To the Editor: The two excellent articles in the MJA on an issue important for medical education provided too few strategies for improvement.1,2

First, there is a need for a fundamental attitude change concerning the role of student “doctors”. As long as they are viewed as inexperienced novices, intruding on hapless “guinea pigs”, barriers will always be found to reduce access.

Patients should be informed that interview and examination by a student doctor adds much to the discussion of their problem, with real clinical advantage for their care program. Student doctors are usually grateful for the privilege, and should be encouraged to be part of the team, and assured of the value of discussion with nurses, residents and other team members. No additional funding should be needed for such activity.

Secondly, as surgical patients are admitted on the day of operation, students should attend the preadmission clinics to help with fuller evaluation. Most teachers would welcome student doctors in their rooms, but this requires planning. It works best when there is a separate examining room for students and patients seeking the added benefit of re-examination.

Thirdly, although it is difficult to conduct symptom analysis for someone without symptoms, much value can be obtained from rehearsing specific interrogation and physical examination of all systems in normal people; for example, family and friends. It is not surprising that a few students in exams cannot feel pulses, when they have never tried to feel their own!

Fourthly, with modest financial compensation, an army of people with abnormal signs, not in need of treatment, could be recruited for clinical teaching. This task could be assigned to a teaching coordinator, with skills in social interaction, and would need the cooperation of clinical staff.