Clinical Challenge

Case 1

Naveen is a GP with 20 years of clinical experience, including multiple stints working in countries with developing economies. Inspired by Naveen’s interest in global health, Sam, his GP registrar, is keen to follow the same path and meets with Naveen to discuss preparation for overseas work.

Naveen begins by discussing the role of the World Health Organization (WHO) and the six building blocks to strengthen health systems.

Question 1

Which of the following is an example of a WHO building block?

1. Health workforce
2. Service delivery
3. Leadership and governance
4. Healthcare financing
5. All of the above

Sam is interested in learning more about the challenges affecting child and maternal health in Asia-Pacific countries.

Question 2

Which one of these countries has the highest under-5 mortality rate?

1. Indonesia
2. Laos
3. Cambodia
4. Papua New Guinea
5. Bangladesh

Question 3

Which one of these countries has the lowest maternal mortality rate?

1. Thailand
2. Sri Lanka
3. Cambodia
4. Fiji
5. Myanmar

Sam is keen to undertake activities in Australia that will best prepare him for working in countries with developing economies.

Question 4

According to Médicine Sans Frontièrs (MSF) Australia, which one of the following activities is the best predictor of performance on an overseas field mission?

1. Successful completion of the Masters of Public Health program
2. Committing to at least a one-year term instead of short-term deployment
3. Clinical experience in Aboriginal and Torres Strait Islander communities
4. Previous engagement with the Australian Medical Students Association (AMSA) Global Health committee

Case 2

Arthur has been asked by his local medical school to host medical students in his GP practice. Arthur has heard mixed reports from his colleagues about this and requests a meeting with the medical school to raise a series of concerns.

Question 5

The common concerns raised by GPs regarding hosting and teaching medical students in general practice include:

1. physical space and time for teaching students
2. patients being upset by the presence of students
3. potential financial disadvantages to the practice
4. having the requisite knowledge and skills
5. all of the above.

Question 6

The medical school prefers prolonged placements over short-term attachments, where possible. The most important factor when considering longer placement is:

1. students’ reports of predominantly negative experiences
2. exam results showing students were disadvantaged educationally
3. students’ confidence and motivation being enhanced
4. decreased interest in a general practice career.

Arthur’s practice employs four GP registrars across all stages of training and with varying requirements for supervision. Arthur has been considering how best to address the complexity of meeting their educational needs and how this may be approached in a structured manner.

Question 7

Which of the following is considered to be a category of standard for postgraduate medical education?

1. Mission and outcomes
2. Assessment of trainees
3. Evaluation of training process
4. Continuous renewal
5. All of the above

Question 8

Which one of the following statements best reflects the training process for GPs in Australia?

1. There is an emphasis on in-practice training.
2. Trainees are more intensely supervised as compared with North American trainees.
3. The duration of training is a minimum of two years post-internship.
4. The training process is producing a sustainable rural general practice workforce.

Question 9

Many professional medical colleges, both nationally and internationally, have curriculum statements and expected competencies that reflect community needs. Which of the following is considered to be a physician role that is required for optimal healthcare outcomes as per the CanMEDS Physician competency framework?

1. Administrator
2. Student
3. Bureaucrat
4. Leader

Arthur is aware that other countries in our region have been grappling with similar issues.

Question 10

Which of the following statements regarding trainees in general practice is CORRECT?

1. Admission point to general practice training is at postgraduate year (PGY) 3 in North America.
2. In Australia, from 1995 to 2016, trainee numbers have increased from 400 to 2500.
3. China has embarked on a drive to train and recruit up to 400,000 general practitioners in the next seven years.
4. Admission point to general practice training is at PGY 1 in Malaysia.