The MBBS Program at the University of Adelaide provides students with state of the art education and training to enable them, as graduates, to practise medicine in the 21st Century. Over the last 15 years, the Faculty has devoted considerable time to reviewing the requirements of graduates to ensure that they will become effective modern medical practitioners and to develop and evaluate styles of learning and teaching that are best suited to producing such graduates. The outcome is a state of the art, integrated educational program. In addition to producing graduates who are fully competent to undertake an internship, a major aim of the curriculum is to make learning enjoyable and stimulating.  It has been important and pleasing to see students so obviously enjoying themselves as they learn.

Program Emphases and Structure

The three major "streams" of the course are the core elements of medical practice: the Scientific Basis of Medicine, Clinical Skills and Medical Personal and Professional Development.  These three streams form the basis of an integrated case-based program in Years 1-3.  Throughout Years 4-6, students will expand their knowledge, experience and skills within these three streams as they undertake placements within the teaching hospitals and in the broader medical community. Case-Based Learning (CBL) has been adopted as the dominant learning mode during the early years of the curriculum. The curriculum begins with an introduction to CBL processes and study continues in small groups using clinical cases of the most common and important diseases as a basis. Lectures are carefully staged throughout each CBL case to provide key information to assist the students as they progress. Resource (or practical) sessions relating to the case are introduced throughout the week at appropriate times. These sessions allow students to work with physiological problems and introduce them to anatomical specimens that demonstrate normal features, often in conjunction with diseased specimens. These sessions are designed to have practical application. Rather than memorising unnecessary detail, the emphasis throughout the prgram is on understanding, and being able to explain, mechanisms and principles. Many students may need help with some of the basic concepts of biology and chemistry in order to study medicine effectively and efficiently. In Year 1, students undertake two semesters of biology: Fundamentals of Biomedical Science A in semester 1 and Fundamentals of Biomedical Science B in semester 2. Throughout the CBL program, learning in medical disciplines such as pathology, anatomy, physiology, and pharmacology are taught in the context of the case under study.  Students are then able to bring this core learning to their later placements within the public teaching hospitals and the broader medical and health community. Training in clinical skills begins in week one. In Years 1 and 2 this is done by senior clinicians in small groups in a dedicated clinical skills laboratory.  The  clinical study program is linked to the system of the CBL case under study.  In Year 3, clinical skills training is located primarily in the public teaching hospitals.  In years 4-6 students will advance their clinical skills competencies throughout a range of clinical attachments. Because clinical skills training begins in Year 1, the traditional divide between "pre-clinical and clinical" teaching has been eliminated. A major emphasis is placed on developing effective communication and decision-making skills, the practice of evidence-based and preventative medicine and on becoming competent users of information and information technology. The Medical Professional and Personal Development stream aims to introduce students to the complex communication, ethical, psycho-social, and preventative medicine competencies required by a medical practitioner.  Preventative medicine is increasingly being recognised as one of the most important elements of a modern health system.  The University of Adelaide MBBS program places a special emphasis on evidence based medicine and the principles of public health that inform the practise of preventive medicine.

Community-Based Learning

Changes in health care arrangements in the community and pressures on the way in which the major teaching hospitals deliver health care have required changes to the traditional approaches to medical training. These changes have resulted in increased opportunities for students to be trained in placements within the community.

The University of Adelaide Rural Clinical School  

The Spencer Gulf Rural Health School (SGRHS) is a regional multi-disciplinary school of health science created as a joint initiative of the University of Adelaide and the University of South Australia http://sgrhs.unisa.edu.au/  SGRHS is supported by the Australian federal government’s Department of Health and Ageing through the Rural Clinical Schools program (RCS), the University Department of Rural Health program (UDRH), the Rural Undergraduate Support and Coordination program (RUSC) and the Primary Health Care Research Evaluation and Development program (PHC_RED). Each of these programs provides funds to the universities for rural student placement and rural research.The SGRHS is based in Whyalla at the University of South Australia’s campus in Nicholson Avenue. The School also has campuses throughout the region including Pt Augusta, Pt Lincoln, Pt Pirie, Minlaton, Maitland, Clare, Kadina and Booleroo Centre.  These campuses are equipped with dedicated student facilities including student accommodation, study areas, libraries and up-to-date information technology (computers and video-conferencing equipment.The SGRHS academic and professional staff comprises a multidisciplinary team of highly trained and experienced health professionals and key support staff. SGRHS provides opportunities for students to be trained in a range of clinical specialties in rural South Australia. All medical students attend a rural week in the Eyre or Yorke Peninsula as part of the Year 3 curriculum. Rural Placements offer students a unique learning environment, often with more clinical and hands-on experience.Enrolment in the Undergraduate Degree of Bachelor of Medicine, Bachelor of Surgery at The University of Adelaide, requires students to undertake rural clinical placements.  Commonwealth Supported Students (in both bonded and unbonded places) need to complete 4 weeks of rural placements before graduation and 25% of them need to complete one year of clinical training in a rural site. All rural programs are provided by Spencer Gulf Rural Health School.

