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Uncategorized Review Articles

COVID-19: Adaptations to Primary Care in Australia

Abstract

Introduction

The Australian Government has implemented its National Primary Care Response action plan to combat the growing threat of the COVID-19 pandemic across the country. The plan recognises the integral role of primary care services in protecting the most vulnerable citizens of our nation and recommends a number of interventions aimed at reducing transmission, including expanding telehealth services, physical distancing measures, and the use of personal protective equipment. The efficacy of these suggested measures needs to be evaluated to ensure everything is being done to maximise the safety of Australia’s primary care system while maintaining the highest level of care possible.

Summary

This review article delves into the benefits and limitations of the interventions suggested in the National Primary Care Response action plan and formulates recommendations on each intervention based on the currently available literature. Based on the literature findings, recommendations have been made to implement telehealth, physical distancing, and face masks in primary care settings across Australia to curb the transmission of COVID-19 across the country.

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Original Research Articles

Exploring the reasons for medical student participation in peer mentoring programs

Reasons why students participate in an existing student lead peer-mentorship program were explored. Tailoring a mentoring program may improve participation rates.

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Case Reports

Skin Rash In a Patient Using Antiepileptic Medications, What It Could Be?

Abstract

Introduction:  Rash is one of the commonest presentations that doctors can be asked to review. Studying this case strengthens the understanding about how to review a patient with rash and how to formalise differential diagnosis based on the clinical condition. This is an educational article that seeks to improve medical students understanding and clinical applications around rashes and to establish an approach that will differentiate between medications evoked rash and rash provoked by other causes.

Case overview: This case study will provide a systemic approach when evaluating a skin rash in a patient, especially in a person who cannot communicate and who has been exposed to rash provoking medications.

Discussion overview: Antiepileptic medications are known to evoke rash. It is important to take that in consideration when evaluating rashes in patients who are using those medications; however we should keep in mind that there are other conditions that can be the cause.

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Feature Articles

COVID-19 as a valuable learning opportunity

Abstract

Most medical students do not receive much public health exposure during their medical education, either in the form of theoretical teaching or practical placement experiences. At the University of Adelaide, students can elect to undertake a public health elective during winter school in addition to limited lectures with a public health focus, but there was not much opportunity for such placements prior to COVID-19. Following the interruption of clinical placements during the peak of the pandemic in South Australia, a modified academic structure saw the introduction of a twelve-week public health placement at the Department for Health and Wellbeing for final-year medical students. This article reflects on the author’s immersive experience at the Department for Health and Wellbeing during the COVID-19 pandemic and includes a brief description of the department’s services along with how it fits into the broader COVID-19 response. Public health placements can impact medical graduates’ understanding and passion for health and society and their role as health advocates. Both of these are included in the Australian Medical Council’s Graduate Outcomes statement. Public health placements are therefore worthwhile pursuing.

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Feature Articles

Climate emergency in Australia and the need for inclusion of Indigenous peoples in solutions

Resolving the high-level barriers to Aboriginal and Torres Strait Islander inclusion will facilitate Australia overcoming race and greenhouse gas emissions challenges

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Feature Articles

AHPRA, Mistrust, and Medical Culture in Australia

From nearly the moment that medical students take their oaths, the assault on one’s mental health begins. Students understand that they will make sacrifices to study medicine, but the understanding that the medical field may take a significant mental health toll is generally overlooked and underappreciated. Many factors leading to this demise have been well-described in the literature, yet, a doctor’s mental health is often not discussed, silenced by both professional and societal stigma. This is a worldwide issue with some disastrous consequences. For example, in the United States alone, an estimated 300-400 doctors commit suicide each year, more than doubling the rate of the general population. This is equivalent to an entire cohort of medical students, making the profession among the most dangerous in the country. In Australia, doctors experience significantly high levels of psychiatric morbidity, which typically manifest as depression, anxiety, burnout, and suicidal ideation, eroding both their personal and professional lives. Many doctors do not seek help for mental health conditions, largely due to stigma as well as an unfounded fear of a notification to the Australian Health Practitioner Regulation Agency (AHPRA). This essay will outline issues surrounding concerns that doctors with mental health issues may have regarding AHPRA and discuss the mistrust that persists in contemporary medical culture in Australia.

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Medical Careers Guest Articles

An Interview with Professor Alicia Jenkins – Endocrinologist, Researcher and President of Insulin for Life

In this issue of the Australian Medical Student Journal, we are fortunate to interview Professor Alicia Jenkins, a Clinical Endocrinologist at St Vincent’s Hospital Melbourne, Director of Diabetes and Vascular Medicine at NHMRC Clinical Trials Centre and President of Insulin for Life. She was also recently awarded the prestigious ADS Kellion Award, which acknowledges an outstanding contribution to diabetes research, clinical or service areas. Prof. Jenkins provides us with an insight into the field of diabetes and endocrinology, the benefits of undertaking research, as well as her charity work for Insulin for Life.

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Review Articles

Simulation training in laparoscopic surgery

This article summarises the role of simulation-based training in laparoscopic surgery, exploring elements for curriculum development, implementation, and current practice.

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Original Research Articles

Enablers and obstacles to medical student satisfaction during obstetrics and gynaecology rotations

Background

Providing care for pregnant women and responding to obstetric emergencies are tasks which medical graduates are expected to be competent in performing. To ensure this, Australian medical schools have set clinical learning objectives for students to achieve during their obstetrics rotation. Alarmingly, several studies have shown students are struggling to participate in these clinical experiences, especially the birthing process. Further evaluation of student experiences on labour ward is needed to identify common concerns and to improve the overall educational experience.

Materials and Methods

Year 5 medical students from James Cook University completed an optional anonymous questionnaire at the end of their Reproductive and Neonatal Health (RNH) rotation. A cross-sectional analysis was performed on responses. Open-ended responses underwent a content analysis and both common positive and negative themes were identified.

Results

Assisting in deliveries and surgical procedures were regarded as highly valuable learning experiences. Male students reported that their gender was a clear drawback to their rotation experience (p <0.001). Competition with midwifery students and poor interactions with midwifery staff were common themes reported and contributed to 57% of students experiencing difficulty gaining clinical exposure whilst on labour ward.

Conclusion

Difficulty in gaining clinical experience within labour wards is increasing as the number of health care students continues to rise and the birth rate falls. The presence of gender bias and misunderstanding of student learning objectives by midwives further contributes to the competitive environment experienced by medical students during their obstetrics term. Greater collaboration and communication between medical schools and midwifery staff is vital to ensure quality education continues to be delivered and clinical requirements are achieved. The use of simulation training should also be further explored as a means to provide standardised educational experiences.

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Categories
Case Reports

An unusual presentation of perforated appendix mimicking a liver abscess in an Aboriginal male

A case report of a 26-year-old Aboriginal male in Alice Springs with an unusual presentation of perforated appendix mimicking a liver abscess.

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