Policy Document Classification of Medical Programs Policy

Transcription

1 Policy Document Classification of Medical Programs Policy Background The Australian Medical Students Association (AMSA) is the peak representative body for medical students in Australia. As such, AMSA is uniquely placed to comment on issues regarding medical school programs within Australia. To gain registration as a medical practitioner in Australia, an individual must hold a primary medical qualification known as a first-professional degree from an accredited university. Traditionally, these degrees have been Australian Qualifications Framework (AQF) level 7 degrees, titled Bachelor of Medicine (BMed) or Bachelor of Medicine, Bachelor of Surgery (MBBS or BMBS). These degrees indicate that the holder has graduated from a medical school with competent medical skills and expertise as deemed suitable by the Australian Medical Council (AMC). Masters-level First-Professional Degrees In 2011, the University of Melbourne took the first step away from the traditionally awarded degrees by replacing its first-professional MBBS program with a Doctor of Medicine program. The change from an undergraduate to a Masters level degree allowed the University of Melbourne to circumvent a ban placed upon it by the Australian Federal Government disallowing it from charging domestic students fullfee places [9]. AMSA addresses this issue in its Domestic Full Fee Places in Public Universities Policy. This in effect elevated its medical degree from an AQF level 7 (Bachelor) to an AQF level 9 (Masters) degree. This move was mirrored by The University of New South Wales BMed/MD program (2013) [1], Flinders University s MD (2013) [2], Griffith University s MD (2013) [3], Western Australia s MD (2014) [4], The Australian National University s MChD (2014) [5], Sydney s MD (2014) [6], and Queensland s MD (2015) [7]. These changes were made possible largely through existing research components to medical degrees, fulfilling Masters (Extended) requirements. In each of these cases, the Australian Medical Council (AMC) found no major change in the course structure, with the exception of UWA s course change from a mixed undergraduate and graduate-entry course to a purely graduate entry course [8]. In addition, Monash University has also changed its MBBS program to award a MBBS (Hons) degree, with no change in course content in Generally, this change of nomenclature had no effect on the AMC s decision to accredit each individual university s medical programs. Thus, students graduate with the same necessary skills and expertise as prior to the change. A table summarising the programs currently offered in Australia is shown below: Degree AQF Level 7 MBBS, BMBS, BMed AQF Level 8 MBBS (Hons) AQF Level 9 MD, MChD University 11: University of Adelaide, Bond University, Deakin University, James Cook University, University of Newcastle, University of New England, University of Notre Dame, University of Tasmania, University of Western Sydney, University of Wollongong 1: Monash University 8: Australian National University, Flinders University, Griffith University, University of Melbourne, University of New South Wales, University of Queensland, University of Sydney, University of Western

2 Australia Prior to the introduction of Masters-level MD awards in 2011, the was a research doctorate (AQF level 10) of equal or higher standing than a Doctor of Philosophy, offered by universities to a small number of highly distinguished researchers. The introduction of the Masters-level MD therefore threatens to devalue and cause confusion for the holders of the higher research MD [9, 10]. Since the introduction of the first-professional MD awards, several of these universities have renamed or ceased intake to their higher doctorate programs. This can be seen in the table below: University Original Program Current Program James Cook University (DMed) [11] (DMed) [11] Melbourne Doctor of Medical Science (DMedSc) [12] Monash University New students no longer admitted as of May 28, 2014 [13] Queensland (Research) (DMed(Res)) [14] Sydney [15] Doctor of Medical Science (DMedSc) [16] Western Australia [17] (DM) [18] Comparisons between MBBS and MD programs At the time of writing, the awards have been adopted by 8 out of the 20 medical schools in Australia. Whilst some universities claim that their new MD programs have increased academic rigour, the AMC has deemed them not significantly different from the MBBS programs they replaced [6, 7, 19]. Anxiety exists in the Australian medical community that the existence of two distinct firstprofessional degrees could possibly result in differing public perceptions regarding the clinical knowledge and skills attained by MD and MBBS graduates [10]. Similar concerns are present regarding views towards graduates from within the medical profession, as their degree title may have the potential to affect the attainment of internship, specialty training, and employment positions [9, 10]. The changing landscape of internship and training availability within Australia creates uncertainty for recent and future MBBS graduates who fear they may be disadvantaged in merit-based internship selections. Similar concerns have been raised for the attainment of vocational training positions and further employment solely due to the title of their degree [10]. Internationally implemented solutions for two-tiered medical awards International medical graduates (IMGs) wishing to practice in the United States face a similar situation to that which is arising in Australia. The first professional degree for medical practitioners in the United States is the MD, different from the MBBS degrees many IMGs obtain. As degrees other than the MD are not recognised or less preferred, a number of US states allow MBBS or equivalent degree holders to use the MD post-nominal without the official conferral of the degree [20]. This is in addition to IMGs requiring certain steps to practicing in the United States. An alternative solution