Electives

In the later years of the program, there are opportunities to take electives in medical disciplines. In Year 4 and 5, students choose from a range of medical and scientific attachments. The Year 6 program offers a semester of three, 6-week internships and a semester of four, 4-week elective placements in community and ambulatory locations. By the end of Year 6 a student must have completed at least 4 weeks located in a rural environment. However, students may elect to do more than 4 weeks in a rural area.

Support Structures 

Many students entering the medicine program at the University of Adelaide are from rural, interstate or international locations, and some students experience problems adjusting to life in Adelaide. As well, students may experience stress in adjusting to university life and self-directed study. We provide support to students through this time of transition. Structures are in place to provide students with both informal counselling by staff members and access to more formal counselling arrangements. There are also student led organisations that provide support and assistance to students with particular backgrounds and interests, such as the Rural Club and an Indigenous students group.

Academic Language and Learning in Medicine Program 

This program is an integrated skills development program. In conjunction with the curriculum, this further develops the communication skills needed for talking with others (including patients), as well as tertiary learning skills (especially those needed for successful participation in problem-based learning groups). The delivery mode is both in small groups and individual sessions. Small groups operate in years 1-3, and individual sessions are also available as needed. Students in Years 4-6 can have individual sessions for specific purposes.  In the first instance all international students enter this Program for orientation to tertiary studies in Australia and CBL skills development. In Year 2, international students participate in a module on academic writing skills. Other students may be selected or referred to the program, based on a written assessment in Orientation Week or ongoing tutor reports. Students can also self-select to join an ongoing group in Years 1-3 or for individual assistance.

Honours 

The Honours degree of Bachelor of Medical Science is a program of study available only to students who have passed the Third Year Examination in the MBBS.  The recommended option is for MBBS students to intermit for a year and enrol in the Honours degree of B.Med.Sc. on a full-time basis.

Professional Accreditation/Registration 

From July 2010 all medical students will be registered with the Medical Board of Australia, which has the responsibility of ensuring that all persons permitted to practise medicine should be fit and proper persons who maintain appropriate professional standards. 

Careers 

Before being admitted to full registration as a medical practitioner in Australia, a medical graduate must serve at least twelve months as an intern in an approved hospital. After successfully completing the internship and obtaining full registration to practice, graduates have to make a career decision regarding postgraduate specialty (including general practice) training programs offered by a professional college. There is a wide range of medical career paths and options become apparent as students progress through the program.

Introductory statement regarding the Inherent requirements of the Medical Program

The University of Adelaide Medical Program aims to provide its graduates with the basic knowledge, skills and competencies required for the practice of medicine as a junior hospital doctor. These attributes form the foundation for future career options and ongoing self-directed learning. A broad-based, experiential and patient-oriented curriculum is necessary for the development of such knowledge and skills. In this sense the Program is different from many other programs offered by the University.

The approaches to individual learning, academic values and teaching methods used are designed and used with this aim in mind. In particular, the importance of functioning as part of a team, the ability to communicate effectively, habits of ongoing, self-directed learning and the adoption of a high standards of professional and ethical conduct are repeatedly emphasised. The University of Adelaide Medical Program is a strongly experiential course: simply acquiring knowledge is not sufficient. Rather, students actively participate in practical learning experiences which will prepare them for their future careers as doctors, should they wish to practice. Because the award of the combined degree MBBS does entitle graduates to obtain medical registration, the University must ensure that those upon which it confers this award can present themselves as having the appropriate knowledge, experience and expertise.

Timeliness is a key factor in relation to many elements of the Medical Program. The ability of a medical practitioner to carefully observe, communicate, formulate judgements and then act in a timely manner may be crucial in the performance of their duties. An appreciation of the importance of timeliness and the ability to perform in a timely manner is therefore emphasised repeatedly during the medical program. Assessments during clinical placements and in the form of examinations (e.g. oral and/or practical examinations) usually include some assessment of timeliness.

The Medical Program places substantial demands on its students. The learning style and assessment techniques are likely to be different from those experienced elsewhere. Clinical placements can require significant time commitments of students, which may include time periods normally regarded as ‘after hours’. Students will need physical and mental stamina, as well as flexibility with respect to hours of attendance. Placements are undertaken at a range of locations around South Australia, some of which will be in rural and/or remote areas.

The accompanying Inherent Requirements document provides a detailed statement of the skills that students require as a part of the University of Adelaide Medical Program, together with some examples of where and how these skills may be required. The Program teaches and assesses these skills and they are core/inherent learning requirements of the Program.

