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American Express
Gold Card Edition
AKA The Apocalyptic Electronic Device Edition
Feat. Convention and GHC Highlights,
Rural Health Exposes, South American
Football and Eggplant
Proudly Sponsored by
American Express
PANACEA II 2008
Contents
Your industry super fund. The contents contained herein are a work of fiction. Any resemblance to real contents, living or dead, is a coincidence.
The Thank You
For over 40 years.
2. Oh, Frabjous Day! 14. Moratorium Conundrum Column
The editor tries to explain exactly how she became Ever wondered what this “moratorium” business was
this stupid while trying (unsuccessfully) to link that about? Read here. You’ll, like, find out and stuff.
to Jabberwocky. Reserved for those
people, objects or TV
16. The Challenge of the Three Monkeys programs that have made
3. Four More Years Jodi Allen implores us all to scruitinise a little more
Michael “Iron Fist” Bonning delivers his last words while this publication possible.
what we see around the hospital.
contemplating how to stage a military coup and make it
look like an accident. Lorenzo Calabro
19. Top 9 Songs to Not Study By, Part II A man of such
Her thirst for self-indulgence hardly slaked, the editor prodigious skill and
4. The Smiling Assassin
Top rated industry fund ^
Tim “Roadblock” Smith, the M to Bonning’s Bond,
delivers the next instalment of songs not to study by.
She’s cool!
talent that it makes you
want to punch him right
divulges how National Registration and Accreditation
in his face. Thanks for
Over $7.6 billion in assets
will affect your future.
20. Silence is Goalden the cover, Lorenzo!
5. Back to School Kim Bruce, med student and soccer nut, takes us to South
America, where he meets a soccer team with a difference. The AMSA Executive
Healthy returns and low fees*
Bear and Jorgo head back to school to teach the
kids a thing or two about disembowelling. Despite figuring out
22. Jamaican Me Crazy about two days into
the year that this
6. Physician Hindrance?
Over 200 000 members Carly “Fleet” Fox delivers the skinny on physician
Jake “Dirty Hippie” Parker tries to explain how hanging
out in beachside bars in the Carribean was part of his
publications thing is a
much bigger and uglier
assistants - help or hindrance? job description.
monster than I thought,
Online facilities 8. Inhospitable Hospital Tunes 23. GHC: Healing the World
they coaxed me through
with kid gloves.
Justin Chau lets us in on a little secret - singing Gnarls D-Squared put us all to shame by healing the world Aww. You guys.
Member Privileges Program
Barkley’s “Crazy” in the mental health ward is not AND looking great in a pair of slacks.
actually appropriate.
Sam Gaghan
25. Vector Just... my God. How
9. Around the World in an 80’s Haze
Specialising in the Health and Sam Merriel and Carlee Van Dyk, the despots
All Global Health, All the Time. Get the word from
the GHN right here.
have you not murdered
me yet?
Community Services Sector behind Convention08, take us on a fluoro-fuelled
trip around Melbourne.
Bradley Whitford
30. WhoMAT?
Jonathan Nolan tells us exactly what’s wrong with the I will never, ever stop
10. Convention Ballad loving you.
Sean “Banjo” Williams takes us back to colonial UMAT process - and it might not be what you think.
days with his 19th Century retelling of a modern
favourite - Convention. 31. We Feel the Need... The Need to Lead Diet Iced Tea
Nicholas “Boyd” Jorgensen details the effects on the
For being a delicious,
non-fizzy alternative to
12. Indigenous Health Essay 1: nation’s capital when students from around the country
Coke Zero.
Competing with a Handicap come to stay.
Winner of the Indigenous Health Essay, Jonathan Rihanna’s “Disturbia”
Epstein, takes us through the barriers to Aboriginal 32. By Our Powers Combined For teaching me to
* Please refer to Health Super’s current Product Disclosure
self-determination. Prasad Jankiram Athreya divulges how, as medical students, have the courage of
Statement (PDS) for full disclosure of fees, charges and past
returns. Past performance is not indicative of future performance. we have much more to offer than we may have realised. my convictions. IT’S
^
Source SuperRatings 2008, analysis of 310 super funds.
13. Indigenous Health Essay II: A GOOD SONG
Visit www.superratings.com.au for more information. Edentulous at 30 35. AMA-CDT: Feel the Love EVERYONE!
Winner of the Indigenous Health Essay, Joni Nissen, outlines Big Sister Alex Markwell keeps us up to date with SHUTUP SHUTUP
the travesty that is dental care in Aboriginal communities. happenings at AMA-CDT. SHUTUP
Merriam-Webster’s
Word of the Day
Despite being unable to
This product is issued by Health Super Pty Ltd (ABN 97 084 162 489, AFSL No. 246492) as Trustee of the Health Super Fund (ABN 88 293 440 675). Rep Reports remember any of them, I
You should consider our Product Disclosure Statement (available by contacting our Superline on Freecall 1800 331 719 or visiting our
website www.healthsuper.com.au) before making any decision about acquiring or holding our products. feel somehow smarter.
36. UnoW, or a Picture Tells One Thousand Words 45. MUMUS, or Blood, Pocari Sweat and Tears
37. AMSS, or Rockin, the Suburbs 46. TUMSS, or Those Little Tigers
From little things, big things grow. 38. ANU, or the ,S, is Silent
47. UMMSS, or the Low Growl of Thunder
39. FMSS, or You Can Leave Your Hat On
48. UNMS, or Dancefloor Nation
Contact our Superline on Freecall 40. GUMS, or Check Out Our Sweet Guns
1800 331 719
49. UQMS, or There,s Something in the Water
41. JCUMSA, or Crocodile Rock
50. USyd, or Mad, Mad Love
42. MeDUSA, or By the Beard of Zeus
or visitwww.healthsuper.com.au
43. MSAND, or Getting to Know You 51. UWS, or Harley and His Band of Horses
44. MSSBU, or Group Bondage 52. WAMSS, or How to Bear It © Willierossin | Dreamstime.com
1
PANACEA II 2008
Oh, Frabjous Day! Four More Years?
