The new Australian medical schools: daring to be different

Increasing diversity at the cost of decreasing equity? Issues raised by the establishment of Australia's first religiously affiliated medical school

“…The establishment of medical schools at Bond University on the Gold Coast, Queensland, and the University of Notre Dame in Fremantle, Western Australia, are particularly noteworthy developments. A recent article in the Journal claimed the new medical schools will foster diversity and are commited to fill “particular workforce needs” 1 . We argue that increasing the range of options for medical education is not an unquestionable good, as it may threaten academic freedom and equity in medical education as well as just provision of health care.…”

“…The recent article in the Journal outlined concerns raised about the Notre Dame program, including the inclusion of a mandatory theology course, and more generally how the institution's Catholic ethos may affect the medical education provided and the skills and attitudes of physicians being trained 1 . While many factors, including postgraduate education and clinical experience, may influence a doctor's values or practice, it is undeniable that medical education is formative.…”

“…Furthermore, it is clear that different medical schools will have special emphases depending, in part, on their student and local populations. For instance, the private medical school at Bond University will emphasise organisation, administration, and information technology skills, along with communication, law, and ethics 1 . Indeed, provided there are structural safeguards, it may be desirable for different schools to produce graduates with not only core attributes necessary for the practice of medicine, but also additional specialised skills suited to particular fields of practice or sociocultural contexts.…”

“…The existence of conscience clauses in codes of professional conduct is indicative of the fact that guidance is needed to mitigate the impact of religious beliefs on medical judgement and the delivery of care. Although Notre Dame officials have stated that their graduates will be educated to discuss these issues in a “non‐judgemental, respectful and ethical manner … in relation to [the patient's] needs and circumstances”, 1 they also note 1 that use of contraception is an immoral act according to Catholic doctrine (as, of course, are termination of pregnancy and many forms of cessation of life‐sustaining treatment, particularly in light of the recent Papal allocution that artificial nutrition should not be withdrawn from patients in a persistent vegetative state except where it is of insufficient therapeutic benefit or overly burdensome to them) 11…”

“…Third, the adequacy of the education provided should be assessed by independent observers in terms of the abilities of graduates to deliver care that is consistent with the varying needs, beliefs, and values of the broader Australian community. This is a valid expectation, particularly in view of the significant number of federal government‐subsidised student positions that will be available (50 of 80 positions at Notre Dame will be funded by HECS [the Higher Education Contribution Scheme]) 1 . These processes are essential for any medical school to deal effectively with moral and religious pluralism and to ensure academic, scientific and religious/moral freedom.…”