The University of Adelaide supports the inclusion of students with disabilities by providing reasonable adjustments. In determining whether an adjustment is reasonable, the University will take into account:

• the nature of the disability
• the effect of the adjustment on the student’s ability to achieve and demonstrate the required learning outcomes and participate in the program
• the effect of the proposed adjustment on anyone else, including staff and other students
• the reasonability of costs and logistical impact

Reasonable adjustments may include modification to assessment and provision of additional support services; however, adjustments cannot be provided which would undermine the core or inherent learning required and thus compromise the academic integrity of the Program.

Once enrolled in a course at The University of Adelaide, students with disabilities have access to the University’s Counselling & Disability Services, whose role is to collaborate with other University staff to provide adjustments required for courses and examination, and to provide information and advice to assist students to achieve their learning outcomes Further information about these services can be accessed at http://www.adelaide.edu.au/disability

UNIVERSITY OF ADELAIDE
FACULTY OF HEALTH SCIENCES

INHERENT REQUIREMENT STATEMENT: UNIVERSITY OF ADELAIDE MBBS PROGRAM

1. OBSERVATION

   Observational skills (vision, hearing, smell and touch) are required as part of this program
   Observational skills that are required include:

   At a distance

   Observing the broader environment e.g. observing multiple patients, monitors and different components of the experience

   Precise and rapid reaction to sensory stimuli e.g. identifying hazards and safety issues and reacting within a limited timeframe.

   Close at hand

   Gathering and interpreting data e.g. patient notes, X-rays, hand-written and computer documents, printed material, test results and medication charts, clinical and pathological specimens

   Recognising and interpreting sensory stimuli relating to vision, hearing and touch

2. COMMUNICATION

   Communication skills are required as part of this program
   The communication skills that are required include:

   Speech
   Capacity/Ability to:

   speak to elicit information

   instruct and describe as necessary

   be understood by others

   Hearing
   Capacity/Ability to:

   hear in order to gather and organise information provided

   differentiate sounds, background noise, alarms and speech

   participate in group discussions

   Observation
   Capacity/Ability to:

   perceive non-verbal communication

   Interpret distress, a change in mood, activity or posture

   Writing
   Capacity/Ability to:

   document ideas and information

   construct legible hand writing

   Reading
   Capacity/Ability to:

   read information in a variety of formats, including hand written, printed text, on-line information, graphs and diagrams

3. MOTOR

   Motor skills are required as part of this program
   The fine motor skills that are required include:

   Capacity/Ability to:

   manipulate instruments

   use hand eye coordination to complete tasks as necessary

   gather and interpret information through touch

   perform and/or assist at diagnostic and therapeutic procedures
    

   The gross motor skills and mobility that are required include:

   Capacity/Ability to:

   Maintain a standing position while using both upper limbs for another task

   undertake physical or manual tasks e.g. moving or positioning equipment, percussion or palpation

   manoeuvre around equipment and in confined spaces and over defined distances

   assist with patient transfers

   provide general and emergency patient care including basic life support (requires use of both arms and may require assumption of a kneeling position)

4. INTELLECTUAL-CONCEPTUAL, INTEGRATIVE AND QUANTITATIVE ABILITIES

   Intellectual-conceptual, integrative and numerical abilities are required as part of this program.

   (e.g. recalling information without reference, drug calculations)

   Timeliness

   (e.g. completing a task in a safe/appropriate time frame) is a factor in relation to intellectual-conceptual, integrative and numerical skills required as part of this program.

   (e.g. problem solving, reasoning and synthesis of information occur within a clinical context in which decisions and actions are required within defined timeframes)
    

   The types of reasoning that are required include:

   Capacity/Ability for:

   scientific reasoning

   sound decision-making

   consistent judgments

   clinical reasoning and rational thought

   ethical reasoning
    

   The types of problem-solving that are required include:

   Capacity/Ability to:

   break problems down into their component parts

   prioritise tasks and workload appropriately

   undertake and interpret measurements and calculations

   The ability to synthesise information that is required includes:

   Capacity/Ability to:

   apply learned information in decision-making

   utilise conceptual frameworks to guide practice

   identify and apply important and relevant information

   assess and diagnose  (assess and interpret information to define a problem and develop a plan to resolve appropriately)

5. BEHAVIOURAL AND SOCIAL

   Behavioural and social skills are required as part of this program

   The behavioural skills that are required include:

   Capacity/Ability to:

   function effectively in stressful situations

   deal with uncertainties

   demonstrate consistent cognitive function

   demonstrate sufficient self awareness to manage fluctuations in health and emotional status

   adapt to change

   maintain logical and realistic thinking patterns
    

   The social skills that are required include:

   Capacity/Ability to:

   Perceive, recognise and respond appropriately to emotion

   perceive and respect relationship barriers

   demonstrate personal insight in regards to safe and professional practice

   interact with patients and colleagues from a variety of cultural backgrounds

   communicate sensitively with others, and with cultural awareness

Student stories for Inherent Requirements Project

Dyslexia – Tom’s story

Having been diagnosed with dyslexia from a young age I didn’t think I would be able to study Medicine.  I thought it was beyond me.  However, I decided to give it a try and I ticked the disability box on enrolment and from then on I was able to receive some assistance.  My problem is my writing speed, I understand the concepts, but getting them down on paper takes me longer than other students.  I have been able to have additional time in some of my written exams and now I finish the exam papers instead of running out of time.