I remember the day vividly. It was a blithesome Summer morning;
the kind of morning evocative of an era when sprinklers were Words by Michael Bonning,
allowed, when every family seemed to be on the front lawn AMSA National President
seeking solace from the heat, when every sprinkler was one of
those sweet ones that shudders in a graceful arc from right to left.
It was the kind of morning that opens every Stephen King movie. You
know the one: it’s a beautiful Summer day in Anytown, USA. The
protagonist is riding his bike around town, playing card jarring in the
spokes beneath him, laughing as the wind flies through his hair and
thinking to himself “Boy! This is the BEST SUMMER EVER! I sure hope
it never, ever ends!” and all the while viewers are throwing their shoes
at the television and screaming “Idiot boy! There’s a clown in a sewer
just waiting to make you realise your worst fears! Can’t you see?”
I didn’t know it at the time, but that Summer morning I WAS that boy.
And instead of a sewer clown, I had a Western Digital external hard
drive.
That particular Summer morn, I found myself at the local Officeworks
- I enjoy nothing more than a spot of stationery shopping at the
change of season. Having wandered the deliciously colourful
aisles with unusual self-restraint, I presented to the checkout
with a single package. Handing over my gleaming EFTPOS card, I
absentmindedly exchanged pleasantries with the pock-marked cashier There comes a time in every President’s life when they write their The extension of this issue regards International students studying at
as I mentally patted myself on the back. “Well done, Gemma,” I second report for a Panacea; this is a difficult time, because there is Australian medical schools – we are of the opinion that these students
thought to myself. “Storing all the publications material on such usually much to say and very few words in which to say it. So I will should receive internships as part of their training in Australia. (To
a device will certainly save you a lot of bother when your laptop tougher than this!” Unfortunately, the tiny mechanical sounds were
restrain myself to talking about... (rest of sentence edited for length obtain your RDI of moratorium info, get thee to page 14 – Ed.) Given
inevitably crashes. It’s probably best that you don’t make a copy but a snapshot of the dysfunction within: my hard drive was dying. I
issues – Ed.). the Australian health care system’s almost pathological reliance on
of anything and keep everything on this single machine. It’s well bundled it into the original styrofoam packaging, thinking feverishly.
International Medical Graduates, it is unacceptable that we should
known that electronic devices with small moving parts never fail.” “It’s fine, it’s completely fine,” I jabbered, feeling faint as my eyes The main reason that AMSA can advocate on such a variety of issues We not give preference and training to students who have helped
I exited the store into the bright sunshine, the cloying scent of darted nervously around the room. “I’ll call the local data recovery and with great impact is because of the 12,500 students we represent. to support our entire framework of undergraduate medical training.
frangipanis heavy in the humid air. I inhaled deeply and smiled. “What store. They’ll fix it. They’ll fix it real nice.” Each of you is a future part of the health care picture, and right now the Their continued service to the Australian health care system will be
a day”, I whispered. “What a frabjous day.” major thing that separates a senior medical student from an intern is invaluable as we witness the “silver tsunami” of retiring baby boomers
To cut a lengthy story down to a less lengthy story, the data recovery their level of responsibility and the amount they are paid. Governments
store could not, in fact, fix it real nice. They couldn’t fix it at all. over the next decade.
It’s right about now that the shoe-throwing becomes frenzied. realise that your experiences as a student are instrumental in your
performance as a doctor, in the career path you eventually choose My final issue for this column is Bonded Medical Places (BMP). The
The hard drive and I were constant companions. At the size of your Google informs me that it was either Alfred Lord Tennyson or The
and in the clinical decisions you make. Therefore, governments (and Health Minister, Nicola Roxon, has commissioned an Office of Rural
typical eggplant, it was travel-friendly and inconspicuous. When asked Fresh Prince of Bel Air who said: “‘Tis better to have loved and lost
other stakeholders) value what AMSA has to say because of its direct Health to review programs, including BMP. This is an opportunity to
if I had a USB for the purpose of file transfer, I would develop an air than never to have loved at all.” Bollocks, Tennyson. I loved and
relevance and connection with the student body. have your say – jump on the AMSA website and answer a few simple
of smugness as I replied “USB? Oh, I don’t really use one of those. then I lost and it sucked. I would give anything to go back to that
questions to help us build a stronger case against creating more of
I’ve got an external hard drive.” I savoured the astonished looks Summer’s day and have bought a stack of DVD-Rs instead. Maybe The major issues that will affect your careers and training include these unfunded, bonded positions.
on my colleagues’ faces as I fished the eggplant-sized device from then I wouldn’t be sitting here, head in hands as I contemplate starting National Registration and Accreditation, Intern Training Capacity, the
my pocket. Panacea II afresh. 10-Year Moratorium and its impact on international students, and an As I sign off at the end of my term on the AMSA Executive, I turn my
old chestnut – Bonded Medical Places. thoughts towards the future of the organisation as it enters its fiftieth
Yes, they were halcyon days. But, like eggplants, external hard drives
So forgive me, dear reader. I was naive and I was burned, and now this year. This is no small feat for a student association that grew from the
cannot live forever. The idea of National Registration is a simple one – have a national
comes to you later than I had ever dared imagine. Were it not for the idea that medical students should meet up once a year to discuss the
sincere affection I feel for you all (along with a contractual obligation), system of registration rather than practitioners having to register in relevant issues in their medical courses (and have a little bit of good-
In hindsight, I should have seen the warning signs. Response times
I might have given up entirely. A heartfelt thanks goes to the AMSA different states when they travel to undertake training or to work. (For natured, 1960s style fun). The feats of this organisation place it not
were lengthening. A low hum would emanate from within after
Exec and Councillors, Sam Gaghan and the people below, our major the low-down on National Registration and Accreditation, get thee to just as one of the premier advocacy bodies in the health field, but as
prolonged use. And then: whirr... click click. Whirr... click click.
page 4 – Ed.) However, the proposed involvement of the government in the most powerful and active student association in the country.
sponsors, for turning a blind eye to my rampant stupidity and offering
accreditation is being opposed by AMSA, in conjunction with the AMA,
“What’s wrong?” I pleaded, as my computer repeatedly failed to nothing but encouragement. I am indebted - Ed.
