Two decades in the making : reflecting on an approach to increase the participation and success of Pacific students at the Otago Medical School in New Zealand.
Main Article Content
Keywords
diversity, equity, health workforce, education policy
Abstract
Introduction: Health professional institutions are required to train a health workforce to meet the needs of their increasingly diverse communities. One approach is to increase the diversity of their student cohorts. This article provides some reflections on the approach from one institution to increase the participation and success of Pacific students, an under-represented group in its medical programme.
Methods: A review of the University’s strategic documents and initiatives to improve the participation and success of Pacific students in the medical programme was conducted. The total number of Pacific students enrolled in medicine and their completion rates from 1996 to 2016 was requested from central university administration. The academic performance of Pacific students for the same period was requested from the medical school administration. The two extracts were merged and the annual performance for all Pacific students was analysed using Microsoft Excel. Interpretation of the results and perspectives discussed are shaped by the authors’ institutional knowledge.
Results: The earliest recorded efforts to increase the participation of Pacific students in the medical programme was through an affirmative action approach in 1951. Pacific student numbers, however, did not increase over subsequent years, until a more strategic approach was taken through the establishment of a Pacific Strategic Framework in 2011. The Framework coordinated a University-wide approach, engaged senior University leaders in the process, empowered Pacific staff, enabled targeted support for students and meaningful engagements with Pacific communities. These coordinated efforts coincided with positive outcomes for Pacific students’ in the medical programme.
Conclusions: The building of capacity and capability for under-represented groups require patience, persistence, advocacy, diplomacy and risk-taking. Having a university-wide strategic approach that is endorsed at the highest levels, supported well through appropriate resourcing, including the empowerment of minority leadership within the institution is required. It is important also for senior institutional leadership to be consciously aware of institutional racism and the historical, economic and social forces that lie behind it. Last by not least, building genuine and meaningful engagements with these minority communities is vital, and will support institutional efforts to meet the needs of their diverse communities.
References
2. Hennen B. Demonstrating social accountability in medical education. Can Med Assoc J. 1997;156:365-367.
3. Bodenheimer T, Laurie B. Rethinking the Primary Care Workforce—An Expanded Role for Nurses. N. Engl. J. Med. 2016;375(11):1015-1017.
4. Robert W, Lee G. Zero to 50,000 - The 20th Anniversary of the Hospitalist. The New England Journal of Medicine. 2016;375(11):1009-1011.
5. Goodyear?Smith F, Ron J. New Zealand rural primary health care workforce in 2005: more than just a doctor shortage. Aust. J. Rural Health. 2008;16(1):40-46.
6. Scott J, et al. Small?area estimates of general practice workforce shortage in rural and remote Western Australia. Aust. J. Rural Health. 2006;14(5):209-213.
7. MacDowell M, et al. A national view of rural health workforce issues in the USA. Rural and Remote Health 2010;10(3):1531.
8. Murray R, Ian W. When the tide goes out: health workforce in rural, remote and Indigenous communities. Med. J. Aust. 2006;185(1):37.
9. Wilkinson Dea. Impact of undergraduate and postgraduate rural training, and medical school entry criteria on rural practice among Australian general practitioners: national study of 2414 doctors. Med Educ. 2003;37(9):809-814.
10. Puddey IB, Playford D, Mercer A. Impact of medical student origins on the likelihood of ultimately practicing in areas of low vs high socio-economic status. BMC Medical Education 2017;17(1):1-13.
11. Larkins S, Michielsen K, Iputo J, et al. Impact of selection strategies on representation of underserved populations and intention to practise: international findings. Med Educ. 2015;49(1):60-72.
12. Crampton P, Weaver N, Howard A. Holding a mirror to society. The socio-demographic characteristics of Otago's health professional students. NZMJ. 2012;(In press).
13. Bernardino-Costa J, De Carli Blackman AE. Affirmative action in Brazil and building an anti-racist university. Race Ethnicity and Education. 2016:1-13.
