OPINION: When the University of New South Wales confers its first Doctor of Medicine (MD) degrees later this year the medical profession may be asking what’s in a name?
What does the shift towards the MD — familiar in Australia as the post-nominal of various US television doctors in hospital dramas — mean for the future of Australian medicine?
Firstly, for Australian doctors holding the traditional Bachelor of Medicine/Bachelor of Surgery (MBBS) nothing should change. The Medical Board of Australia that approves a particular medical qualification accredits both the incoming MDs, as well as the traditional MBBS still favoured by some Australian medical schools, on equal terms.
However, in our view, there were two good reasons for UNSW to initiate the process which led to the switch to the MD this year. Firstly, medicine is arguably changing more rapidly than ever before and, secondly, our graduates need to be equipped to navigate an increasingly complex field of practice.
That’s why UNSW’s current undergraduate entry medical education program has for 10 years been run over six years, enabling us to incorporate a year-long Independent Learning Project into the curriculum. The ILP is a compulsory personal research project that equips students to think creatively, critically evaluate medical and scientific literature, initiate and design their own research projects and effectively analyse complex issues.
Today’s students are aware that a career in general practice, for example, may involve new diagnostic protocols, that their preferred surgical specialty may be safely and effectively carried out in future by robotic equipment and that new diseases or public health challenges will emerge in their lifetime, just as today’s diseases may be combated by new drugs.
Undoubtedly, digital information communication technologies (ICT) are also fast changing the way we work, and providing new opportunities to use virtual environments and cloud-based repositories of knowledge. With students taking charge of their own learning they connect with these aspects of medicine in a way that we cannot teach in the classroom or on the wards.
Many UNSW Medicine students can publish in their ILP year. One of this year’s upcoming MDs, for example, worked on research into markers in the breath that may be used for the early diagnosis of asthma and chronic pulmonary obstructive disease. We also require students to take several general education units, to pick up anything from a language, literature or history, to astrophysics.
When we conducted our own internal review of our existing MBBS program, we found that our students were already working at a level equivalent to a post-graduate degree.
We then received approval for the new Bachelor of Medical Studies/Doctor of Medicine (MD) — a level 9 qualification on the Australian Qualifications Framework (AQF) scale, compared to level 7 for the outgoing MBBS — as well as recognition for the MD from the Medical Board of Australia.
In offering the Bachelor of Medical Studies/Doctor of Medicine program, we are not making substantial changes to our medical education program. We are simply catching up.
For current UNSW Medicine students who enrolled in the original MBBS program, the new MD is optional. However, most of this year’s graduating students chose the MD, so our first cohort of graduates will be sizeable. Other universities are moving towards MDs for graduate programs, so the traditional MBBS will be less visible in Australia in future.
Familiarity with the MD tag — undoubtedly pushed by proliferating US hospital dramas — means today’s aspiring medical students may favour the MD as a good start for a career in a rapidly globalising healthcare sector.
But for UNSW, appropriate recognition is more important; the new UNSW MD finally recognises our graduates at an academic level commensurate with what we demand and what they achieve.
Professor Peter Smith is Dean of Medicine at UNSW and President of Medical Deans Australia and New Zealand.
This opinion piece was first published in Medical Observer.