Specialty Colleges and Medical Deans, to show those involved that an I would like to congratulate the members of the NSW Bid Team, who
recognise the device I had plugged into it. “Come on now, you’re
independent process WILL deliver a well-trained medical workforce. took on a strong team from Adelaide at October Council, for winning
the opportunity to represent you all in 2009 as the new executive. So
The issue of intern training capacity is close to the heart (and bank much has happened in the fifty years that followed this organisation’s
balance) of all medical students, as we exist under the assumption inception and I look forward to seeing the organisation grow under
that we are guaranteed jobs on graduation. While many states are still new leadership into the future.
very safe in that assumption, there are some states that are gazing
upon the swelling numbers of medical students with some dismay. Finally, it has been my great pleasure to represent you all this year;
AMSA has undertaken to ensure that, as a first step, all domestic however, it has been my even greater pleasure to work with the 2008
Australian medical students are guaranteed an intern position. In AMSA Executive – one would be hard pushed to find a more genuine,
mounting a fairly vigorous campaign on the issue we have been less hardworking and generous bunch. (Edited to remove a long, glowing
than impressed with some responses that, while assuring there will be paragraph regarding the Publications Officer. Despite how excellent
jobs, are vague as to how and where these jobs will be created. We she is, it’s just not really fair – Ed.) They together with the AMSA
are working with these parties in the hope of gaining a commitment to Executive Officer, Shayne McArthur, have my most profound and
implement plans that are specific. heartfelt thanks.
2 3
PANACEA II 2008
Back to
School
The Smiling
Assassin:
National Registration
and Accreditation
Words by Tim Smith,
AMSA Vice President-External © Rmarmion | Dreamstime.com
You don’t have to be a political aficionado to have realised that the by this prospect. In practical terms it means the Health Ministers’
Words by Bear and Jorgo,
new Federal Government has adopted an ambitious reform agenda for Council could, for example, approve medical school courses that
the Australian healthcare system. One reform proposal on the table is are three years in duration, or remove the need for students to Guys That Go To School
to introduce a National Registration and Accreditation scheme for the do an emergency medicine placement, freeing up clinical training
healthcare professions, including medicine. constraints that limit further expansion of medical student numbers.
At first glance, a national system for tracking health workers and These oversight powers could effectively be used to shorten the
At the end of May 2008, instead of being conscientious students and students - possibly because it’s a great chance for teachers to get
ensuring their qualifications are up to scratch seems eminently duration of medical training and rapidly increase the number of
studying for their exams, Jorgo and Bear decided to do something a their (almost invariably high) blood pressure measured. Careers
sensible. With recent cases of rogue doctors making headlines across doctors being produced which, with an Australian electorate crying
little different: they got on a plane, flew to Darwin and then spent the advice can be difficult to come by at some schools, particularly
the country, the Government could certainly argue it has a mandate out for more doctors, would be a notch in the political belt for any
next week travelling around the Top End of the Northern Territory. in areas where the majority of students do not complete the TEE.
to improve patient safety in this respect. Government. The inevitable result however, will be a dumbing down
Now, before you jump to any conclusions (apologies to any supervisors This is one of the great benefits of the program – interested high
of medical education, which will ultimately compromise the quality of
However, on closer examination, the Government’s proposed who read this) this trip wasn’t purely fun and games. There was a school students are able to talk to current uni students about their
care delivered to patients.
National Registration and Accreditation agenda seems to be more purpose. The NT Rural High School Visit (RHSV) program, organised life and studies. At every visit, the students were interested in the
geared towards enabling expedient Government-driven health Another consideration is the impact this proposed system will by GPPHNT, brought together six university health students (including workload of university study, the challenges of having to move away
workforce reform than protecting patients. The Council of Australian have on the international standing of Australian medical graduates. your faithful authors) from around Australia for an opportunity to from home (often unavoidable for a Northern Territory student) and
Governments’ (COAG) Intergovernmental Agreement (IGA) on Currently, in Australia, the AMC works independently to accredit promote careers in health to high school students throughout the the financial burdens of tertiary study. Fortunately we were able to
National Registration and Accreditation, signed by the Federal and medical education and training. This is in line with the World Health Top End. quell most of these fears with tales of scholarships and college life.
State Health Ministers in the fledgling days of the Rudd Government, Organisation and World Federation of Medical Education (WFME)
outlines the proposed scheme. standards on accreditation of basic medical education, which mandate We visited seven high schools in total, including a couple in Darwin, The NT RHSV and other similar programs in Australia play an important
that accreditation should be independent of both Government and the and others in Katherine, Jabiru and Nhulunbuy. At each of these part in generating interest in health careers amongst both indigenous
Under the new system, a national professional board would be created profession. It is these standards against which the calibre of Australian schools we engaged students in a group discussion about careers in and non-Indigenous rural youth. First hand, it is compellingly evident
for each of the health professions, which register or partially register medical courses is judged internationally. health. We did this using the tried and tested method of a PBL (groan) that there is a continued need for financial and pastoral support for
their practitioners. Ten professional groups are currently earmarked scenario that was relevant to the students. For example, we had the NT children studying away from home in a university health course.
for the scheme including medicine, dentistry, nursing and midwifery, Should the proposed National Registration and Accreditation system story of Gertrude, a young woman who was walking in a gorge when These core issues were raised numerous times by the students at each
physiotherapy, chiropractic, osteopathy, and podiatry, to name a few. go ahead, the accreditation process for Australian medical schools she fell off a cliff, tragically disembowelling herself in the process. The of the high schools, strengthening an impression that this initiative is a
will contravene the WFME guidelines, which may threaten the students were asked to think about what sort of health professionals positive and very worthwhile strategy.
