“I have learnt … a different way of looking at people's health”: an evaluation of a prevocational medical training program in public health medicine and primary health care in remote Australia

Abstract

The purpose of this study was to gain insight into what prevocational medical practitioners (PMPs) learnt during a six-month public health medicine and primary health care training program (the Program) in remote Aboriginal Australia in 2001–2002. The Program's curriculum objectives included clinical and public health management of sexually transmitted infections, immunization, clinical audit and quality improvement, primary health care in remote Aboriginal communities, and working as part of an interdisciplinary team with health and non-health professionals, and lay people. The mode and location of delivery of these objectives was determined by the healthcare needs of the Kimberley population, and availability of safe, supported workplaces. Qualitative data from a variety of sources, including PMPs’ reflective journals, were examined in the context of the Program's curriculum objectives and by conducting a content analysis of journal notes. Findings are presented using the curriculum objectives and other comments that emerged while examining the data. Preliminary data indicated that PMPs gained knowledge and practical experience in clinical and public health management of sexually transmitted infections, immunization and primary health care in poorly resourced remote Aboriginal settings. Deeper understandings of health and illness in a cross-cultural setting also developed, along with professional and personal growth, as illustrated by the following quotations from PMPs: “I have learnt … a different way of looking at people's health … I was encouraged to think more deeply than before about the whys and wherefores of medical practice, and thus consider the most effective ways of influencing patients’ behaviours for the better.” “I was encouraged to examine the thought processes behind the ways … healthcare was provided … [after leaving the Kimberley] I am constantly questioning the reason why we are practising medicine in a certain way in the big city hospitals—much to the consternation of my colleagues … .” The Program was successful in teaching its first four PMPs the basic tools of public health medicine and remote area primary health care.

Notes

Notes

1.  Prevocational medical practitioners are doctors who have not entered a specialist training program.

2.  In accordance with ethical requirements, PMPs gave written consent for the content of their journals to be used in preparation of this paper. PMPs were also invited to comment on this paper prior to its submission.

Additional information

Notes on contributors

Donna B. Mak

DONNA MAK is a public health physician who has worked in general practice and public health for 11 years in the remote Kimberley region of Western Australia (WA) and has taught many medical students and junior colleagues. She is now an Associate Professor based in Perth, WA, working in communicable disease control and teaching population health to medical students.

Aileen J. Plant

AILEEN PLANT is a public health physician. She has extensive experience in general public health, especially infectious disease control, and in educating health practitioners in these areas.

Sandy Toussaint

SANDY TOUSSAINT is an anthropologist who has worked for several decades among Indigenous groups in the Kimberley region of Western Australia. She has published widely on health, legal and environmental issues.