For anyone interested in Australian medical school:
http://wwwsom.fmc.flinders.edu.au/html/courses/gemp/gemp.html
FLINDERS UNIVERSITY OF AUSTRALIA OFFERS A
NEW PROGRAM FOR SELECT QUALIFIED
GRADUATES FROM AMERICA AND OTHER
COUNTRIES
Flinders University of South Australia, founded in 1966, is a modern, progressive
university located just outside of Adelaide, the capital of the State of South
Australia. Adelaide, a cosmopolitan city of about one million people, offers a safe,
clean environment at a relatively low cost of living.
The university is nestled 10 kilometers from the heart of the city in the southern
foothills of the Mount Lofty Ranges. Looking out from campus offers some of the
most breathtaking views of the city, the suburbs, and the world's best beaches.
The campus itself is characterized by modern buildings set in spacious grounds of
natural bushland, a pine forest, formal gardens, a tree-fringed lake and sweeping
lawns. The Flinders Medical Centre is located on campus and is comprised of a
516-bed teaching hospital and medical school with an annual operating budget of
$110 million.
The Centre employs approximately 2,300 full-time staff. Many students look at the
various possibilities that may await at foreign medical schools. Traditionally,
American students would commonly consider schools in the Caribbean, Mexico,
and Europe as options. Few have considered medical school in Australia since most
Australian programs in the past were reserved for Australian residents.
After several years of conscientious planning, three of Australia's top universities
have developed a graduate medical program for international students. The three
universities that are beginning this new program include the University of Sydney,
the University of Queensland, and Flinders University in Adelaide.
The first of these three schools to offer the graduate medical program was Flinders
University which accepted its first graduate class for the 1996 school year which
began in February. The following is an interview with Dr. Andrew McDowell and
Dr. Jillian Teubner, both on the academic staff at Flinders and members of the
International Admissions Committee for the medical school.
JPMS (Journal of Pre-Med Studies): How does medicine in Australia differ from
medicine in the United States?
Dr. JT (Dr. Jillian Teubner): In Australia, I believe we use general practitioners to a
greater extent because you can't go to a specialist unless you are referred to one by
a general practitioner.
Dr. AM (Dr. Andrew McDowell): It works like a filtering system where some-one
with an illness or condition first sees a general practitioner in the community who
diagnoses the patient and then may refer the patient to the relevant specialist.
JPMS: Is this practice dictated by the national health care system?
Dr. JT: Not really. I think this is just how we approach medicine.
Dr. AM: It may be partly due to the health care system since the specialist charge
much higher rates. So you only go to a specialist if you really need to.
Dr. JT: Our national health care system is not like in other countries such as
England or Canada where the doctors are paid by the government. In Australia,
only the doctors that work in the hospitals are salaried by the government. All the
genera1 practitioners and specialists are private entrepreneurs much like in tbe U.S.
They earn as much as they can or want. However, the people are subsidized by the
government for 75-80% of the medical cost.
Dr.AM: Some centers don't charge any more than what isimg covered by the
government Medicare program.
JPMS: What is your medical school curriculum like ?
Dr. AM: Traditionally, we had six year programs where students came straight from
high school and usually finished medical school by the time they were twenty-four.
This system has made it extremely competitive to get into a medical school. There
are only ten medical schools in Australia and only the students with the highest
grades from the best private schools could enter medicine. Only the students in the
top point-one percent were ever accepted.
Independent research and study is encouraged.
Dr. JT: It has also been difficult for students from rural areas to get into medical
school because the schools in the rural areas didn't offer enough competitive high
school courses. These students need to take some more advanced science courses
before they could even be considered. This is part of the reason why the three
universities started the graduate entry medical program. Since the other two
Australian medical schools taking this approach are fairly large, about 40% of all
future Australian medical school students will be going through the graduate
program route.
JPMS:Why was a graduate program developed?
Dr. AM: One reason was that the new doctors were fairly young, and even though
they are extremely intelligent, that doesn't mean they are experienced dealing with
people.
Dr. JT: We consider communication skills very important in medicine and we felt
that students with more living experiences would be able to make decisions that
were more mature. Our admissions people now consider personal qualities equally
important as academic skills. The students now entering have broader
back-grounds. We have more students from rural areas and minority backgrounds.
JPMS: When did the graduate program start?
Dr. AM: Flinders started with the class beginning in February 1996 and the other
two universities will start with the class beginning in February 1997.
