Young doctors fare better after graduate medical training

Interns who have studied medicine in a new graduate-entry program, after completing an undergraduate degree, are at least as well prepared for their intern year as their counterparts who studied medicine as an undergraduate degree, according to research released in the most recent edition of the Medical Journal of Australia.

In 1997, the University of Sydney introduced a graduate-entry medical program. The program is problem-based and emphasises development of life-long learning skills.

"Seventy six graduates from the program participated in a survey, which asked how prepared they felt for clinical practice. The organisers of clinical training at the 17 hospitals that employed the graduates were also asked about their strengths and weaknesses.

"The results show that graduates from the graduate-entry program felt more prepared for hospital practice than did those from other programs in five of the eight areas assessed (interpersonal skills, confidence, ability to collaborate, ability to provide holistic care, and self directed learning)," said Sarah Dean, research assistant from the Department of Medical Education at the University of Sydney, and co-author of the report. They also felt no less prepared than other graduates in the other areas assessed (patient management and practical skills, understanding of science, and ability to provide preventive care).

"The organisers of clinical training rated the graduates highly in clinical competence, confidence, communication and professional skills.

Other authors of the report include Dr Alexandra Barratt and Dr Graham Hendry, senior lecturers, and Dr Patricia Lyon, lecturer, all from the University of Sydney.

In an editorial commenting on the research, Dr Thomas Aretz, Medical Director of International Education at Harvard Medical International, said that as medical curricula and the competencies required of new graduates evolve, evidence-based evaluation of these curricula should become routine.

"As university students, medical students receive an advanced scientific degree, implying a depth of knowledge and mastery of scientific skills."

He commented that assessment has traditionally concentrated on the scientific aspects of medicine, which appear narrow in light of the broad range of competencies now required of medical graduates.

Further more he noted that "Medical schools prepare their students to function as doctors for the rest of their lives" and "Medical education is a life-long endeavour, and all its components - secondary schools, colleges, medical schools, training programs, practices, hospitals and professional societies - need to work together".

"Frequent feedback is absolutely necessary. This study provides one such marker, albeit limited. Similar data collection should be encouraged as a matter of routine to inform the system and improve the training of physicians."

The Medical Journal of Australia is a publication of the Australian Medical Association.

CONTACT: Sarah J Dean, 02 9351 5109, sdean@dme.med.usyd.edu.au

Associate Professor H Thomas Aretz, 0011 1 617 535 6427, tom_aretz@hms.harvard.edu

Judith Tokley, AMA, 0408 824 306