Monash University Handbook 2010

The four year graduate-entry MBBS curriculum is designed as an integrated structure incorporating four themes, within which units are taught in an interdisciplinary fashion by staff from across the faculty, and from a wide range of clinical environments. The basic knowledge, skills and attitudes that form the curriculum will be related to clinical and other problems or issues. Learning in appropriate medical and other health professional contexts is an overarching principle of the curriculum.

For all years, semesters are of 18 weeks duration. The course requires about 28 contact hours per week. This provides students with time for self-directed study, and the time and opportunity to be in control of their own learning and to develop skills in problem-solving and the critical appraisal of information.

The degrees of Bachelor of Medicine and Bachelor of Surgery may be awarded at either pass or honours standard. The conferring of this award with honours is based on academic achievement.

Patient-based learning activities

A patient-based learning model will be used, where the knowledge, skills and attitudes that form the content of the curriculum are brought to life via formal patient-focused learning activities. Most of the learning activities are designed to support students as they work with patient-centred scenarios.

The themes

The faculty has adopted a four-theme structure. These themes are:

• Theme I - Personal and professional development
• Theme II - Population, society, health and illness
• Theme III - Scientific basis of clinical practice
• Theme IV - Clinical skills.

The four themes will run through all years of the course, but will not be of equal weight; nor will they be of constant weight throughout the course.

Theme I

'Personal and professional development' will focus on the doctor as an individual. This theme concentrates on the personal attributes and qualities needed by medical students and, ultimately, medical practitioners. It covers elements of communication skills, information technology, medical informatics and computing skills, ethics and legal issues, and clinical effectiveness.

Theme II

'Population, society, health and illness' provides the structure to develop students' abilities to deal with broader society and population issues. Students will consider the social, environmental and behavioural contexts of illness and the practice of medicine, including an emphasis on rural and remote Australia. Other elements of this theme will be built around health promotion, epidemiology, public health, community diversity, population and global health, and a range of other societal issues. The history and philosophy of the scientific approach to medicine will also be included, extending this to approaches to knowledge and information, and an understanding of evidence-based medicine.

Theme III

'Scientific basis of clinical practice' includes much of the human systems-based teaching in the course. The knowledge and concepts that underpin medicine, both in the basic medical sciences and in the clinical sciences, will be delivered within this theme. In the early semesters, the basic sciences of anatomy, biochemistry, genetics, microbiology, pathology, pharmacology, physiology and psychology of each system will be taught in an integrated manner and from a relevant clinical perspective.

Theme IV

The 'Clinical skills' theme encompasses the whole range of clinical skills, from the earliest to the later parts of the course. Practice in clinical skills (including procedural skills) is stressed early and often. The approach in clinical skills development will be to develop defined clinical competencies. This will begin with clinical aspects of communication skills and move through history taking and physical examinations to the more advanced clinical and procedural skills.

In the early years of the course, this theme will include general practice and rural visits, and an introduction to community clinics and hospitals. Multi-professional education will be promoted through educational interactions with nurses, paramedics, radiographers and other health care professionals. The rural health activities in the early years of the course will provide opportunities for our students to interact with a range of health care professionals. The later years will include advanced elective experience in diverse medical work places, both within and outside the hospital environment.

Community Based Practice Program

The Community Based Practice Program (CBP) is an integral and innovative component of the new MBBS course for Year A medical students. CBP provides a meaningful context for future medical practitioners to gain an understanding of issues that relate to social justice, equity and diversity in the wider community.

Students complete a community-based placement, attend orientation and integration lectures, and complete a report so that they understand the context and links between health and illness, medicine and social justice.

Rural practice

The graduate entry curriculum is rurally contextualised, and in addition, includes a week focused on Indigenous health. Additionally, students are encouraged to join the rural students club 'Wildfire'.

The Monash University Gippsland Medical School will strive to graduate doctors who:

• are knowledgeable, skilful, reflective and compassionate
• are innovative in their approach to and solution of problems
• are skilled at accessing, appraising, and applying the best available evidence to their everyday practice
• demonstrate awareness of the social, ethical, economic and environmental context of health and illness and psychological wellbeing and delivery of care
• are committed to the health of populations as well as individuals
• are concerned with issues of equity, quality and humanity in health care and act as advocates for the disadvantaged and dispossessed
• maintain high standards throughout their professional life by a commitment to have the skill to address the key questions relevant to the community and to medicine
• are capable of leadership and yet are comfortable working as a team member
• uphold the community's trust and expectations of the role of a doctor
• are advocates for health by practising preventative medicine and health promotion
• recognise the essential role of research in underpinning medical practice.

Special requirements

Health requirements

For the protection of other students, patients and themselves, students in the MBBS course should comply with certain precautionary procedures.

Prospective students should note that, on enrolment, they are provided with detailed written information about the effect that HIV, hepatitis B or other infections may have on the ability of health care workers to practice their profession. Students are expected to enrol in Year A, with their immunisation status up to date.

