Doctors worried about plans to alter medical degree

The University of Otago clocktower. Photo: ODT files
The University of Otago clocktower. Photo: ODT files
Doctors are questioning University of Otago plans to drop mental health and women’s health as compulsory final-year subjects in its medical degree.

College of Psychiatrists national chairman Mark Lawrence, an Otago Medical School graduate, is not convinced expanding on those areas in years four and five of the programme will make up for the loss of the subjects being standard in year six — the trainee intern year.

He is worried proposed changes could lead to fewer medical students getting practical experience in important fields and this could have implications for the future medical workforce.

One hundred and sixty doctors have signed a letter asking for the university to change its mind, Radio New Zealand reported this week.

The College of Obstetricians and Gynaecologists also wrote to the university in February to express concern about reducing practical teaching in women’s health.

However, university programme director Tim Wilkinson said the proposed changes did not place any less importance on psychological medicine and obstetrics and gynaecology.

"These topics would become optional in year six but remain compulsory and covered in more detail in eight-week attachments each in year five," he said.

"Foundations in these areas are also laid in years two, three and four.

"It will remain possible for students to continue to work in these areas in year six if they are interested in doing so," Prof Wilkinson said.

The university is reviewing the final three years of its medical degree.

It has adjusted its original proposal and could make further tweaks before bringing in the new model in 2023.

Dr Lawrence, who specialises in adult psychiatry, is a senior lecturer in Auckland University’s programme and he has a daughter at the Otago Medical School.

He felt the sixth year was best for exposing students to complex and practical realities connected with psychiatry.

He cited himself as an example of a student who did not intend to pursue psychiatry but he learned late that he enjoyed what it involved and shifted his focus. Sufficient exposure to the field was key and the proposed changes came at the same time as a growing focus on mental health.

Prof Wilkinson provided details about the proposed changes.

"Currently, students in the sixth year spend several weeks each working in the areas of medicine, surgery, paediatrics, emergency medicine and anaesthesia, general practice, obstetrics and gynaecology and psychological medicine.

"We are proposing that in future, final-year students work in five areas but with two additional six-week periods remaining available for training in an area of the student’s own choice."

The university adopted an apprenticeship style of learning in years four to six, he said.

Students would have fewer practical stints in the final year but they would last longer.

College of Obstetricians and Gynaecologists vice-president John Tait was worried the changes could be detrimental to women’s health.

Practical experience in the field was important for specialists and for general practitioners, he said.

Dr Tait feared learning earlier in the degree might not make up for what could be lost from the practically focused final year.

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