120 years on Med School gears up for challenging future
The University of Adelaide's Medical School has an interesting story to tell, from its humble beginnings in 1885, to modern times where issues such as doctor shortages, internationalisation, globalisation and increased accountability are commonplace.
Now, 120 years on, the medical school is entering a new era.
But, before embarking on Professor Justin Beilby's journey when he succeeds Professor Derek Frewin in July this year as Executive Dean of the Faculty of Health Sciences, let's turn back the clock and take a stroll down memory lane.
In his informative account of the Medical School's history (The Medical School of the University of Adelaide: A brief history from an administrative viewpoint, August 1991), former registrar Vic Edgeloe says the University Council took its first faltering steps towards providing education for the medical (and legal) profession in 1877, but in each case found itself unable to finance even a significant beginning of a formal course.
"The first real step towards establishing a medical course was taken in 1881 when Dr Edward Charles Stirling was appointed part-time lecturer in physiology," Edgeloe writes.
Council and Dr Stirling regarded the appointment as a prelude to the introduction of at least the first part of a medical course. However, at that stage the Council envisaged providing only the first two years of a five-year course, with the students having to transfer to Sydney or Melbourne or travel overseas to complete the remaining three years.
Although Sir Thomas Elder, a personal friend of Dr Stirling, gave £10,000 ($20,000) for a Chair in the Faculty of Medicine, there still remained a substantial hurdle to overcome. The General Medical Council in London required the various subjects of the curriculum to be taught by independent people, and chemistry was not provided for independently of biology.
The way was finally cleared in April 1884 by John Howard Angas, who promised £6,000 ($12,000) for a chair in chemistry.
This allowed Council to take the necessary steps to start the beginning of a medical course in 1885: the appointment of professors of anatomy and chemistry, the passing by the provincial government of an appropriate Anatomy Act, the appointment of a University nominee of the Adelaide Hospital Board, and the provision of a small dissecting room for anatomy.
It was also in this same year that Council prepared a statute to establish a Faculty of Medicine and in October 1885, the Senate approved it and the faculty was formally constituted.
In The University of Adelaide: 1874-1974, authors WGK Duncan and Roger Ashley Leonard write that a "building to house the medical school was then built at the rear of the University, so severely plain in appearance that The Register said that there was 'nothing ornate' about it, 'any more than there is about a 300-gallon iron tank.'"
Although the building might not have been elaborate, the Medical School has produced many distinguished alumni over the years.
Sir Henry Newland, who lectured in many aspects of surgery, became a world-renowned plastic surgeon.
Sir Hugh Cairns was another outstanding graduate. He went to Oxford as a Rhodes Scholar, became a neurosurgeon, and was appointed Hunterian Professor at the Royal College of Surgeons in 1925, and the first Nuffield Professor of Surgery at Oxford.
Another Rhodes Scholar became famous as the leader of the team of scientists that isolated penicillin. Howard Florey received many honours: he shared the Nobel Prize for Medicine in 1945, was knighted in 1944, and created a life peer and admitted to the Order of Merit in 1965.
With the 20th century offering glorious memories and achievements, what is the future role of the Medical School as it moves further into the 21st century?
Professor Justin Beilby, the incoming Executive Dean of Health Sciences, said that he hopes to build on the exceptional and personable fashion in which his predecessor, Professor Derek Frewin had managed the Faculty.
"Professor Frewin has an extraordinary ability to work with all kinds of people and at different levels. He does everything in a gentlemanly way and this unique manner typifies the quality of the man," he said.
"This approach has provided a solid base for growth in the future."
Because the Medical School is now part of a large faculty, some adjustment will be required as all disciplines are more effectively integrated, Professor Beilby said.
"Psychology, nursing and health science graduates will become as important in providing service delivery in South Australia as medical graduates.
"And as the health system faces challenges from an ageing population, increasingly articulate and informed consumers, and the move to specialisation in postgraduate training, the faculty will need to learn to balance input from all discipline groups," he says.
He adds that the growth in team-based health care will create the need for excellent training for all these groups. And there may even be place for debate regarding the role of a generic health worker, who is trained across all the faculty disciplines over a three-year period.
Professor Beilby says our medical workforce will also be expected to fill medical vacancies across the globe.
"Training will need to embrace this perspective. Conversely the Medical School will be called upon to provide more training options for countries across the Asia-Pacific region. We have to make our Medical School user-friendly to all potential applicants."
He adds that we now have a workforce that wants to work shorter hours. At the same time we have lengthened our postgraduate training.
"The debate is now required about our undergraduate training. Is six years too long for our medical course? This is even more pressing when you consider rising medical costs to study medicine," Professor Beilby says.
In discussing educational models, he says there is a need to review how we deliver clinical teaching.
"The apprentice model of placements in hospitals and general practices may need to give way to more focused clinical placement, with planned and focused educational experiences with specific skill training.
"It may be opportune to better define the core competencies that we need all our final year graduates to have, and work out the most efficient model to deliver this training."
Professor Beilby says the Nelson reforms have flagged a number of challenges for the Medical School around the measurement of the quality of research and educational outcomes.
"The Medical School will need to develop tools to measure these outputs and find a way to regularly capture these outputs."
It's a tall order, but pales in comparison, perhaps, to what our forebears faced. ■
Story Howard Salkow