Forty years in the making the Tasmanian School of Medicine

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Forty years in the making - the Tasmanian School
of Medicine

• Ken Kirkby
• Professor of Psychiatry

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The long haul 1840-1965

• 1841 Dr John Frederick Clarke, second incumbent
  of post of Deputy Inspector advocated
• a school of Medicine and Surgery where pupils
  could prosecute and perform their studies in
  conditions easier and more extensive than exist
  in most other colonies, where they might have
  Clinical Lectures and Anatomical Instructions
  afforded, the opportunities being of almost daily
  recurrence

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• Dr Clarke arrived in April 1840 when Hobart
  recovering from a typhoid epidemic affecting 914
  people, a tenth of population, and causing 82
  deaths in only seven weeks
• Wapping town then a focus of disease rather
  than healing

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• Clarke was also president of the Court of Medical
  Examiners, which recognised British, Irish and
  Foreign degrees or diplomas
• Foreign included training in Tasmania,
  required
• Certificates of hospital attendance for 2 years
• pass examinations by the Court in anatomy, morbid
  anatomy, physiology, the practice of medicine,
  surgery, materia medica, midwifery and chemistry
• judged at standard of Royal College of Surgeons
• five guineas for Letters of Testimonial to
  practice in colony

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Training by the profession for the profession

• Dr Edward Bedford - commenced training as
  apprentice to the colonial surgeon, then 2 years
  study in London to obtain MRCS
• rose to be in charge of Hobart Hospital, resigned
  when Clark re-organised same
• establishment of private St Mary Hospital in
  Campbell Street, 1841
• trained ten pupils in next decade, 2 won prizes
  at London hospitals, 6 obtained positions
  overseas

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• Dr Bedford proposed St Marys as a preparatory
  school for London teaching hospitals, 1853.
• Considered by Royal College of Surgeons in UK.
  Committee formed by Legislative Council to
  consider endowment.

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The university connection

• University of Tasmania founded in 1890
• Medical School examined circa 1895. Information
  from schools in Sydney, Melbourne and Adelaide.
  Report by Medical Section of Royal Society of
  Tasmania. Cost of biology laboratory a stumbling
  block
• Uni Tas modest scale - 740 students by 1947
• from 1951 efforts to found a Medical School
  intensified

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Political backing and building a case

• The VC, Torliev Hytten and Dr RD Turnbull,
  Minister for Health consultations with senior
  medicos interstate including Prof R Douglas
  Wright, Dean UniMelb, Dr VM Coppleson, Sydney
  specialist report
• Premier Robert Cosgrove discussed with Prime
  Minister Menzies, 1954. Seeking Commonwealth
  support. UniWA pips Utas

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Grow your own

• mid 1950s, Sydney and Melbourne Medical Schools
  closed to Tasmanian matriculants, ten places in
  Melbourne for out-of-state applicants
• Murray Committee on Universities, 1956
• University, State Government and Colleges present
  proposal to Murray Committee
• Australian Universities Commission set up
  following Murray report, 1959
• Eric Reece, Premier, recommends apply for Medical
  School in AUC submission for 1964/66 triennium

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• AUC supportive, UniTas queued after Monash
• Local UniTas Committee on the Medical School
  included Dr DWL Parker and Dr Keith Millingen and
  Dr K Kelly the secretary of AMA branch and
  convenor of their Medical School Sub-Committee.
  Dr John Edis Director-General of Health also a
  key ally

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Importing talent

• AUC recommends funding for Medical School as part
  of 1964-66 triennium budget
• Pre-clinical chairs established in 1964 - Prof
  Cyril Barnett, Anatomy and Foundation Dean, Prof
  Arthur Cobbald, Physiology (Dean 1970-1982),
  Prof E Holdsworth, Biochemistry (1965).
• Faculty meets for first time 19 November 1964
• Appts Prof Roland Rodda, Pathology (1966)(Dean
  1968-69), Prof A Baikie, Medicine (1967), Prof R
  Mitchell, Surgery (1967)

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• Chair of Obstetrics and Gynaecology advertised in
  1966, filled pro-tem by Directors Drs Williams
  (first Tasmanian appointee) and Corry, then Prof
  D Cavanagh in 1970 for 18 months, then Dr Joe
  Corry as director from 1973 till promoted to
  Chair in 1978.
• Prof Colin Wendell Smith, Anatomy 1968 (Dean
  1983). Conjoint funding Prof Ian Lewis, Child
  Health 1968 (Dean 1984-88), Prof Scott Henderson,
  Psychiatry 1968
• Prof Norelle Lickiss, (first woman and Australian
  Graduate) Community Health 1976 Prof Terence
  Dwyer, Community Health 1985 (Dean 1988-)

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Student intake and locations

• 1966 first intake, 24 second year students 36
  from 1969 in Medical Sciences building- first
  overseas students, Colombo plan and Fiji
• The Advocate Medical School starts in dreary
  surroundings in Sandy Bay - RAAF WWII huts for
  biochemistry, anatomy, physiology
• 1968, temporary clinical accommodation in Argyle
  St. Clinical School building ready for first 6th
  year in 1970. Clinical rotations in LGH, Queen
  Victoria, NW General, Repatriation, RDH from 1968.

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The numbers game

• In 1970, 70 first year enrolments (science
  subjects), 36 second year places - limited by
  funding for staff and equipment
• 38 passed first year, two withdrew,
• hey presto!
• Next year 47 passed, only 36 could proceed
• Places increased to 48 in 1973

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Curriculum and external review

• Curriculum committee formed in 1966, overview and
  integration
• General Medical Council accreditation 1971. By
  then 35 staff and 94 honorary teachers. Three
  visitors from UK. Approval given
• Standing Curriculum Review Committee formed in
  1984

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Some further milestones

• 1969 General practice attachments with
  preceptors, Med 5
• 1974 Dean half-time
• Late 1970s too many doctors/students
• Menzies Centre for Population Health Research
  1988. Funded by Menzies Trust and Foundation,
  State Government, trustees of St Johns Hospital,
  AMP society, University and Faculty of Medicine.
  Prof Dwyer inaugural Director
• Alumni Association established 1990

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Curriculum Issues

• A priority since inception of the school
• Integration and balance across course
• curriculum committee or disciplines?
• Medicalising pre-clinical science component
• Early introduction of clinical experiences
• Unwieldy number of clinical disciplines
• Elusive chairs - anaesthesia/emergency,
  geriatrics, pharmacology

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Curriculum issues II

• AMC accreditation travails
• discipline rivalries
• Didactic versus student led with facilitator -
  problem based learning
• Formative and summative assessment
• Evidence based medicine vs received wisdom
• Information technology
• Three clinical schools, UDRH
• Rising student numbers - inc mature entry,
  overseas students, overseas trained doctor
  lateral entries, bonded rural

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Plus ça change .

• Professions - AMA and colleges, clinicians
• External review - AMC
• Partnerships in Health
• Political patronage
• University strategy eg medical research
• MEU

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.plus cest la même chose

• 1965 and 2005
• New building, new course, new curriculum
• ..with Tasmanian characteristics!

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