Each board would be responsible for registering qualified practitioners international employment prospects for Australian medical graduates. would be needed to help Gertrude recover from her injuries. After
and for setting the accreditation standards for training courses. The With international students accounting for over 20 percent of this brainstorming session we split into small groups where one of the Our trip throughout the Top End was as intense as it was regrettably
latter function will be able to be assigned to an existing body should Australian medical students, many of whom want to return to work leaders would show the students some interesting things we get to brief. We covered over 2000kms by van and plane and were afforded
one already exist. In the case of medicine this would mean the state and in their countries of origin, this prospect is extremely concerning for do in our lives as health students. A favourite station was plastering, the opportunity to see some of the majestic landscape of the Top End.
territory medical boards would be amalgamated into a single National AMSA and Australian medical schools. where the students got to plaster up their friend’s arms/legs/fingers/ In addition, the opportunity to talk to rural/remote indigenous and non-
Board of Medical Professionals, and the accreditation of medical schools heads and then think up a story to tell their parents which would indigenous kids about the challenges and rewards of a career in health
and specialist training programs would be assigned to the Australian To date, AMSA has voiced these concerns through our submissions
explain their injury. Anarchy was rife but it was great fun! was an amazing personal experience. There is perhaps nothing more
Medical Council (AMC), the existing accreditation body. to the Health Workforce Principal Committee, and in discussions
satisfying than assisting someone to fulfil their goals and reach their
with politicians in Government and Opposition at the Federal and
Ah yes. Well, we’re all about evidence-based practice these days, potential. Hopefully we were able to do this in some small way.
The problem however, lies in the fact that the proposed legislation, State level. AMSA will also be working closely with the Council of
so it would be pertinent to ask whether this trip was worthwhile
which will be introduced state by state in three bills over the next Presidents of Medical Colleges, Medical Deans of Australia and New
from the high school students’ perspective. Certainly, judging from For those interested in becoming a part of the NT RHSV program,
12 months, makes provision for the Health Ministers’ Council to have Zealand, and the Confederation of Postgraduate Medical Education
the evaluation forms we received, it was evident that the students there are two trips offered (Top End and Central Australia) in May –
final say on registration and accreditation standards. That is, a council Councils to raise awareness that this is a shared concern among
absolutely love the workshops. Perhaps more importantly, a large for which you should contact Melly Lewis at melly.lewis@gpphcnt.
composed of the Federal, State and Territory Health Ministers would medical educators and the medical profession.
proportion of students indicated that they were considering a career org.au. We would urge all interested health students to apply for a
be responsible for approving or amending the length, structure and
The accreditation standards of Australian medical education and in health more favourably following our visit. program that is challenging, exciting and extremely rewarding.
content of University and specialty training courses.
training should not be subjugated to short-term, politically-motivated
AMSA, in conjunction with a number of other groups representing the workforce imperatives. The future and safety of the Australian Anecdotal evidence from teachers at the high schools was also Get onto it - you can pass those exams later.
medical profession and medical educators, is extremely concerned healthcare system depends on it. very favourable. They enjoy the sessions almost as much as their
4 5Physician Hindrance?
The Royal Australian College
The Skinny on PAs of General Practitioners
Words by Carly Fox,
AMSA Public Relations Officer
Free online student membership
Your passport to valuable education resources
Like a career with portable skills? Consider a career in general practice.
Unless you’ve been living under a branch in Wallace Rockhole for the fewer resources and difficulties accessing infrastructure. This is only
last three years, you will have heard the term “Physician’s Assistant” set to worsen as more and more students move through the system.
As a medical student you are invited to take up free online RACGP student membership* to access
(PA) used by everyone from Ms Roxon to, well, me. PAs have been valuable clinical resources to support your education. Your student membership package includes access
both revered and ridiculed by stakeholders in healthcare, and they Consider a PA working in a cardiology department at The Prince
Charles Hospital. The PA, as one aspect of their work, would take to gplearning interactive online medical education, the RACGP John Murtagh Library online, Australian
continue to be the source of significant controversy as we stand
on the brink of their introduction into the Queensland and South detailed histories and examinations of new patients. The PA would Family Physician (AFP) online, free membership to the college’s National Rural Faculty and more.
Australian Health workforces. present the essentials of the patient’s history and examination to the
cardiologist, who would direct patient care from that point.
PAs are health care professionals who practice medicine with
physician supervision. PAs originated in the United States in the 1960s This role description is strikingly similar to the tasks of a final year
in response to the shortage and uneven distribution of primary care
physicians. The first PAs were Navy Corpsmen who had received
medical student undertaking a medical rotation. In fact, it is an
optimised picture of how medical training should occur – the student Upgrade your free online student
considerable medical training and experience during their service, but is integrated into the medical team, performs a meaningful role and is
who had no comparable civilian employment. given some degree of responsibility. These opportunities for medical membership for only $49 and receive:
students are becoming increasingly scarce. Introducing PAs into the
Today, the PA workforce in the US is around 65,000 strong. The scope of mix will see these opportunities quite literally become extinct.
practice of US PAs is broad. They may conduct physical exams, diagnose
• Australian Medicines Handbook CD 2008 (new)
and treat illnesses, order and interpret tests, counsel on preventive PAs are also trained to perform specific practical procedures. Already, – the independent, evidence based medicines
health care, assist in surgery, and write prescriptions. The PA exercises a as a medical student, it is difficult to gain procedural experience. A
significant degree of autonomy within the Clinician-PA relationship. colleague of mine spent four weeks of his medical rotation waiting reference including information on drug classes as
on the neurology ward to be allowed to perform a lumbar puncture. well as drug monographs containing new/revised
In recent years, there has been a push to introduce PAs into the He had no luck however, as there was always a resident or a registrar
Australian Health Workforce as a means of addressing doctor waiting to be taught ahead of him. The shortage of opportunities for evidence and comparative data (valued at $115)^
shortages and ensuring a sustainable workforce for the future. At procedural experience was confirmed in a recently published article,
present, 9% of Australians are employed in the health sector. By 2025, examining interns at a major metropolitan teaching hospital in Brisbane • check on CD 2007
up to 20% of the workforce will need to be engaged in health-related over a four year period. The study found that interns often did not – self education program. Written by clinical experts,
jobs to sustain present levels of healthcare, let alone to work towards gain adequate procedural experience during their first postgraduate
innovation. Our ageing population, increasingly burdened with chronic year to adequately equip them for progression to PGY2 and beyond, this highly interactive format provides instant
disease, compounds this problem. and this was due to a lack of training opportunities. feedback on clinical scenarios. Topics covered
On the surface, the introduction of PAs may appear to be an The PA programs under way in Queensland and South Australia include paediatrics, neurology, emergencies and
economically attractive proposal. PAs take up 10% of the time of are pilot programs, examining the impacts of PAs on the existing
the supervising doctor but can address 85% of the caseload of the substance abuse (valued at $68.20)
workforce and training. We welcome independent and unbiased
physician in most circumstances. PA educational programs run for 24 research into the impact of PAs on patient care, quality, other health
months and training a PA costs about 20% of medical practitioner professions, efficiency, patient satisfaction and above all, training. We • Australian Family Physician
training in the United States. do not support the blind introduction of these practitioners into the – monthly hard copy subscription plus bimonthly
fold without consideration of these impacts and adequate planning
The Queensland and South Australian governments have been so GPReview and GPessentials (valued at $55).
