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Health services administration

Environmental health Perspectives 14 November 2019 Free

The 2019 report of the MJA–Lancet Countdown on health and climate change: a turbulent year with mixed progress

The lack of national policy means that Australia remains at significant risk of declines in health due to climate change — substantial and sustained national action is urgently required

Paul J Beggs · Ying Zhang · Hilary Bambrick · Helen L Berry · Martina K Linnenluecke · Stefan Trueck · Peng Bi · Sinead M Boylan · Donna Green · Yuming Guo · Ivan C Hanigan · Fay H Johnston · Diana L Madden · Arunima Malik · Geoffrey G Morgan · Sarah Perkins‐Kirkpatrick · Lucie Rychetnik · Mark Stevenson · Nick Watts · Anthony G Capon

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Digestive system diseases Research 28 October 2019 Open Access

The predicted impact and cost‐effectiveness of systematic testing of people with incident colorectal cancer for Lynch syndrome

Universal tumour testing strategies for guiding germline genetic testing are likely to be cost-effective compared with no testing

Yoon‐Jung Kang · James Killen · Michael Caruana · Kate Simms · Natalie Taylor · Ian M Frayling · Tristan Snowsill · Nicola Huxley · Veerle MH Coupe · Suzanne Hughes · Victoria Freeman · Alex Boussioutas · Alison H Trainer · Robyn L Ward · Gillian Mitchell · Finlay A Macrae · Karen Canfell

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Medical education Letters 7 October 2019 Free

Flinders medical students pilot free clinic for homeless men

To the Editor: Student‐run clinics (SRCs) empower students to employ logistics, operational management and clinical skills to provide free or affordable health care to underserved populations. SRCs have the dual benefits of student learning and care for underserved patients and promote health equity, interprofessionalism and student leadership.1,2 These clinics are well established in North America but are nascent in Australia. Some sections of the Australian population still face challenges accessing health care, including Aboriginal and Torres Strait Islander people, refugees and rural and homeless populations;3 SRCs not only meet this need but also assist with the growing demand for clinical placements for medical and allied health students.4 In 2012, the first Australian SRC began providing medical, nursing, social work and physiotherapy services in Melbourne,3 and similar clinics have also sprouted in New South Wales and Queensland.2,5 In the same vein, medical students from Flinders University in Adelaide piloted the Flinders Student Run Clinic (FSRC), with the support of faculty and of the Vinnie's Men's Crisis Centre, which provides crisis accommodation, meals, showers and case management for up to 47 homeless and vulnerable men aged over 18 years. From December 2016 to January 2017, student volunteers staffed weekend shifts providing consultations to residents. Clinic days were well subscribed, with about a dozen clients attending each session. Students were surveyed before and after volunteering on aspects of clinical training, preparedness and motivation. Out of 24 medical student volunteers, eight responded to the pre‐survey and six to the post‐survey. Before volunteering, students believed their clinical knowledge and skills would improve and they would be able to manage problems and unexpected events. After volunteering, students were less confident in their abilities and felt less valuable to the clinic, but were more prepared to work with vulnerable individuals, face morally challenging issues and achieve their goals. Volunteering also clarified students’ motivations and values, demystifying primary care with underserved populations, and they were motivated to be involved in similar programs in the future. Feeling less prepared may stem from exposure to responsibilities as primary health care staff on the ground. Further studies can explore expectation‐matching for different parties and the financial impact of similar programs. Furthermore, the use of SRCs in Australia to both teach and serve the community should be encouraged.

Andrew IH Phua · Yvonne K Parry

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