National standards in medical education

Matt Schiller, Ania Lucewicz & Timothy Yang

Tuesday, March 29th, 2011

Matt Schiller
Editor-in-Chief, AMSJ
Sixth Year Medicine/Arts
University of New South Wales

Ania Lucewicz
Associate Editor, AMSJ
Third Year Medicine
University of Sydney

Timothy Yang
Editor-in-Chief, AMSJ
Sixth Year Medicine
University of New South Wales

Since 1999, the number of Australian medical schools has doubled.

While this has brought about diversity, it has arguably also created a worrying lack of standardisation in the skills of graduates. National curricula are currently a hot topic, with the development of a standardised Australian curriculum for Kindergarten to Year 12 well underway. Is it time to rekindle a similar debate within Australia’s medical education sector?

Presently, the only force acting to maintain a degree of standardisation between Australian medical curricula is the Australian Medical Council (AMC) and its accreditation processes. The AMC accreditation standards guide, while laudable, does not direct the specific structure or content of curricula, leaving the door open for the veritable potpourri of programs that we now have across the country. For example, the guideline for curriculum content of the basic biomedical sciences, which occupies one line of the document, does not even mention the names of the various biomedical disciplines: “[t]he course provides a comprehensive coverage of … basic biomedical sciences, sufficient to underpin clinical studies.” [1] Either the AMC is not prepared to put more specific guidelines in the public domain, or little guidance exists to direct curriculum development. The open-ended regulatory framework has seemingly acted for more than a decade to feed a process of medical schools constantly reinventing the wheel with ‘revolutionary’ medical programs.

Of all the medical science disciplines, the teaching of anatomy has been the most criticised in recent times. Anatomy provides a case study in teaching disparities between universities. In a recent national survey, striking differences were demonstrated between medical schools in several areas, including the amount of hours dedicated to formalised anatomy teaching, the delivery of lessons, the use of cadavers, and the manner of assessment of anatomy knowledge. [2] For example, eleven of the nineteen medical schools surveyed have no specific requirement that student demonstrate sufficient anatomical knowledge at examination. Most medical schools pool anatomy questions with those of other disciplines, and calculate an overall passing grade. Thus, a student could be considered competent in basic clinical sciences without passing anatomy. These and other findings have prompted recent calls for a national curriculum for anatomy. [3] However, despite being extremely topical of late, anatomy is but one example of the heterogeneity in teaching across Australia. It would be difficult to make a strong case for having a standard curriculum for one subject and not others.

The suggestion…