3 is effect in states such as New York, where IMGs are eligible for the official conferral of a MD degree from the state education board upon payment of a fee [21]. Position Statement AMSA believes that there is no difference in the clinical ability of MD level and Bachelor level medical graduates, however recognises differences in research components of the degrees. AMSA also believes that there should be consistency of nomenclature across primary medical qualifications awarded by all universities in Australia. The two-tiered system created by the introduction of the MD award threatens to create a misunderstanding amongst prospective students, clinicians, employers, and the general public regarding the clinical qualifications of medical practitioners in Australia. Policy AMSA calls upon: 1. Australian state and federal governments to: a. Recognise the similarity in clinical ability, of the two degree levels: Masters and Bachelor degree 2. All medical schools across Australia to: a. Award a medical degree which has a consistency in its nomenclature (title). This would include: i. All degrees within a particular AQF level (ie. 7 or 9) to have an identical nomenclature. ii. All research higher degrees previously named to be renamed uniformly as agreed to by the medical schools iii. Not promoting and marketing the current Masters-level program as a clinically superior version of the undergraduate MBBS version and instead, promote the fact that both the MD and all undergraduate medical degrees are to be considered equivalent in all clinical aspects. This is to ensure prospective students are not unduly influenced in their choice of program b. Work with Medical Deans Australia and New Zealand to implement these changes 3. The Australian Medical Council to: a. Continue to provide equal accreditation to graduates of Masters and Bachelor programs. b. Publicly reinforce the equivalency of Masters and Bachelor degrees in terms of clinical ability. 4. Health Care Facilities and Specialty Colleges across Australia to: a. Formally recognise the equivalence of Bachelor level and Masters level medical degrees with regards to medical practice. b. Not discriminate in hiring or selecting doctors based solely on degree title. References 1. Australian Government Department of Industry, Innovation, Climate Change, The Commonwealth of Australia and New South Wales. Canberra; 2014 [cited April]. Available from: _ _compact_final.pdf

4 2. Australian Government Department of Industry, Innovation, Climate Change, The Commonwealth of Australia and The Flinders University of South Australia. Canberra; 2014 [cited April]. Available from: 3. Australian Government Department of Industry, Innovation, Climate Change, The Commonwealth of Australia and Griffith University. Canberra; 2014 [cited April]. Available from: 4. Western Australia.. Perth; 2014 [cited 2015 April 30]. Available from: data/assets/file/0007/ /md-graduateweb-april pdf 5. Australian Government Department of Industry, Innovation, Climate Change, The Commonwealth of Australia and The Australian National University. Canberra; 2014 [cited 2015 April 30]. 23. Available from: 6. Sydney. The Sydney MD. Sydney; 2014 [cited 2015 April 30]. Available from: ney-md.pdf 7. Queensland. degree at UQ. Brisbane; 2014 [updated February ; cited 2015 April 30]. Available from: %28md%29-at-uq.aspx 8. Australian Medical Council. Medical school accreditation program and status report. Canberra; 2015 [cited 2015 April 30]. Available from: 9. Roberts-Thomson RL, Kirchner SD, Wong CX. MD: the new MB BS? Med J Aust Dec 6-20;193(11-12): Australian Medical Council. Changes to Primary Qualifications for Admission to Practise Medicine in Australia: Implications for AMC Accreditation. Canberra; 2012 [updated October 2012; cited 2015 April 30]. Available from: James Cook University. [Research]. Townsville; 2015 [updated April ; cited 2014 November 22]. Available from: Melbourne. Doctor of Medical Science. Melbourne; 2015 [updated February ; cited 2015 April 30]. Available from: Monash University.. Melbourne; 2015 [cited 2015 April 30]. Available from: Queensland. (Research) (DMed(Res)). Brisbane; 2015 [cited 2015 April 30]. Available from: Sydney. University of Sydney Handbooks Archive: Doctor of Medicine. Sydney; 2012 [updated December ; cited 2015 April 30]. Available from: Sydney Medical School Handbook 2015: Doctor of Medical Science. Sydney; 2014 [cited 2015 April 30]. Available from:

5 shtml 17. Western Australia. Course Regulations Schedule. Perth [cited 2015 April 30]. Available from: data/page/29035/schedule_of_courses.rtf 18. Western Australia.. Perth; 2014 [cited 2015 April 30]. Available from: xtension=printer_friendly_pages 19. New South Wales. From MBBS to MD: changing the UNSW degree. Sydney [cited 2015 April 30]. Available from: American Medical Association. IMGs in Medicine and other FAQs. [cited 2015 April 30]. Available from: New York State Education Department Office of the Professions. Conferral of M.D. Degree. New York: New York State Education Department; 2009 [updated December ; cited 2015 April 30]. Available from: Policy Details Name: Classification of Medical Programs Policy Category: A Medical School Programs and Admissions History: Adopted, First Council, 2011 Reviewed, Second Council, 2015