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A future medical workforce that drives equitable outcomes for Indigenous peoples

Medical Deans’ new Indigenous Health Strategy released in late 2021 affirms our longstanding commitment to improving outcomes for First Nations people and re-sets the bar in terms of the key priorities and outcomes we are striving to achieve.

This series of Medical School Stories showcases some of the ways in which medical schools in Australia and Aotearoa New Zealand are working to recruit and graduate increasing numbers of Aboriginal and Torres Strait Islander and Māori medical students, and support the development of technically capable and culturally safe new doctors.

The four medical schools profiled in this release are located at Newcastle & New England Universities (their Joint Medical Program), James Cook University, and Western Sydney University in Australia, and The University of Otago in Aotearoa New Zealand. Each story shines a light on the medical schools’ approaches and highlights how the school’s local context, and local needs and connections, informs and supports their strategy and initiatives.Some common strategies for success become apparent when looking at the four stories as a group. The importance of having Indigenous leadership positions stands out, as does empowering and involving Indigenous staff across the medical school or health faculty, and prioritising Indigenous Health in the curriculum. Even in the competitive environment of medicine, the stories include some interesting examples of how preferencing collaboration over hierarchy and group success over individual success has helped Indigenous students to thrive. All the stories resonate with the findings of research on the systemic factors affecting the recruitment and retention of Indigenous students in health professional programs[1]:

“This most successful strategies implemented by nursing, health and medical science faculties to improve retention were multi-layered and started before the student commenced at university. Specific strategies included: culturally appropriate recruitment and selection processes; comprehensive orientation and pre-entry programs; building a supportive and enabling school culture; appointing Indigenous academics; developing mentoring and tutoring programs; flexible delivery of content; partnerships with the Indigenous Student Support Centre; providing social and financial support; and ‘leaving the university door open’ for students who leave before graduation to return.”

Universities have seen some strong results in growing the Indigenous medical graduate workforce [2] but more is needed – especially in Australia – for us to reach population parity [3],[4] and for both Australia and Aotearoa New Zealand to stamp out racism and culturally unsafe practices in medical education and in the health system. The stories presented here shine a light on how some medical schools are working towards these vital goals, with the aim of encouraging and supporting our members and all those involved in health professional education and training to strengthen their efforts to ensure equitable outcomes for Aboriginal and Torres Strait Islanders and Māori, and realise the benefits offered to all in Australia and Aotearoa New Zealand of a future medical workforce that is representative of, connected to, and learning from its First Peoples.

Richard Murray
President
Medical Deans Australia and New Zealand

September 2022

[1] Emma V. Taylor, Alex Lalovic, Sandra C. Thompson, Beyond Enrolments, International Journal for Equity in Health, 2019.

[2] Notably, the implementation of Indigenous Health within medical schools’ curricula, increased numbers of Indigenous graduates, and a growing Indigenous academic, research and professional workforce.

[3] In 2021, 2.1 per cent of domestic graduates were Aboriginal and Torres Strait Islander people (2020_MDANZ-Student-Statistics-Report-1.pdf (medicaldeans.org.au), compared with 3.3 percent of Australia’s population [Australian Bureau of Statistics].

[4] 0.47 per cent of employed medical practitioners identified as Aboriginal and Torres Strait Islanders in 2020. [Australian Government Department of Health]. 3.5 per cent of medical practitioners identified as Māori [2019 Medical Council of New Zealand], compared with 16.7 per cent national population [2020 NZ stats, NZ Government].