Early and Sustained Clinical Experience:
Part of the School of
Medicine's Tradition
It is twenty five years since the School of Medicine admitted its first students. The School was located within Flinders Medical Centre, making it the first Australian purpose built academic medical centre and beginning the continuing concern with teaching, patient care and research. Early clinical contact has been a feature of the medical course since its inception and was one of the first principles adopted when the School moved to a graduate entry course in 1996. The Australian Medical Council described the latter course as a 'blueprint for the future delivery of medical education'.
In Years 1 and 2 one quarter of the medical course is devoted to Doctor and Patient where students learn communication skills, history taking and physical examination. Within weeks of starting the course students are placed in general practices and hospital wards to learn and develop the hands on skills required of doctors. This continues throughout the whole of years 1 and 2 and is closely related to the problem-based cases from which students develop their knowledge of health and illness. In the final 4 weeks of year 2 all students undertake a four week clinical skills consolidation block at either Flinders Medical Centre or the Repatriation General Hospital to fine tune their clinical skills before entering year 3. This includes an intensive involvement in bedside tutorials, outpatient clinics and ward attachments and is described by students as 'overall excellent' and 'worthwhile' preparation for clinical practice.
Years 3 and 4 are spent wholly in clinical contexts.Students undertake rotations in Medicine, Surgery, Women's and Children's Health and General Practice, as well as studying Liaison Psychiatry. Students gain intensive clinical experiences as a member of a ward team supported by tutorials, outpatient sessions, bedside learning and one-on-one teaching and guidance. Recently the range of options available to students has expanded. Up to fifteen students take year 3 in the Northern Territory Clinical School centred in the Royal Darwin Hospital, a community hospital with a broad mix of patient presentations and conditions. Another eight students can opt for the innovative Parallel Rural Community Curriculum where they spend the whole year in rural general practices and associated hospitals. Students become well integrated into the local community and local health professional networks.
Student internships are the basis for year 4. Students are given increasing responsibilities in clinical contexts in Acute Care, Ambulatory, Rural and Mental Health settings. The emphasis is placed on gaining practical and relevant experience which is built upon the sound academic foundations of the first three years. There is a great deal of choice of location in urban and rural South Australia and the Northern Territory. Students value the diversity of experience available to them. Up to 12 weeks can be spent on electives either in Australia or overseas where students can pursue special interests while gaining knowledge and experience in other health systems.
The graduates of the School of Medicine are well recognised
for their competence in clinical skills. At the end of
their course
they are well prepared for the demands of internship and
subsequent medical practice. This is directly attributable
to the early
and
sustained clinical contact which is a fundamental part
of the medical course.
