An initiative for teaching about alcohol and other drugs in Australian medical schools

Education in Australian medical schools is presently under review, including teaching about alcohol and other drugs. In August 1986, the Alcohol and Drug Foundation, Australia (ADFA) presented to the Deans of Australasian medical faculties (including those of Fiji, Papua New Guinea, and New Zealand) a number of options to develop the alcohol and other drugs content of medical courses. It was proposed that a coordinator of education in alcohol and other drugs be appointed in medical faculties; this proposal had been modelled on the US Career Teacher Training Program in Alcohol and Drug Abuse. The Deans expressed interest in ADFA's proposal. This paper discusses the role of undergraduate medical education in alcohol and other drugs, and the background to, and some guide-lines from, the ADFA proposal.     

Balloon dilation treatment of phimosis in boys. Report of 512 cases.

Five hundred and twelve boys, aged from 5 months to 12 years, with phimosis were treated by application of a specially designed balloon catheter (patented). 1% dicaine topical anesthesia was used. 3-6 months follow-up showed that all the patients were cured. The procedure is simple, safe and much less traumatizing than the conventional circumcision. The mechanisms of balloon dilation, the age-specificity and the anesthesia were discussed.

     

Problem-Oriented medical information system (PROMIS) for Australian medical education

The Problem-Oriented Medical Information System (PROMIS) is a computer-based data system which was developed in the United States to provide an improved approach to clinical teaching and patient care. The introduction of this system into Australian medical schools and hospitals is proposed. PROMIS, which is now widely accepted in the United States, has shown its value in overcoming some of the deficiencies inherent in other medical records systems. The merits of the system, and the salient features of its operation, are discussed. Some potential constraints and difficulties in its implementation, none of which appears insurmountable, are outlined briefly.     

Balancing work, family and other lifestyle aspects: a qualitative study of Australian medical students' attitudes

OBJECTIVE: To explore the attitudes of Australian medical students to the balance between work, family and other aspects of lifestyle, within a broader exploration of the issues that they regard as important to their decisions about future career. DESIGN: Qualitative study using semistructured focus groups and individual interviews. SETTING: The three medical schools in New South Wales and a national conference for students interested in rural practice. PARTICIPANTS: First- and final-year medical students who volunteered for focus groups held between March and August 2002 (82 students in 10 groups) or for individual interviews held between July and December 2003 (48 students). MAIN OUTCOME MEASURES: Emergent themes relating to the balance of work, family and other aspects of lifestyle. RESULTS: Most students referred to a balance of work, family and lifestyle as an important factor in their career decisions. While indicating they were committed to medicine, they were unwilling to work to the exclusion of all else. Most saw family commitments as a high priority, and many saw "time out" as important in maintaining their health. Female students spoke of part-time work as essential for future happiness, while some male students expressed a preference for working part-time. They would seek to achieve balance by choosing to work in disciplines, locations and structures where limited-hours work is available, and would negotiate support from their partners and parents in caring for children. CONCLUSIONS: It is important that the medical profession continue to develop working and training structures that allow a balance of work, family and lifestyle.     

Asbestos-related pleural disease in Western Australian gold-miners

Three retired gold-mine workers from Western Australia (WA) were diagnose with asbestos-related pleural disease (two with pleural plaques and one with mesothelioma). Asbestos fibres have been found in air samples from WA gold-mines, and all three patients had worked in these mines (for five to 17 years) and had no other significant known asbestos exposure. To our knowledge, this is the first report of asbestos-related disease in gold-mine workers.     

Academic general practice in Australian medical schools

This paper reports on a survey of the current state of academic general practice in the ten Australian medical schools. Despite its lack of resources, low profile and ambivalent acceptance in Australian medical schools, academic general practice has survived. Its problems and potential contribution for producing better doctors are outlined and discussed.     

Pharmaceutical advertisement claims in Australian medical publications

OBJECTIVE: To determine the quality of claims in advertisements published in Australian medical publications, describe how benefits and harms are presented, and examine the level of underpinning evidence. DESIGN AND SETTING: Audit of a consecutive three-month sample of advertisements appearing in six popular Australian medical publications. MAIN OUTCOME MEASURES: Proportion of advertisements with quantitative information; proportion of claims conveying clinical outcomes; where retrievable, level of underpinning evidence. RESULTS: Of 1504 claims, 855 could be substantiated quantitatively. Of these, 45% were supported by compelling evidence (randomised controlled trials or better). Of 13 claims explicitly reporting quantitative outcomes, none provided the absolute risk reduction or the number needed to treat. CONCLUSIONS: Our audit invites greater diligence by pharmaceutical companies in substantiating their claims and greater vigilance among clinicians when reading them.     

Cigarette smoking and the Australian medical profession

The smoking habits, attitudes and associated actions of Australian doctors and their organizations are reviewed historically in the light of the medical profession's responsibilities in this area of public health. The proportion of Australian doctors who smoke has fallen to very low levels by community standards; doctors virtually are in total agreement about the disease effects of smoking; and they have taken many extraordinary actions over recent decades to encourage the necessary public-health measures. In spite of a major reduction over all in smoking in recent years, the present proportion of Australians who smoke demands the medical profession's continuing effort to discourage smoking in the community.     

The medical case for an Australian national cyclotron facility

Both a national cyclotron and a reactor are necessary to provide Australia with the complete range of radioisotopes. For the last 17 years, Australia has been well supplied with reactor radioisotopes by the Australian Atomic Energy Commission which provides a daily nationwide distribution service, but, to be self-sufficient, Australia also needs a national cyclotron. Many cyclotron radioisotopes are too short-lived for importation, and the demand can be met only by domestic production. Despite the availability of the necessary expertise and instrumentation, Australian patients are being denied a wide range of important clinical investigations because of the lack of suitable radioisotopes, for example, krypton-81m and iodine-123. An Australian medical cyclotron is overdue. Australia and New Zealand are the only developed countries that do not possess at least one medical cyclotron. The historical events in Australia's quest for a medical cyclotron are summarized, and the medical reasons why the writers believe that Australia should now acquire its own medical cyclotron are reviewed.