impressed with these statistics that they’ve implemented PA pilot for the integration of PAs into the Australian Health Workforce. Of
programs. In Queensland, the pilot program will run at five sites concern, the University of Queensland is seeking to accept their first
across the state. PAs will operate at Mt Isa and Cooktown, and the intake of PA students in 2009, before the conclusion of the pilot
remainder will be integrated into metropolitan settings at hospitals program in 2010.
* RACGP Affiliate student upgrade membership applies from 1 July 2008–30 June 2009.
around Brisbane. AMSA is not advocating a position of no physician assistants. We
^ The CD-ROM version of AMH is suitable for Windows or Macintosh systems.
However, the implementation of these pilot programs raises many recognise that Australia needs a sustainable, flexible and mobile
questions, the most pressing of which is the effect that the introduction health workforce for the future. We need solutions that will see the
of PAs will have on medical student and junior doctor training. residents of Wallance Rockhole have access to high quality, accessible
medical care. However, this must not be done at the expense of
For more information visit
We’ve all heard the statistics – the number of medical graduates is
Australia is projected to increase from 1,200 in 2002 to over 3,000
training opportunities for medical students and junior doctors. We
urge stakeholders to execute this scheme with due consideration to www.racgp.org.au/membership/students
by 2012. Already, current medical students are feeling the pinch of the impact it will inevitably have on medical training, the quality of
the increased numbers. We experience reduced hours of teaching, future medical workforce and, above all, the quality of patient care. or call 1800 331 626
6PANACEA II 2008
Inhospitable
Hospital Tunes
Words by Justin Chau, UNSW
Around the World
in an 80’s Haze:
Melbourne08
Words by Sam and Carlee,
© Zhudifeng | Dreamstime.com Melbourne08 Convenors
Like most of the population, I suffer from a condition known as Earworm Eminem’s ‘Just Lose It’ and Gnarls Barkley’s ‘Crazy’ made their presence In the minds of the uninitiated - that is, Con-virgins - AMSA Convention Convention even unearthed a celebrity: Vinay Kumar – Man About
Syndrome. Also known as the ‘Annoying-Song-Stuck-In-Your-Head’ felt. Even the annoying, squeaky High School Musical song ‘Get’Cha is little more than a week of debauchery and outrageous partying. Town. You may know him as the Pathology author, but we soon
phenomenon, it is a guilty pleasure I secretly indulge in and is perhaps best Head In The Game’ implanted itself into my mental Walkman as I When I arrived back to uni, a week late and with Convention Acquired discovered he is so much cooler than that. See for yourself – add him
epitomised by the ‘sha na na’ of Kylie’s appropriately-named ‘Can’t Get hurried out of the Neurology ward. Pneumonia only to be challenged by some little upstart who claimed on Facebook. No really.
You Out of My Head’. Most of the time it becomes a repetitive, musical Convention was exactly that, I had two questions. The first: have you
irritation that you have no control over and a large amount of oral restraint However, after the first few minutes of mental turbulence, I actually ever actually been to Convention? The answer? A predictable no. The Wow. I’m beginning to feel a bit like I’m bragging. However, I am from
is required to stop revealing to the world that tunes like ‘Hot Potato’ by began to find it offensively amusing. And as I passed other wards, I second: since when have medical students ever shied away from a Monash, so when it comes to intervarsity competition this is where I’ll
the Wiggles are on your cranial playlist. Self-control is especially essential began to internally formulate a list so that, in the future, I could hum or good time? pipe down. Congratulations must go to UWA for winning not only the
if you’re a guy hanging out with his mates and you’ve got ‘Don’t Cha’ by the sing inappropriate songs in front of patients I didn’t like. I subsequently
debating, but also the Welch Allyn Emergency Medicine Challenge.
Pussycat Dolls on an involuntary mental loop. However, being the ever- spent that afternoon collating this brief list of clinically callous songs: AMSA Convention is a week revered by those who have been there Also to the boys from Tasmania for upsetting (quite literally - I’m sure
observant medical student, I have also discovered it is more important that before. Simply having Hawaii 5-0 on repeat every single night and I saw them weep) the Adelaide Cascade Cup team. Luckily their girls
you don’t fall into the trap of thinking that your stethoscope earplugs feel EPILEPSY Good Vibrations - Beach Boys, revelling in the sheer awesomeness - and occasional awkwardness - won the Pipps Cup for some semblance of redemption.