Dr. JT: Sydney and Queensland are larger medical schools compared to Flinders. I
think the intimacy of the smaller class size leads to a happier student body. We have
fifty-eight Australian students and twenty international students with about 60-70%
of those students from the U.S. Most of the international students go to American
undergraduate universities.
Dr. AM: With our six year approach we had international students mostly from
South Asian countries that had similar educational systems as Australia such as
Malasia, Hong Kong, Japan and India. Now that we are moving towards more of a
graduate school approach like America, our program is more relevant to American
students.
JPMS: What credentials do you look at when considering applicants ?
Dr. AM: We look at the academic record, personal experience, the GAMSAT for
Australians or the MCAT for Americans, and the interview.
JPMS: Do you have a preference for a student's major?
Dr. JT: We have no preference for any particular course of study. In Australia we
do not have the same premedical requirements that must be taken. We do like to
see that a student has some science background and can do well on the GAMSAT
(or MCAT), but we do not, for instance, formally require one year of physics or
one year of organic chemistry.
Dr. AM: We're looking for people with a sound educational background who have a
strong interest for medicine and in to help people and serve the community. We
want people who want to make medicine more "user-friendly" and more empathic.
In Australia we have about many students who were previously working in the
allied health professions and about twenty percent are Ph.D's. I think that this
works well for PBL [Prob-lem Based Learning] schools where the varied
backgrounds of the students bring much to the educational process.
Dr. JT: One of the reasons we are changing to PBL is that knowledge in medicine is
expanding at an exponential rate and there is no medical school in the world that can
teach everything there is to know about medicine. PBL teaches the students how to
self-educate themselves so that they will continue to learn throughout their lifetime
rather than just learn while they are in medical school.
JPMS: What is PBL?
Dr. AM: Problem Based Learning is an educational concept that has been around
for several years. A number of the schools in the states have shown leadership in
PBL including Harvard, New Mexico and UCLA, and many of the people involved
with those programs have helped us set up our PBL program. PBL is students
involved in their own self-directed learning. With didactic learning, students sit in
lecture halls for thirty hours a week and practice for ten hours. This method can
often be unenjoyable for students and be-comes reflected in their performance.
With PBL we keep lectures to a minimum, usually no more than seven hours a
week of structured time, and the rest of the time the student is assigned to an actual
medical case.
Tutors assist students with case studies.
JPMS: Do the lectures correspond to the case a student is given ?
Dr. JT: It is very integrated. We must ensure that all important concepts are
covered and the material is learned. We have a list of textbooks for students to read
about the various topics covered. In case studies, a tutor directs the students with
their studies and research.
JPMS: What is a tutor?
Dr. JT: A tutor is a faculty member with knowledge in a special area. Some schools
call the tutor a facilitator because they are not really teaching the group. They are
facilitating or directing the course of the learning. In fact, a good tutor usually needs
to say very little. If a tutor sees that a student is getting off track, they will help to
steer the student back in the right direction. Each case has a set of learning
objectives or goals set by the faculty. The tutor has to make sure the students
obtain those goals which they usually do without intervention. Each case is
evaluated in the end.
Dr. AM: With each case, students work in groups and must cooperate and share
their knowledge. It is very non-competitive.
Dr. JT: In the first two years of medical school there are no grades. Students simply
get a non-graded PASS, if they pass. Students are not graded until their third or
fourth year and then they are graded more on their clinical competence.
JPMS: How does PBL actually work?
Dr. AM: Students get case stud-ies that integrate the leaning of several disciplines
such as biochemistry, physiology and histology. As you learn more about a case you
get more information that helps you make new and better decisions. This is very
much the way in which medicine is practiced. The whole PBL approach is practice
oriented. It's not theoretically oriented like a didactic system of learning. PBL
requires a mature student.
Patient contact begins in year one.
Dr. JT: A new case is usually started on a Friday. The students in a group are given
a brief history and presentation. They must identify what their learning goals are in
various areas. Members of the group are assigned different items that they are to go
and research over the weekend. On a Tuesday, the members get together in a
tutorial and report on what they have discovered and they assess the information by
interacting with one another. When new facts are learned they decide how the
information fits in with their diagnoses of the last week. If they started out with
seven possibilities of diagnosis, they may now begin to narrow it down. On the next
Friday, half the tutorial is spent finishing that case and the other half of the tutorial
is spent learning a new case.
