Graduating with hope

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henness wong Henness Wong, Public Relations Officer (Australian Medical Students’ Association)

Henness is a MIPS member in his final year of medicine and has long been an advocate of change among his peers. Here are some of his thoughts as he completes his final year and embarks on a long and illustrious career.

Graduating from medical school is a milestone worth celebrating in any year. Fellow students in this class of 2020 should be incredibly proud of their perseverance; surviving the year is a noteworthy achievement in and of itself. While I reflect on my personal experiences, I would like to pay respects to the Dharawal and Yuin people for hosting this international student from Hong Kong and thanks to MIPS for inviting me to look back on the journey thus far.

COVID-19 has no doubt challenged us in innumerable ways in the final year of training and assessments, especially when there is often very little room for missed steps and missed opportunities. Some of us have become “Zoomers”, some of us had to cancel overseas electives that were prerequisites to an internship in home countries. All of us have had some manner of disruption to medical education. How university faculty and student leadership navigated the challenges have no doubt directly impacted the experiences of all healthcare students, for better or for worse. Granted, the extent of this pandemic was unforeseen by the medical and dental schools and the management and response to COVID-19 varied across the spectrum. Often, the unfortunate circumstances were unintentional outcomes by the faculty. It is at this time that the participation of medical students in providing constructive feedback will be beneficial to the learning process of all parties.

Positively, the novel recruitment of final year students (eg Assistant in Medicine positions in NSW and Sub-Interns in Victoria) represents a unique arrangement that capitalised on the competence of final year medical students to fortify and strengthen the medical workforce in anticipation of a worst-case scenario under COVID-19. This rapid adaptation of student placements to ensure that our cohort could meet the graduating requirements of clinical placement was welcomed and signposted a potential future conversation discussing the possibility of providing financial stipends and industrial protections for final year medical students to contribute their growing expertise to the healthcare workforce, similar to that of New Zealand's Trainee Intern system.

COVID-19 presented as yet another ‘stress test’ to the wellbeing and mental health of medical students, with graduation prospects fluctuating throughout the year. MIPS has been a steadfast advocate for this matter, from providing confidential indemnity advice to sponsoring student-based wellbeing activities.

It needs to be stated that the resilience of medical students in the face of adversity is something of great value. Throughout the year and during the pandemic, there was an underlying, selfless message of hope; the health profession holds great power when it bands together, such as in this time of crisis, to work for the safety and betterment of others.

The mental health of medical students and junior doctors receives national attention and Federal funding with the recent launch of Everymind National Framework for tackling the Mental Health of Doctors and Medical Students. It is a milestone in response to the repeated demand of Australians medical students for systemic and cultural changes on the matter, as reflected in the annual National Student Survey by Australian Medical Students’ Association (AMSA). Other fervent nominations of AMSA’s advocacy efforts in recent years called for action for climate health, action against sexual harassment, bullying and discriminations, and the need for specialty vocational training in regional and rural Australia.

Ancient wisdom from the saged Chinese medical practitioner Sun Simiao (孫思邈) in the Tang Dynasty described three nobilities of doctors:「上醫醫國,中醫醫人,下醫醫病。」

“Superior doctors treat the country. Middle doctors treat the person. Inferior doctors treat the disease.”

Medical students’ participation in advocacy has enabled cultural shifts within the medical profession, as witnessed by the 2020 cohort in a variety of sectors over our training. Climate change has been declared a health emergency, and medical students are standing together with progressive organisations in demanding that all stakeholders collaborate to seek strategies to mitigate the impacts of climate change. The medical student voice has been clear from AMSA, catalysing AMSA’s divestment efforts away from fossil fuels this year.

2020 has also been pivotal in the pursuit of racial justice too. The #BlackLivesMatter movement from America raised global attention, but Australia has been dealing with its own racial inequalities with its treatment of Aboriginal and/or Torres Strait Islander peoples since Invasion Day. Current affairs raised essential conversations not only about the world around us, but also about diversity and inclusion in medicine. Medical students have seen brand new conferences dedicated to improving our competence in recognition of clinical signs from racially diverse populations. This is not a silver bullet, and it will take consistent and dedicated hard work to heal years of inequity. However, these opportunities are crucial for grappling with the representation of patients of racially diverse backgrounds, culturally-safe communication and healthcare, and being aware of medical education’s longstanding Eurocentricity.

Within our medical student community, we have elected increasingly diverse leaderships to reflect the modern composition of our cohorts, embodied by the first Asian AMSA President Jessica Yang in the 60th year of the national organisation’s history. One more example to be proud of, it is a step towards the inclusion of sexual and gender diversity when AMSA invited pronouns for attendees at National Councils in 2019. The rainbow lanyard that replaced the usual black or orange strap beaconed inclusivity to every colour in the rainbow family.

The class of 2020 is about to join the medical profession, carrying the experiences and lessons unique to our training. We are a cohort who has risen despite adverse challenges, with the resilience to recognise opportunities in every crisis. The mission to improve the lives of patients will be our first and foremost vocation and may those willing also enable positive changes towards a safer, more inclusive society for all.

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