In the early 1900s, when Abraham Flexner wrote the landmark report that revolutionised medical training across the world, doctors were prescribing morphine for teething babies, hydroelectric baths for migraines, and starvation diets for patients with aneurysms. Thankfully, medicine has evolved dramatically over the past century. Today’s doctors, however, largely continue to be educated in the same model that Flexner developed in 1910: a system based on scientific foundation followed by clinical immersion.

Preparing doctors to work with people and not just diseases

Dr Kathryn Ogden, an academic general practitioner at the UTAS School of Medicine, is among those who believe we need to ensure medical education is fit for purpose. As a PhD candidate researching medical education, Dr Ogden is exploring the ways that students can develop the various attributes and qualities they need to thrive as clinicians in today’s complex and evolving healthcare system.

‘The Flexner Report has been very effective for the past 100 years but now we need to think about the next 100 years,’ says Dr Ogden. ‘And while medical education has evolved to a certain extent over the past two decades, we still focus our students on accumulating clinical knowledge and skill. This is important, but medicine is about so much more than that.’

Today’s doctors need to have skills such as collaboration, patient centredness, quality improvement, self-awareness and the ability to work within systems. They need to communicate, manage difficult situations and understand what other services are available for patients. Equally significant have been the changes in healthcare conditions in that there is much more complexity and multi-morbidity; people rarely have one disease these days and there are usually multiple interactions between those diseases and conditions.

‘My research interest is in how we provide students with opportunities to develop that set of skills that will allow them to function effectively within the systems that they work,’ says Dr Ogden. ‘We want to prepare doctors who work with people and not just diseases.’

A patient-centred approach

Part of the inspiration for Dr Ogden’s research has come from her involvement with the Patient Partner Program in the Launceston Clinical School. This award-winning program teams medical students with members of the community who are living with chronic illnesses. The unique knowledge and experience offered by the community members provide a learning partnership that fosters a patient-centred approach in young doctors.

Dr Ogden is drawing upon the lessons from programs such as these to try to clearly enunciate what it is that educators should be working towards – not only the programs that are required to produce doctors who are ‘work ready’ but a definition of what that term actually means.

‘As a doctor, there are things you come to learn as you get older and wiser and you wish you could get there a little bit sooner,’ Dr Ogden says. ‘These are uncertainties, like the fact that you cannot cure everyone. But you can still help them.

‘Medical students can be very focused on curative medicine and that’s the way we train them – someone comes into the hospital with a problem, they receive treatment, and they go home. My passion is to educate students to go into the workforce without the burden of these narrow expectations. Medicine is much more satisfying when you accept the complexities and the ambiguity. Current students find uncertainty, which are more prominent in some branches of medicine, difficult and less appealing, so we’ve got a bit of work to do to turn that around.’

As well as working towards her PhD, Dr Ogden mentors clinicians from the Launceston General Hospital in her role as Research Program Development Fellow with the Clifford Craig Foundation. She also continues to work as a GP.