

[7]  The Medical Board of Australia. Good medical practice: a code of conduct for doctors in Australia. 2014. Available at: http://www.medicalboard.gov.au/Codes-Guidelines-Policies/Code-of-conduct.aspx [verified 6 July 2015].

[8]  Wilkinson D. A new paradigm for assessment of learning outcomes among Australian medical students: in the best interest of all medical students. Aust Med Student J 2014; 4 45–47.

[9]  ten Cate O, Billett S. Competency‐based medical education: origins, perspectives and potentialities. Med Educ 2014; 48 325–32.
Competency‐based medical education: origins, perspectives and potentialities.CrossRef |

[10]  Harrison C, Wass V. The challenge of changing to an assessment for learning culture. Med Educ 2016; 50 704–6.
The challenge of changing to an assessment for learning culture.CrossRef |

[11]  Geffen L. A brief history of medical education and training in Australia. MJA 2014; 201 S19–22.
A brief history of medical education and training in Australia.CrossRef |

[12]  Holmboe ES, Batalden P. Achieving the desired transformation: thoughts on next steps for outcomes-based medical education. Acad Med 2015; 90 1215–23.
Achieving the desired transformation: thoughts on next steps for outcomes-based medical education.CrossRef |

[13]  Australian Medical Council (AMC). Standards for assessment and accreditation of primary medical programs. Canberra: AMC; 2012.

[14]  Anonymous. Three of my colleagues have killed themselves. Medicine’s dark secret can’t go on. Sydney Morning Herald 10 February 2017. Available at: http://www.smh.com.au/comment/three-of-my-colleagues-have-killed-themselves-medicines-dark-secret-cant-be-allowed-to-go-on-20170209-gu9crd.html [verified 18 July 2017].

[15]  NSW Health Department. The clinician’s toolkit for improving patient care. Sydney: NSW Health Department; 2001. Available at: https://wdhb.org.nz/contented/clientfiles/whanganui-district-health-board/files/rttc_clinician-s-toolkit-for-improving-patient-care-nsw.pdf [verified 25 September 2017].

[16]  Nylenna M, Gulbrandsen P, Førde R, Aasland OG.. Unhappy doctors? A longitudinal study of life and job satsifaction among Norwegian doctors 1994–2002. BMC Health Serv Res 2005; 5 44
Unhappy doctors? A longitudinal study of life and job satsifaction among Norwegian doctors 1994–2002.CrossRef |

[17]  Mahmood JI, Grotmol KS, Tesli M, Vaglum P, Tyssen R. Contextual factors and mental distress as possible predictors of hazardous drinking in Norwegian medical doctors: a 15-year longitudinal, nationwide study. Eur Addict Res 2007; 23 19–27.
Contextual factors and mental distress as possible predictors of hazardous drinking in Norwegian medical doctors: a 15-year longitudinal, nationwide study.CrossRef |

[18]  Kaur B, Carberry A, Hogan N, Roberton D, Beilby J. The medical schools outcomes database project: Australian medical student characteristics. BMC Med Educ 2014; 14 180
The medical schools outcomes database project: Australian medical student characteristics.CrossRef |

[19]  Muller D. Kathryn. N Engl J Med 2017; 376 1101–3.
Kathryn.CrossRef |

[20]  Billett S. Developing students’ personal epistemologies. Integrating practice-based experiences into higher education. Haarlem: Springer; 2015.

[21]  Wald HS, Anthony D, Hutchinson TA, Liben S, Smilovitch M, Donato AA. Professional identity formation in medical education for humanistic, resilient physicians: pedagogic strategies for bridging theory to practice. Acad Med 2015; 90 753–60.
Professional identity formation in medical education for humanistic, resilient physicians: pedagogic strategies for bridging theory to practice.CrossRef |

[22]  Richards J, Sweet LP, Billett S. Preparing medical students as agentic learners through enhancing student engagement in clinical education. Asia-Pac J Coop Educ 2013; 14: 251–263.

[23]  Rogers ME, Creed PA, Searle J, Nicholls SL. Coping with medical training demands: thinking of dropping out, or in it for the long haul. Stud High Educ 2015; 41 1715–32.
Coping with medical training demands: thinking of dropping out, or in it for the long haul.CrossRef |

[24]  Lumley S, Ward P, Roberts L, Mann JP. Self-reported extracurricular activity, academic success, and quality of life in UK medical students. Int J Med Educ 2015; 6 111–17.
Self-reported extracurricular activity, academic success, and quality of life in UK medical students.CrossRef |

[25]  Stern DT, Frohna A, Gruppen L. The prediction of professional behaviour. Med Educ 2005; 39 75–82.
The prediction of professional behaviour.CrossRef |

[26]  Carr SE, Celenza A, Puddey IB, Lake F. Relationships between academic performance of medical students and their workplace performance as junior doctors. BMC Med Educ 2014; 14 157
Relationships between academic performance of medical students and their workplace performance as junior doctors.CrossRef |

[27]  Dean SJ, Barratt AL, Hendry GD, Lyon PM. Preparedness for hospital practice among graduates of a problem-based, graduate-entry medical program. Med J Aust 2003; 178 163–6.

