Investing in Indigenous medical education

As an Australian leader in Indigenous medical education, The University of Newcastle has graduated almost half the country’s Indigenous doctors

Yet, Indigenous doctors remain severely underrepresented. Right now, 204 Aboriginal and Torres Strait Islander doctors are practising in Australia. To reach population parity, this number must increase to 2,800.

On Monday 16 November, UON’s David Maddison Memorial Lecture brought together five health experts from across Australia to discuss the progress and barriers to improved Indigenous medical education.

Dr Sarah McEwan flew from Port Hedland, Western Australia to join the discussion. As an Aboriginal UON medicine graduate, Sarah has piercing insight and reams of personal experience to share. Here, she tells us why improved Indigenous medical education should be a high priority for every Australian.

Sarah, why should we be concerned about Indigenous health?

Australian Aboriginal and Torres Strait Islander people continue to have much poorer health and much shorter life spans than the population as a whole. The health disparity is stark and requires extensive attention. Increasing the number of Indigenous doctors is an issue of equity, and it could also help improve Indigenous health outcomes. There are still a very small number of Aboriginal and Torres Strait Islander doctors in Australia. Ideally it would be fantastic to see population parity.

Do you think Indigenous doctors help improve Indigenous health?

Perhaps it’s too soon to tell, but it appears that Aboriginal and Torres Strait Islander doctors act as “cultural brokers” between Aboriginal patients and the health system. This ensures our patients are cared for in a respectful, safe and secure way. Indigenous doctors offer a holistic medical perspective that is beneficial for all Australians, not just Indigenous people – such as placing increased emphasis on community wellbeing.

What advice would you give non-Indigenous doctors treating Indigenous patients?

It’s so important that all health professionals have an understanding of the Indigenous culture so they can be respectful and understanding. This will also make it easier to identify and overcome health problems. For example, it might be helpful to know that Aboriginal men are reluctant to admit their ill health, particularly in front of women. One step further would be to speak with Aboriginal patients in their own language – as simple as using local words for certain body parts. This way, Aboriginal patients can better understand potential harms or benefits of the procedures offered. It is also important to understand the importance families place on not using recently deceased patients names during sorry time or that some patients may also not eat red meat during this time as other examples.

There are also lots of ways to make Aboriginal people feel more comfortable in clinics, such as displaying Aboriginal artworks. Personally, I’d love to see more Aboriginal artwork within our hospitals and health clinics. I recently donated an artwork to our maternity unit which depicts an Indigenous woman during labour. It a breath taking, inspiring piece – I feel there should be more communication through art to ensure cultural safety.

Have you experienced racism during your medical career or education?

Yes, on many occasions. But I’ve used these situations to become a stronger and more well rounded person. I represent the major diversity of our Indigenous identity. I hope future generations of students and doctors won’t face racism of any kind, and that it becomes the norm to have Indigenous doctors in the workforce, rather than us being some “special” species as we are now.

As a UON graduate, I’m forever thankful to have been granted the opportunity to receive such a fantastic medical education within a supportive environment. However, my education experience wasn’t always rosy. Universities still battle racism among students, clinicians and even academics. There should be no place for racism in any shape or form, whether directly or indirectly through a lack of Indigenous cultural knowledge and understanding.

How can we improve Indigenous medical education?

Indigenous medical education has improved over the years, but there’s still a long way to go. Strategies for improvement could include tutoring and mentorship relationship building, investing in increased cultural awareness and creating a space for conversation between Indigenous and non-Indigenous students. Aboriginal and Torres Strait Islander Peoples have a diversity of cultures, experiences, histories and geographical locations. They are not a homogenous population, and this should be reflected in the design, delivery and evaluation of curricula.

I believe that there needs to be further in-depth, inspiring engagement with non-Indigenous clinicians to better tailor cultural awareness training to their needs, to assist in developing holistic, curious clinicians that take ownership over their learning in this area.

I believe that cultural awareness training should be tailored to the knowledge gaps of non-Indigenous clinicians and provided in a non-confrontational manner.

Information should be location specific and collaboratively delivered in a two-way respectful learning space. I think that everyone would gain more from cultural awareness training should it be targeted this way.

Watch the David Maddison Memorial Lecture 2015

Dr Sarah McEwan is a UON medicine graduate who currently works as a medical officer at Hedland Health Campus in Port Hedland, Western Australia. She holds a Fellowship of the Australian College of Rural and Remote Medicine and an Advanced Diploma from the Royal Australian College of Obstetrics and Gynaecology, amongst many other qualifications. In 2010, Dr McEwan was named the Rural Registrar of the Year for her commitment to rural practice and her dedication to providing high quality medical care to the remote communities in her region.

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