Beyond the Triradiate – A global experience of medical education
For half a century, the triradiate building on the corner of Grattan Street and Royal Parade in Parkville has been the home of the Melbourne Medical School and the nucleus for medical education at the University of Melbourne, including, more recently, biomedical education.
Designed in a period of architectural brutalism, and completed in 1968, the building itself has morphed over its lifetime as medical education has evolved, notably with the addition of a pharmacology department on top of the three-pronged anatomy, physiology and pathology wings.
With works on the new Parkville train station this year transforming the landscape around the building, plans are under way to ensure the location endures as a home for medical and health education and research at Melbourne. Fortunately, such disruption does not impact the education of students as much as it might have done previously.
According to the Head of the Department of Medical Education, Professor Steve Trumble, the fabric of medical education has now changed so dramatically that the physicality of the classroom is no longer central to the education of medical students.
“Medicine is out there in the community, so the best classroom for the students is now out there in the community, too,” he says.
After their first year spent learning the basics in the medical building on the Parkville campus, students disperse all over Melbourne, Australia and beyond to learn within and gain knowledge from diverse communities.
“We’ve got some good evidence that the further away you go from the orthodoxy the more you learn, and we do encourage students to take a few risks,” says Professor Trumble. “Learning on the wards in a clinical school is a much sounder way to learn medicine than to sit in a centralised library reading books.”
Students’ experiences are a testament to this view.
Final year MD student Sarah Marshall (BBiomed 2014) has completed clinical placements in Shepparton, Echuca and Wangaratta, and says that in rural communities she has found herself part of a much smaller team, which provided many opportunities for getting involved.
“There tends to be fewer people between you and your patient in the rural hospitals, so you are able to be an important part of conversations that transpire about the management of a patient and have closer involvement in procedures and surgeries,” she says.
Responsibility and resourcefulness are also important lessons that MD final year student Hellen Geros (BBiomed 2014) learned while undertaking the John Flynn Placement Program in the Northern Territory.
“We were mentored by a remote nurse with no doctor present and limited resources, which meant sometimes we had to be very creative while on the job,” Hellen says. “Being in a remote area also meant that, sometimes, we would have to wait five to six hours for a Royal Flying Doctor’s plane to airlift a patient to the hospital in Alice Springs, so we had to learn how to make a call on whether a patient really needed to travel and how to look after them in the meantime.”
Hellen believes these experiences helped shape her into a more confident and competent doctor for her work at Western Health.
Another, perhaps more unexpected, discovery Hellen made while on her NT placement was that the University’s medical academics were not always cooped up in the medical building in Melbourne. During a clinical tour in the remote Indigenous community of Papunya, she glanced into an office and was surprised to see Professor Trumble sitting at the desk.
“As [Hellen] walked past the door you could sort of see her head get yanked back like in a cartoon [and her] thinking ‘What the hell is he doing out here in remote Northern Territory?’ ” recalls Professor Trumble.
“I think it is really important for our students to realise that medicine and medical education is taking place all around Australia.”
Students also have the opportunity to learn about medicine beyond Parkville and Australia, even as far away as 16,000 kilometres, as final year medical student Alex McCutchan (BSc 2014) experienced in her exchange to Universitetet i Oslo, Norway.
“Learning to overcome language and cultural barriers, and seeing people in different stages of their lives in different parts of the world, has made me a much more well-rounded doctor and person,” says Alex.
Taking on education in different cultures and countries introduces students to things they might not ordinarily experience and to unexpected events.
“During my placement in Norway, when I accidentally followed Hans Kristian instead of Per Kristian, I found myself observing an emergency surgery for a ruptured ectopic pregnancy!”
Another key learning for students travelling overseas is just how varied medical education around the world can be.
“I came to realise that even in a country so advanced as Norway, nothing came close to the clinical exposure we have in Australia,” says Alex. “At my home hospital, the Northern Hospital, we’re really made to feel part of the team and participate in ward rounds, meetings, and everything occurring at the hospital.”
The Melbourne MD: A new benchmark in 21st century medical education
Introduced in 2012, the Doctor of Medicine (MD) is a four-year graduate medical degree. An extended masters-level program, it was the first truly graduate entry-to-practice medicine qualification in Australia and sets a new benchmark in medical education.
The MD program consists of:
- One year of integrated bioscience and clinical learning at Parkville
- Two core clinical training years in partner hospitals and healthcare facilities, including metropolitan and rural/regional settings
- A semester of immersion in a single medical discipline to complete a research project
- A capstone semester in which students rehearse the skills required for effective, safe clinical practice
- An annual world-class conference, designed by students for students, providing opportunities to interact with community and healthcare leaders.