[28]  Burford B, Whittle V, Vance GH. The relationship between medical student learning opportunities and preparedness for practice: a questionnaire study. BMC Med Educ 2014; 14 223
The relationship between medical student learning opportunities and preparedness for practice: a questionnaire study.CrossRef |

[29]  Goodyear HM. First year doctors experience of work related wellbeing and implications for educational provision. Int J Med Educ 2014; 5 103–9.
First year doctors experience of work related wellbeing and implications for educational provision.CrossRef |

[30]  Illing JC, Morrow GM, Rothwell nee Kergon CR, Burford BC, Baldauf BK, Davies CL, Peile EB, Spencer JA, Johnson N, Allen M, Morrison J. Perceptions of UK medical graduates’ preparedness for practice: a multi-centre qualitative study reflecting the importance of learning on the job. BMC Med Educ 2013; 13 34
Perceptions of UK medical graduates’ preparedness for practice: a multi-centre qualitative study reflecting the importance of learning on the job.CrossRef |

[31]  Bingham CM, Crampton R. A review of prevocational medical trainee assessment in New South Wales. Med J Aust 2011; 195 410–12.
A review of prevocational medical trainee assessment in New South Wales.CrossRef |

[32]  Carr SE, Celenza T, Lake FR. Descriptive analysis of junior doctor assessment in the first postgraduate year. Med Teach 2014; 36 983–90.
Descriptive analysis of junior doctor assessment in the first postgraduate year.CrossRef |

[33]  Katelaris AG, Jorm C. Improved assessment needed for young doctors. Med J Aust 2011; 195 369
Improved assessment needed for young doctors.CrossRef |

[34]  Scott G, Chang E, Grebennikov L. Using successful graduates to improve the quality of undergraduate nursing programs. J Teach Learn Grad Employ 2010; 1 26–44.
Using successful graduates to improve the quality of undergraduate nursing programs.CrossRef |

[35]  Shah M, Grebennikov L, Nair CS. A decade of study on employer feedback on the quality of university graduates. Qual Assur Educ 2015; 23 262–78.
A decade of study on employer feedback on the quality of university graduates.CrossRef |

[36]  Cutler D, Skinner J, Stern AD, Wennberg D. Physician beliefs and patient preferences: a new look at regional variation in health care spending. Cambridge, MA National Bureau of Economic Research; 2013.

[37]  Reschovsky JD, Rich EC, Lake TK. Factors contributing to variations in physicians’ use of evidence at the point of care: a conceptual model. J Gen Intern Med 2015; 30 555–61.
Factors contributing to variations in physicians’ use of evidence at the point of care: a conceptual model.CrossRef |

[38]  Lambert DR, Lurie SJ, Lyness JM, Ward DS. Standardizing and personalizing science in medical education. Acad Med 2010; 85 356–62.
Standardizing and personalizing science in medical education.CrossRef |

[39]  Cook DA, West CP. Perspective: reconsidering the focus on ‘outcomes research’ in medical education: a cautionary note. Acad Med 2013; 88 162–7.
Perspective: reconsidering the focus on ‘outcomes research’ in medical education: a cautionary note.CrossRef |

[40]  Asch DA, Nicholson S, Srinivas S, Herrin J, Epstein AJ. Evaluating obstetrical residency programs using patient outcomes. JAMA 2009; 302 1277–83.
Evaluating obstetrical residency programs using patient outcomes.CrossRef | 1:CAS:528:DC%2BD1MXhtFylsb%2FI&md5=5e775769fdef7b95c2dc1a95fa6c9182CAS |

[41]  Chen C, Petterson S, Phillips R, Bazemore A, Mullan F. Spending patterns in region of residency training and subsequent expenditures for care provided by practicing physicians for Medicare beneficiaries. JAMA 2014; 312 2385–93.
Spending patterns in region of residency training and subsequent expenditures for care provided by practicing physicians for Medicare beneficiaries.CrossRef | 1:CAS:528:DC%2BC2MXit1Ogtr8%3D&md5=566099ec17a77951cbddfe6d6cc8b0d3CAS |

[42]  Feldman K, Chawla NV. Does medical school training relate to practice? Evidence from big data. Big Data 2015; 3 103–13.
Does medical school training relate to practice? Evidence from big data.CrossRef |

[43]  Harden RM. What is a spiral curriculum? Med Teach 1999; 21 141–3.
What is a spiral curriculum?CrossRef | 1:STN:280:DC%2BC3M7ltl2ruw%3D%3D&md5=2262adf5108c14ac02cf9c712677fb6dCAS |



Export Citation

View Altmetrics