like iPod headphones and inadvertently start to sing embarrassing songs Shake It - Metro Station of 850 pairs of hands flapping around like mad, led by Adelaide’s Ross
out loud in the clinical setting. RESPIRATORY Take My Breath Away - Berlin, Roberts-Thompson screaming “Go left! Go left!” would be enough Imagine 4,000 dumplings, foam, glow-sticks, icy poles and 25 people
No Air - Jordin Sparks & Chris Brown for most. However, like man himself, Convention has evolved. dressed as giant Singha bottles in the lobby of the Hotel. This could
This important lesson occurred to me one afternoon at hospital whilst
JAUNDICE Yellow - Coldplay only mean one thing: the social programme. Costuming is inevitably
waiting for my guide. There I was, a trendy med student, clicking The week began with the Governor of Victoria welcoming delegates
one’s fingers and tapping one’s feet outside the room like I had just CARDIOLOGY Achy Breaky Heart - Billy Ray Cyrus, This Heart Attack a high-priority pre-convention and the effort this year was simply
to our great city. As a medical professor himself, he set the tone
made love to a metronome. Getting into the groove, I nonchalantly - Faker, Why Does My Heart Feel So Bad? - Moby stunning. The aforementioned bottles of Singha, the elephants who
for the world-class academic programme to follow. Favourites among
started to hum ‘Let’s Get Retarded’ by the Black Eyed Peas, as nurses, HAEMOPHILIA Bleed It Out - Linkin Park, had a giant straw right the way through their trunk and those ambitious
the delegates included: Jeffrey Rosenfeldt, Head of Neurosurgery
doctors and patients walked by. After a minute or so of head-bopping, Bleeding Heart - Leona Lewis Adelaide boys who came chained together and blindfolded. A reliable
at the Alfred Hospital and trauma surgeon in Iraq; the passionate
I started to get strange looks from a few passers-by but didn’t really source tells me breaking the seal was not the only toileting issue they
AMPUTEES I’m Still Standing - Elton John, Footloose - Kenny Loggins and moving Jeff Kennett, speaking on behalf of Beyond Blue; the
take notice, conceding that either they were grumpy that I was young, faced that night. Furthermore, you know your costume is good when it
STIs Sexual Healing - Marvin Gaye entertaining Dr Rick Kausman, who shared a wealth of knowledge on
healthy and happy, or that they were admiring my physical features. body image, eating awareness and other food related issues; and the seats four people and is confiscated by the venue for being hazardous,
About half-a-minute later however, my guide comes back and tells BLIND I Can See Clearly Now - Jimmy Cliff, brave Professor Chris O’Brien, who shared with us his experience as as was the case with Adelaide’s Tram on Victoria’s Secret night.
me to “Keep it down - especially with that song. After all, we are in Suddenly I See - KT Tunstall
a patient, having been diagnosed with a brain tumour 18 months ago.
the neurology ward”. That’s when it hit me that I was singing out loud DEAF Do You Hear What I Hear? - Destiny’s Child Stirring indeed. Melbourne 08 culminated in spectacular style with the “Winter
a highly insensitive tune and, mortified, I hastily apologised profusely. Wonderland”-themed ball. Entering the ball was breathtaking and the
DUMB A Little Less Conversation - Elvis Presley,
The fact that my voice sounds worse than a corrupted Paris Hilton Don’t Speak - No Doubt And that was only Monday and Tuesday. night ahead equally so. A celebration of the week we had all shared,
mp3 file (Don’t ask. The perils of downloaded music and curiosity...) a time to reminisce and a time to embrace the AMSA spirit, this night
didn’t help the humiliating revelation either. This list is by no means anywhere complete or perfect, but hopefully Dr Peter Larkins, Dr Greg Hoy and Dr Peter Brukner united with elite was undoubtedly the pinnacle of the week gone by.
it’ll provide a good foundation of what tunes should not be sung in front athletes James Hird, Michael Klim and Damien Fleming to expose
Embarrassed by my vocal faux pas, I immediately tried to mentally
of patients if you’re interested in passing your OSCEs. Furthermore, I the exciting and emerging field of Sports Medicine. It was a fabulous It’s been 10 weeks and I still have PCD. No, not a Pussy Cat Doll:
erase the song. But no matter how hard I tried, the BEPs would not
do not condone the use of them towards annoying patients, especially session and a favourite among many of the male delegates. Of course, Post-Convention Depression. Thankfully, like man, Facebook too has
tune out. Not one to give up, I hit upon the golden idea that if I played
if you have a voice as bad as mine (imagine William Hung intoxicated no programme would be complete without a little controversy. evolved and I can keep in touch with all of those amazing people from
another addictive song in my head, it would then supplant my current
on helium balloons with a pitch wobblier than MJ’s nose). Welcome Pro Drugs in Sport campaigner Dr Tony Millar featured around Australia who made Convention what it was: the best week
one. I then thought to myself, ‘What songs are there that won’t offend
in what was a spirited debate with Peter Larkins. We also figured of my life.
people with neurological or psychiatric conditions?’ Now excuse me while I go and sing Mika’s ‘Big Girl You Are Beautiful’ featuring Philip Nitschke was a great way to prise delegates out of
to some anorexics. bed on Friday morning.
Big mistake. Like the person on a very high structure who looks down
once you tell them not to, I started to get an infestation of the very (Justin is a UNSW medical student who wonders if the ‘three-second’ rule still
music I was trying to avoid. Cypress Hill’s ‘Insane In The Membrane’, applies during an organ transplant.)
8 9PANACEA II 2008
Convention Ballad
WIT
HP
O
SEA ET LA
NW U
ILL REAT
IAM E Wednesday was sports day, and for the EMC we were so keen,
S That out of a hat, the names we had to choose,
So Cossie, Chloe, Rebecca, Rishi, Chandra and Sanjana made our team,
And you’ll be pleased to know, we even didn’t lose!
There was a murmur at convention, for the word had passed around,
That the kids from UWS were on their way, Nothing beats the taste of goon, in the morning on your lips,
With a thirst to make our mark, raise our voices, make a sound! And it led to some crazy stunts,
All 36 of us were ready to play. We danced on tables, hijacked cars, had photos with Sean’s four nips,
Despite the mix of first and seconds, to all of us this game was new, And told UQ they were a bunch of … gentlemen.
The older unis looked on, pretty coy, For the tug’o’war that arvo, we gathered a formidable side,
But by weeks’ end, those who didn’t know us indeed were few, And anchored by Big Vic we were quite hopeful,
Because we rocked that Melbourne town, YEAH BOI!
We planted our feet, tightened our grips, but landed on our hide,
Before any of us could even shout out “Pull!”
Sunday saw us check in at the Sebel, what a line!
But luckily none of us turned home,
To finish the arvo we opened our gullets, ready for boat races,
For the AMSAdam party that night was quite sublime,
And I was proud of Kyle and Caitlin for getting action in the foam. Con and Guy starred for the fellas in the Cascade Cup,
The costume most creative? Prob’ly Bobby’s twister board, We lost narrowly to USyd, after a re-row put us in our places,
While most others went the fluoro route instead, But it only fuelled our spirit - bottoms up!