14. Douglas-Scott S. Affirmative action at the University of Michigan. King's Law Journal. 2003;14(2):245-254.
15. Lakhan SE. Diversification of US medical schools via affirmative action implementation. BMC Medical Educatio. 2003;3(1):6.
16. Crampton P, Dowell A, Parkin C, Thompson C. Combating effects of racism through a cultural immersion medical education program. Academic Medicine. 2003;78(6):595-598.
17. Sopoaga P, Connor J, Dockerty J, Adams J. Training medical students in Pacific health through and immersion programme in New Zealand. NZMJ. 2012;125(1349):37-44.
18. Rapp DE. Integrating cultural competency into the undergraduate medical curriculum. Medical Education. 2006;40(7):704-710.
19. Seeleman C, Suurmond J, Stronks K. Cultural competence: a conceptual framework for teaching and learning. Medical Education. 2009;43(3):229-237.
20. Boelen C, Woollard B. Social accountability and accreditation: a new frontier for educational institutions. Medical Education. 2009;43(9):887-894.
21. Boelen C, Woollard R. Social accountability: The extra leap to excellence for educational institutions. Medical teacher. 2011;33(8):614-619.
22. Leinster S. Evaluation and assessment of social accountability in medical schools. Medical teacher. 2011;33(8):673-676.
23. Strasser R, Hogenbirk JC, Minore B, et al. Transforming health professional education through social accountability: Canada's Northern Ontario School of Medicine. Medical Teacher. 2013;35(6):490-496.
24. Worley P, Murray R. Social accountability in medical education–an Australian rural and remote perspective. Medical Teacher. 2011;33(8):654-658.
25. K Brake. Immigration of Pacific Islanders to New Zealand, 1986-1991 : policies, patterns and outcomes. New Zealand Population Review. 1993;19(1):173-203.
26. Iredale R HC, et al. Migration in the Asia Pacific : Population, Settlement and citizenship issues. : Edwarnd Elgar Publishing Inc. ; 2003.
27. Statistics New Zealand. Demographics of New Zelands Pacific Population 2010.
28. Ministry of Health. The Health of Pacific Peoples. 2005; http://www.moh.govt.nz/moh.nsf/pagesmh/3914.
29. Ministry of Health. 'Ala Mo'ui Progress Report : December 2015. 2015.
30. Ministry of Health. 'Ala Mo'ui Pathways to Pacific Health and Wellbeing 2014-2018. Wellington2014.
31. Ministry of Education. Pasifika Education Plan 2013-20172012.
32. Callister P. Special measures to reduce ethnic disadvantage in New Zealand. Wellington: Institute of Policy Studies, Victoria University. 2007.
33. Hunt M, Pywell S, Le L, Lay D. UMAT 2012. Report on the 2012 undergraduate medicine and health sciences admission test. Aust Counc Educ Res 2012.
34. Medical Council of New Zealand. The New Zealand medical workforce in 2011 2011.
35. Mauiliu M, Sopoaga F, Ekeroma A. Community experience of a Pacific Immersion Programme for medical students in New Zealand. NZMJ. 2013;126(1376):9-18.
36. Boelen C, Jeffery E H, World Health Organization. Defining and measuring the social accountability of medical schools 1995.
37. BOELEN C. Global consensus on the social accountability of medical schools. Sante Publique. 2011;23(3):247-250.
38. Australian Medical Council Limited. Comptence-based medical education AMC consultation paper. 2010; http://www.amc.org.au/accreditation.
39. Crampton P, Weaver N, Howard A. Holding a mirror to society? Progression towards achieving better sociodemographic representation among the University of Otago’s health professional students. NZMJ 2018; 131 (1476) : 59-69.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Articles on this website and article downloads are provided free of charge by Open Access under a Creative Commons with the author retaining all copyright to the material. eg © PacifichealthDialog 2021. Except as provided by the NZ Copyright Act, no part of this publication may be reproduced or stored in a retrieval system in any form or by any means without the prior written permission of the copyright owner and the Pacific Health Dialog. Manuscripts can be used for private study but must not be used for commercial purposes.