Dr. AM: At the same time during the week, there might be some special lectures
running about the particular aspects of a case. Also, during each of the cases, the
students are presented with perspectives on public health, law, economics, ethics
and psychobehavior. Students also attend their scheduled lectures and additional
tutorials. We also have scheduled clinical skills training. When researching certain
aspects of a case, a student will spend time in the library or they may choose to use
our computers to search databases and the Internet or they may choose to go see a
clinician, a community agency or a patient for information.
Dr. JT: One recent case involved a person who had cystic fibrosis. One of the
scheduled lecture hours was with the President of the Cystic Fibrosis Association,
himself a cystic fibrosis sufferer, who talked with the students about his experiences
with the disease. He actually had a heart-lung transplant and the students asked him
about his quality of life. Whenever we can, we send the students out to the
community to visit with doctors in their practices.
Dr. AM: The doctors really enjoy their teaching role. It's a very validating
experience to have a young person who is so eager to learn medicine want to talk to
you. The faculty at Flinders is very friendly. It's such a small group, only 80
students a year, that you can learn every student's first name. It's a very personal
type of education.
JPMS: What is the program during their third and fourth years, when students
receive grades ?
Dr. AM: It's similar to the U.S. Students have their various rotations in medicine,
surgery, ob/gyn, pediatrics, psychiatry. There are no formal exams during this
period. Grades are based solely on clinical performance. During this time there is
even more opportunity for students to direct their own learning. There are still
certain topics that must be covered, but they have more latitude in how they
address those topics. They may select different hospitals in South Australia and in
the Northern Territory in Darwin where we have a clinical school in tropical
medicine and rural health. Some students are allowed to go overseas to do part of
their fourth year. Some of our students have gone to South America, India, Europe,
Africa and other places that they wanted to go if they had an interest in a certain
technique or type of medicine.
JPMS: Does the school help them find these special places to study?
Dr. AM: Yes. Many of the faculty know people in different parts of the world. I
helped one of my students find an AIDS hospital to visit in London. Another
student I helped find a spot in a rural hospital in Bangalor, India. One of my
students last year went with a consultant on an immunization visit to Indonesia.
Also, some of our students choose to go the U.S. for some of their electives.
Dr. JT: We also have rotations called selectives, which are different from the
electives. For example in a certain elective in medicine there may be six selectives
which you can choose from in order to broaden or focus your experiences.
JPMS: What should American students think about if they want to consider going
to medical school in Australia?
Dr. AM: I think the experience of an international education is a good one. Students
need to be enthusiastic. They need to be not just interested in an aca-demic
education. They can have re-search interests which are very favorably addressed at
Flinders. Flinders has one of the highest publication rates and research funding
rates. And they need to be mature and capable of handling a self-directed learning
program.
JPMS: Are students well prepared for the USMLE (United States Medical
Licensing Examination) ?
Dr. JT: At a recent conference on medical education in Holland, there was a report
that indicated that the passing rate on the USMLE for students trained at
international medical institutions was less than 50% for step one and step two of the
exam. The newest study indicated the passing rates by the country of training and
Australia had a exceptionally high passing rate. In fact, for the part two exam of the
USMLE, Australian trained physicians had a passing rate of nearly 100% which is a
higher rate than students trained in the U.S. At Flinders, American students take
special electives during their education that specifically help prepare them for the
U.S. boards.
JPMS: Your tuition is comparable to a private U.S. school. For many students
this is an important consideration. Is your medical school approved for U.S.
loans?
Dr. AM: The Flinders program is approved. We felt that this was very important to
set-up early on because we want to make sure that students do not feel like they are
struggling while they are away. We have approval by Stafford Loans title IV and by
the ISLP (the International Student Loan Program) out of Boston. The ISLP
integrates a Stafford Loan with their supplemental loan guaranteed by TERI (The
Education Research Institute).
JPMS: What is the application process for American students interested in
applying to a medical school in Australia?
Dr. JT: Students need to remember that in Australia our summer and winter months
are opposite those in America. This being the case, our school year begins in the
month of February. Qualified students are encouraged to apply prior to June 30th.
Students can call us toll-free to request an application. We will ask for transcripts
and MCAT scores which get reviewed by the admissions committee. We then invite
the best, most interesting students to a formal face-to-face interview conducted in
cities in the United States. In some very special cases, a telephone interview may be
conducted but we really prefer to meet candidates. We try to inform most students
of their acceptance as early as possible in order that they may begin to plan for the
relocation and make the necessary arrangements early on.
Dr. AM: Everyone at the university is very supportive of our international students
and they make sure you are taken care of when you arrive. We want you to enjoy
your total experience at Flinders on an academic, professional and personal level.