Our pres Gokul met a broad - and a nice one - we applaud! Next the came the girls, anchored by Anisha and Nishanta,
But remember: don’t spin Bobby’s Right Hand Red! Kicked off by Caitlin and by Fay,
They did UWS med proud, skulled that beer like it was Fanta!
Monday’s academics kicked off, with a surgeon known as God, And made the second round, our heroes on the day!
Who told us that he wasn’t, but then out he spelled,
That in fact he was quite great, this neurosurgeon sod, Pub Crawl that night, we told ourselves would be a quiet one,
Luckily there was sanity in your vanity, Professor Rosenfeld. But we obviously forgot to touch wood…
Then Kausman took the stage, told us eating quickly was quite naughty, “Free” vodka, Germans, cold pies and cheap J-bombs meant it was quite fun,
Take an hour, a Mars Bar, just to eat! A night so very bad, that it was good!
And you can get the DVD, and the posters too for just $10.40, Flannelette, surf life-savers, Steve Irwins and all other things Australian,
Pity most stuff, eaten slowly, tastes like sheet. Disguised us on our crawl from pub to pub,
And I don’t recall it all but there were stingrays, crocs and others non-mammalian,
Fire breathers and elephants, were Monday’s Thai Bucket Party, Someone please tell me how I ended up almost in the nud?
An empty inch in that place was hardly found,
And with my home-made palm-tree hat, I felt quite arty-farty! On Thursday eyes were bleary, for we were all quite weary,
The cages were über popular all-round. But the next speaker wouldn’t keep us down,
It’s said, that when in Thailand, of lady-boys one should be wary, The King of Path himself, Vinay Kumar, made us cheery,
And on Monday night Robbie gave us proof, Befriend this man on Facebook, what a Man About Town!
By dressing up as one, and looked so good it was quite scary -
Following was a funny talk, with a captivating title,
He kissed a straight guy: bet he felt like a goof!
“Should human beings really be having sex?”,
A question such as this, at Convention was quite vital…
It’s easy to feel down, after two nights of heavy partying, innit?
While poor Deniz would tell you no, Kyle would certainly say yes, yes, yes!
But then what better way,
To crawl out of it, with a talk from Beyond Blue’s Jeff Kennett,
A great start to a great Tuesday. So many other stories from this week, I haven’t time to tell,
With Beijing looming, next came a panel on sports medicine, Though I think it’s fairly safe to say,
With the awesome Damien Fleming and Michael Klim. Victoria’s Secret, Havana Nights and Winter Ball rocked as well,
This was followed by a talk, most touching and inspirin’, And that chicken and passion-pop went down well 5am Sunday.
By the surgeon Chris O’Brien, we send best wishes to him.
All 36 did us proud, the largest crew in our short history,
We went to Tokyo on Tuesday, and Barber was a rock-star, But now I better do some bloody PBL so catch you laters!
While Craig impressed with his scrubs-ninja skills, Why plenty more of you weren’t there, to me remains a mystery,
He knew that links with MDOs can take medsocs very far, What’s done is done, no need to care - I’ll see YOU in Brisvegas!
And got friendly with the Avant rep with looks to kill!
10 11PANACEA II 2008
y y
enousssa g enous
Essa]
d i g E ] d i
n [I n
[I
Winner
Health Winner
Health
Competing with a Handicap:
The Hypocrisy of Aboriginal “Self–-Determination” Edentulous at 30
Words by Jonathan Epstein Words by Joni Nissen
You have to make a choice”, Dr L was telling Henry, an Aboriginal man jargon is used. Likewise the English words Aboriginal people do speak The first thing Jambin does when he comes home is to grab a packet and report difficulty in paying the bill.’ Thus, it is evident that ‘the
in his late-20s sitting on the hospital bed in dusty brown jeans and often signify different meanings. For example, asking a patient whether of chips and a coke, sit down out the back, and proceed to nourish development of culturally appropriate services’ should be investigated.
shirt. “You have to tell me how you want me to do this operation. I they have a temperature is often understood not as asking about fever, the millions of bacterium living cooperatively in their thick, tenacious
can do it either way; it’s your choice. You just have to let me know”. but about whether their body is hot, as all bodies are when they are biofilm, attempting to obliterate Jambin’s dentition. After dinner that An initiative established in South Australia has been designed to create
alive. This “Aboriginal English” is conditioned by uniquely Aboriginal night, Jambin thinks nothing of the vicious microbes achieving victory a dental environment in Port Augusta that provides specific care to the
In January 2007 I completed a student elective at Katherine, a flat and concepts of the body, time, disease and man’s place in the world. All at the enamel-dentinal border, but goes straight to bed. No thought of needs of the Indigenous community. A single chair dental office was set
humid town three hours south of Darwin, where I spent most of my this is ignored in the standard “doctor-patient relationship” model. cleaning his teeth, or of the concept of oral hygiene and why should he? up in the community, serviced by a graduating dentist, a dental assistant,
time in the Emergency Department of the local hospital. About 75% His mother and father never bothered, no one has told him otherwise, and a full time Aboriginal Health Worker who organised ‘research
of patients were Aboriginal, and they came in with problems largely Additionally, even assuming they have the language to do so, and when he was handed a toothbrush from a visiting dentist months assistance, health promotion, client recruitment and follow up and
related to drinking, fighting and to just poorly looking after themselves. Aboriginal people may choose not to talk to the doctor. It is culturally ago his father took it and used it to clean his fishing gear1. program development.’ The project was an immediate success in the
Henry was admitted because of a fight a few days back where he’d cut inappropriate to reveal certain information to people of the opposite community, and may be attributed to ‘the location of the clinic within
one of his fingers. By the time we saw him it was infected. Dr L had to gender and young people may be especially reluctant to respond as It’s only weeks later when a searing pain presents itself emanating the main health centre premises, promoting dental care as an integral
cut it open to release the pus, but he’d given Henry the choice: should the main experience they’ve had with being questioned is with the from a newly erupted tooth, that Jambin pays any attention to his part of general health care, resident dentist, allocation of Aboriginal
he inject local anaesthetic into the hand or should he block the nerves police. Finally, there is the problem of the doctors’ own competency mouth. But what help is there for Jambin now? Living in Ngulupi, he is Health Worker, and the flexibility of the program in regards to the
in the arm? He explained the risks and benefits to Henry, and then with the English language, as the majority of clinicians in Territory hundreds of kilometres of dirt road away from the nearest dentist. Even acceptance of cultural diversity and its impact on clinical services.’