Medical condition

Sarah was concerned that she would be excluded from studying Medicine due to an ongoing medical condition.  She met with the Disability Advisor and explained some of the difficulties she experiences.  The Disability Advisor, with her permission, then met with the Academic Staff at the Medical School and they designed an Access Plan to assist her with her clinical placements.   Sarah was permitted to work afternoons and evenings when she felt physically stronger to manage her shifts.  Sarah has been doing well with her placements and is pleased that she sought advice on how to manage her medical condition.

Hearing Impairment

Jake thought he wouldn’t be able to study Medicine because of a hearing impairment.  He uses hearing aids and with the use of an amplified stethoscope Jake manages well with his clinical placements.  Jake has successfully completed his degree.

Physical disability – Roshmeen’s story

A couple of years ago I injured my wrist and it is now an ongoing condition that I have to manage. The pain can be extreme when I have to do write for long periods of time.  I am able to cope with my studies well but I have difficulty completing my exams.  I met with the Disability Advisor and I now have alternative exam arrangements with the use of a computer, an ergonomic keyboard, and extra time for rest breaks.

Our undergraduate program at the University of Adelaide Medical School seeks to produce an undifferentiated doctor with the abilities and skills appropriate for both the seamless transition to post-graduate training, and to continue into advanced training
programs for the full spectrum of career paths.

The University of Adelaide Medical graduates will be distinguished by:

• Being thoroughly versed in the skills and application of adult learning.
• Deriving enjoyment for the process of learning and the pursuit of knowledge and understanding (where knowledge is defined as information that can be used effectively in familiar and unknown situations).
• Having a superior ability to integrate knowledge across disciplines.
• The ability to apply basic scientific knowledge to facilitate understanding and management in clinical practice.
• A highly developed sense of their ‘duty of care’ for their patients.

At the end of the program of undergraduate medical education the student will have acquired through the Scientific Basis of Medicine, Medical Personal and Professional Development, and Clinical Practice streams the attitudes, knowledge and understanding, and skills essential to the practice of medicine, including:

Medical Personal and Development

• Respect for patients and colleagues that encompasses, without prejudice, diversity of background and opportunity, language, culture and way of life.
• Recognition of patients’ rights in all respects, and particularly in regard to privacy, confidentiality and informed consent.
• Ability to cope with uncertainty and adapt to change.
• Awareness of the moral and ethical responsibilities involved in individual patient care and in the provision of care to populations of patients.

• Development of the capacity of self-audit and for participation in the peer-review process.
• Capacity to recognise and accept limitations in one’s knowledge, understanding and clinical skills.
• Ability to work effectively as a member of a team.
• Willingness to use his or her professional capabilities to contribute to community welfare as well as to individual patient welfare by the practice of preventive medicine and the encouragement of health promotion.
• Acceptance and practice of the theories and principles that govern ethical decision making, and of the major ethical dilemmas in medicine, particularly those that arise at the beginning and end of life and those that arise from the rapid expansion of the knowledge of genetics.
• Ability to retrieve (from electronic databases and other resources), manage, and utilise biomedical information for solving problems and making decisions that are relevant to the care of individuals and populations.
• Acceptance of the responsibility to contribute as far as possible to the advancement of medical knowledge and research in order to benefit medical practice and further improve the quality of patient care.
• Willingness to contribute to teaching and the professional development of others.
• Ability to communicate effectively in writing with patients, colleagues and others in carrying out their responsibilities.

All medical students will be registered with the The South Australian Board of the Medical Board of Australia, which has the responsibility of ensuring that all persons permitted to practise medicine in the State should be fit and proper persons who maintain appropriate professional standards.

Bachelor of Medicine and Bachelor of Surgery Program Rules

• Medicine Learning and Teaching Unit Support Staff
• Medical Course Overview
• Medical Course Structure
• Health Sciences Program Information Leaflet
• Information about Undergraduate programs in the Faculty of Health Sciences
  
• Surgery at the University of Adelaide
• Spencer Gulf Rural Health School (SGRHS)
• Undergraduate Medicine & Health Sciences Admission Test (UMAT)
  
• The South Australian Board of the Medical Board of Australia
• Undergraduate Scholarships
• University Contact Centre enquiry form
• Inherent Requirements for MBBS