Medical schools in Australia and New Zealand are undergoing significant institutional changes to be more culturally responsive, new research shows.

A report released today in the New Zealand Medical Journal describes a 2015 change by the Australian Medical Council (AMC) in accreditation standards, to include a specific focus on indigenous people’s health.

These changes aim to hold medical professionals to account for the health of the indigenous people of Australia and New Zealand, and focus on specific training in the health, history and cultures of both countries as well as interacting with people in culturally-appropriate ways.

Putting action into the revised Australian Medical Council standards on Aboriginal and Torres Strait Islander and Māori health serves as a commentary to support the medical colleges’ responsiveness to the updated standards.

The AMC is an independent national standards body for medical education and training, which acts as an external accreditation entity and also works with the Medical Council of New Zealand (MCNZ) to accredit programmes of study leading to registrations in both countries.

Many of the medical colleges are Australasian, so trainees across New Zealand and Australia are required to meet the same standards.

The report states that real change, and successful accreditation against the standards, will only be achieved through an organisation-wide commitment to respectful relationships and a genuine desire to address indigenous disadvantage.

It discusses in depth seven recommended areas for consideration: leadership and governance, partnership, health workforce development, advocacy strategy, curriculum and assessment, collaboration and celebration and how these elements work together.

Associate Professor at University of Otago Christchurch’s Māori/Indigenous Health Institute Dr Suzanne Pitama is the New Zealand author of the paper, and says the AMC accreditation standards give all Australasian colleges clear expectations when it comes to cultural responsiveness.

“In terms of this, different colleges have pursued different approaches over the years,” says Dr Pitama.

“New Zealand medical colleges (or branches of the Australasian colleges) tend to have more Māori doctors as part of their membership, due to graduating higher numbers of indigenous doctors than Australia.

“This also means they may be more likely to have had Māori doctors on their senior leadership groups, which have influenced the way they have approached cultural responsiveness to Māori.

“However, for instance the College of Surgeons in Australia has been working with Dr Kong, who was the first indigenous surgeon in Australia, over many years to develop online learning modules in indigenous health.

“I think with ongoing health inequities in indigenous peoples in both countries, the AMC accreditation standards challenge health clinicians and their colleges to address systemic and interpersonal bias in order to support and contribute to indigenous health gains,” says Dr Pitama.

“It will be interesting to monitor and evaluate different initiatives employed by each of the colleges to address these standards/challenges both for their acceptability of the college’s members, and also their impact on indigenous health patients experiences – and then eventually health outcomes.”

The paper concludes that most Australian and New Zealand medical schools have undergone significant institutional development to include indigenous students, curriculum and leadership over the past decade.

This has in turn lifted awareness of the healthcare needs of Aboriginal, Torres Strait Island and Māori people.

“With the AMC Indigenous health standards now firmly in place, it will not be a question of if colleges develop the required changes to meet the standards, but rather a question of when, and how,” the authors write.

Dr Pitama says the standards will help all medical professionals shape a more equitable health system.

“It was a great pleasure to be involved with my Australian colleges with this paper, in an attempt to encourage the medical colleges to embrace the new standards,” she says.

“We see them as something that will assist us as health professionals to provide equitable care, and be able to actively support indigenous communities in their health aspirations.”

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