waited for a response, urging the patient to “just tell me which way rural communities have been, like Dr L, trained overseas. if he has the use of a car to travel in to get there, he faces the issue of Services such as these that provide oral health care to the community,
you’d prefer”. Henry nodded, refusing to answer as the doctor became being able to be seen by the busy dentist that services the surrounding
These communication barriers make the health system something with cultural diversity in mind should be closely monitored, and if
more and more frustrated. “Yes, yes, yes”, he said. hundreds of square kilometres and of affording the extensive dental
foreign and strange to many Aboriginal people. Yet, despite our appropriate implemented in other areas of rural Australia.
fees. There is also the concept of voluntarily subjecting himself to
We all know the statistics. Aboriginal health is a disgrace to this avoidance of paternalism, the Western health system is a major part
the fear inducing environment of the white coated doctor with the The inaccessibility of dental care for many communities constitutes
country. The average life-span is about 15 years lower than that of the of the lives of many Indigenous Australians. How can Aboriginal
great big needle, quaking at the knees with his father’s story of ‘the a strong need for a preventative approach to oral health. Good oral
non-Indigenous population, and conditions such as diabetes and heart people understand this system and make decisions about their health,
Butchers of Biloela’2 repeating itself in his head. hygiene should be taught to children from an early age, to ensure
disease have combined with the social problems of alcoholism and if they cannot even understand their doctors?
welfare dependency to make Aboriginal Australia a Third World nation appropriate habits are maintained throughout life. This may be
This is the current place of Aboriginal people in Australian society. Prognosis for Jambin? High carbohydrate load, processed foods, acidic implemented by developing programs in the schools curriculum, so
within a prosperous country. Unlike fifty years ago, it is no longer
We have attempted to enshrine their right to an education and their drinks, minimal knowledge of preventative dental care and no fluoride students are aware of the aspects involved with disease prevention
possible to blame the situation on lack of funds or governmental
autonomy over health. We respect their difference. But at the same supplementation? Mix in a general increase in diabetes in Aboriginal and thus the importance of basic oral hygiene, as well as introducing
racism. Indeed, according to many, the Aboriginal community entered
time, in an amazing act of cultural blindness, we ignore the fact that populations, which has a known association with increasing the chance the protective benefits of fluoride to the community either through
its greatest crisis after the 1967 referendum on citizenship and the
Aboriginal communities are constantly confronted with Western and severity of periodontal disease- Jambin’s prognosis for a happy
granting of self-determination to much of the Territory. water fluoridation or a program implemented in schools.
institutions, such as the health and education systems. Our fear of a and healthy dentition is dismal.
Aboriginal policy, with the exception of the disastrously implemented return to the paternalistic policies of the past denies Aboriginal people Having travelled extensively throughout Northern and Central
“intervention”, is plagued by two conflicting yet simultaneously held the opportunity to learn the basic cultural knowledge necessary The situation of isolation and poor access to dental health care is one Australia, seeing the expansive disposition of this wide brown land
errors. Firstly, in an attempt to respect cultural difference, we believe to understand broader society. Unless we dream of an impossible faced by many Australians living in rural and remote areas. The large and the isolation in which some communities exist, it is no wonder
Aboriginal people should have autonomy over their own affairs and isolationism, every sub-culture has no choice but to come into contact geographical area and dispersed population results in the need to Aboriginal dental health is in such a poor condition.
that too much interference from the dominant culture constitutes with the dominant culture, if only to challenge and change. Aboriginal supply services to communities that are not large enough to warrant
paternalism. Secondly, as a lingering effect of the shameful blindness people are being confined to a dominated social position under the their own dentist.1 This constitutes the need for patients to travel So come on Australia! Let’s focus on the future and preventative dentistry
of Terra Nullius, we fail to appreciate just how different Aboriginal rubric of cultural difference. large distances to receive oral care, which triggers problems related and try to stop kids like Jambin becoming edentulous at thirty!!
culture is, with its complex systems of kinship and landownership. The to transport, time off work, road conditions, and accommodation if
result is that Aboriginal people are constantly exposed to institutions Aboriginal people do not need to become mirror images of middle- necessary. In addition, rural dwellers of a low socio-economic status
1 - Reference made by Dr Porter, University of Queensland Dental School, recalling
constructed according to models foreign to them, yet are likewise class urban Australia. What is required, and what current talk of self- are recognised as a subgroup of the population that do not access when the toothbrushes given to young Aboriginal children whilst working in an
denied the knowledge required to fully participate. determination and respect for difference leaves out, is a knowledge regular oral health care due to the relatively high costs, predisposing Aboriginal community where promptly taken off them by their father’s to clean
of the basic cultural competencies mandatory for life in 21st century the population to poor oral health. fishing gear/ car parts. The issue was solved by disinfecting used toothbrushes
The disastrous state of Aboriginal health therefore has its roots Australia. Likewise, this necessitates a massive attempt by European from hospitals and supplying these to the children’s father’s first before allocating
in the assumption that Aboriginal people are in positions to make Australians to fully understand the Aboriginal world-view, which must A significant proportion of the population in rural and remote Australia new toothbrushes.
autonomous and informed health decisions. Multiple aspects of “culture form the basis of this education. Until Australia reaches this stage, is of Aboriginal descent. According to Brennan and Carter, ‘Indigenous 2 - ‘Butchers of Biloela’ is a quote used by the writer’s father when referring to the
clash” occur in the “doctor-patient relationship” when the patient is Aboriginal people they will always remain dominated, competing with Australians had poorer oral health outcomes (higher edentulism and locum dentist that used to set up in the pub in the early days back in Biloela, Central
Aboriginal. English is a fifth or sixth language for many Aboriginal European Australians, but always with a handicap. denture use), and were more likely to: visit for a dental problem, QLD, when anaesthesia was poor/not used and patients could have a drink to settle
people, who may only pick up certain words: especially when medical have fewer dental visits, experience more toothache, not be insured, their nerves prior to dental work.
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