Letters
Women's health
Volume 199 - Issue 5

Should Australian medical students deliver babies?

Author:  Graeme J Dennerstein

Med J Aust 2013; 199 (5): 326. || doi: 10.5694/mja13.10568
Published online: 2 September 2013
To the Editor: I commend de Costa and Rane1 for highlighting a matter that has been causing me increasing concern over the past few years; namely, the decline in undergraduate education in obstetrics and gynaecology. Coincidentally, a couple of weeks before their article was published, I was the consultant on call at a rural hospital and was asked to see a young woman who turned out ...
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To the Editor: I commend de Costa and Rane1 for highlighting a matter that has been causing me increasing concern over the past few years; namely, the decline in undergraduate education in obstetrics and gynaecology.

Coincidentally, a couple of weeks before their article was published, I was the consultant on call at a rural hospital and was asked to see a young woman who turned out to have a ruptured tubal pregnancy. As we walked to the patient in the emergency department, I asked the intern what he had found on pelvic examination. He replied, “We don’t do them”. He was an Australian graduate who had never done a gynaecological examination.

For me, this was the last straw, and I wrote about this to several colleagues responsible for medical education. I had a detailed reply from the head of the intern’s medical school, who expressed surprise and a little dismay and explained that students are taught pelvic examination by gynaecologists, using pelvic models, and by clinical teaching associates (volunteers on whom students practise gynaecological examinations under their instruction). However, the head of school did report having “. . . more difficulty in building on this experience further in the outpatient clinics”.

Inadequate training of graduates in obstetric and gynaecological clinical skills can only result in an increase in adverse events, including the late diagnosis of cancer and ectopic pregnancy, and the misuse of diagnostic imaging with its enormous, unnecessary cost to the community.

It appears that, in our desperate attempt to make up the shortfall in Australian medical graduates, quality is being sacrificed for quantity. Is this what our profession wants? I doubt it.

View this article on Wiley Online Library

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