Police and Working with Children checks

It is essential that all MBBS students have current Working with Children and Police checks regarding their suitability to undertake clinical and community placements. All enrolled and prospective students are advised that they will be required to obtain both checks prior to undertaking their course. As the Working With Children checks cover a five year period, most students will only need to obtain a free check a the commencement of year 1, whilst students must apply and pay for a Police check annually. Note that some community partnered programs require a police check be renewed every six months.

Student registration with the Medical Practitioners Board of Victoria

In keeping with a student's professional responsibilities, all MBBS students must be registered with the Medical Practitioners Board of Victoria and must keep the Faculty of Medicine, Nursing and Health Sciences informed of any matters that would impact on that registration.

Clinical practice units

This course requires students to undertake off-campus clinical placements. In the clinical setting students will have an opportunity to apply theory to practice under supervision. Attendance is mandatory for the clinical component of each unit.

Where a student's skill or knowledge is found to be inadequate, access to the clinical component of the unit will be denied. A student may be withdrawn from a clinical practicum if required skills and knowledge are deemed inadequate, or on other grounds deemed appropriate by the Deputy Dean (MBBS Curriculum).

Year A

The overall aim of semester one, Year A, is to introduce students to basic principles of the four themes. Teaching and learning activities include problem-based learning and other tutorials, small group sessions, lectures, seminars, and practical work.

The transition needs of graduate entry students will differ from those of undergraduate entry students, who enter an MBBS program as a continuation of (usually) full-time study. We expect that some of the commencing cohort will have experienced interruptions in their study patterns for reasons such as employment, family or travel. A range of variances will therefore exist in this cohort, not necessarily identical to those in the undergraduate cohort. We accommodate this potential complexity through a range of activities commencing in the first week of Year A.

Year A will introduce ethical and legal issues, population health (basic epidemiology and biostatistics) and knowledge management, and the social context of health, illness and medicine. Significant curriculum time will be allocated to fundamental learning in the key biomedical sciences covering cell biology, basic pathological processes and anatomy and physiology. Students are introduced to the clinical environment from their third week of Year A. During the year they are expected to develop appropriate clinical communication and teamwork skills, basic procedural skills, including physical examination procedures.

During Year A, students explore the whole person through a systems-based approach. Content relating to the clinical science that underpins clinical practice is aligned with human lifespan development, in which the students study the stages of human, physical and psychological development from birth to death. Clinical skills sessions and clinical placement days are aligned with each of the systems. Students develop clinical reasoning and focused history-taking skills in the context of these clinical placements. Students will commence the Community Based Practice programs. Students in the graduate entry program will meet all the objectives of the rural curriculum as prescribed for the undergraduate course, however the timing and progression of this experience will be different.

In Year A, all students will undertake three modules from the Monash University Indigenous Health curriculum. This study will be a mandatory precursor to a four-day Indigenous health and community placement undertaken in semester two. This activity will deliver the objectives identified in the CDAMS Indigenous Health Curriculum Framework (2004). Associate Professor Marlene Drysdale, the faculty Director of Indigenous Health, is working with the Gippsland Medical School to ensure that all requirements for Indigenous health education are met within the curriculum.

Year B

Year B emphasises the integration of knowledge and skills in medicine and surgery, including pathobiology, diagnostics, therapeutic and clinical skills, further development of evidence-based clinical practice (EBCP), occupational and environmental medicine, law and ethics, integrated with continuing personal and professional development and patient advocacy skills. This is the first opportunity for students to work continuously in a clinical environment to consolidate knowledge and skills which they have developed in Year A, within a consistent and authentic clinical context. Vertical integration of learning in the curriculum is promoted wherever possible. Evaluation of year-long placements for students in Year 3 of the undergraduate curriculum has demonstrated that this is a valuable model for learning. Therefore, students in Year B will be placed, where possible, in their preferred clinical location for the full year, with the opportunity to visit other locations for one-week placements as appropriate. We will also enable some limited experience for our students with private healthcare providers, community based practices and industrial sites.

Teaching and learning activities continue to be structured within a framework of problem-based learning (PBL) and experiential activities. Students are placed in clinical attachments for the year and rotated through specialty units in medicine and surgery. These placements are structured to balance students' learning needs and to provide an opportunity for students to participate in the daily ward-based care of medical and surgical patients under the supervision of clinical teaching staff. Students are strongly encouraged and supported to be self-directed; they are offered a broad opportunity to acquire the clinically relevant knowledge, skills and experiences that will support them in later years of the curriculum.

Year C

Year C of the graduate entry MBBS course continues to vertically integrate and consolidate generic skills and attributes such as clinical skills, clinical reasoning, professional judgment and professional behaviour. The key focus of the year will be on experiential learning during clinical attachments that link existing knowledge and clinical skills to new clinical contexts and the development of higher level skills in a range of clinical settings.

The approach to teaching and learning in Year C provides students with an experiential learning program built around an inclusive clinical clerkship. Across the year, students are placed in a range of clinical situations (for a minimum of one semester) encompassing in-patient, ambulatory and community-based settings. Learning within the clinical environment is guided by directed activities covering the core curriculum content identified for key discipline areas. Key concepts and topics are also addressed in a series of illustrative discussion cases (index cases) which map to curriculum objectives and content.

Year D

Year D of the graduate entry MBBS course has a strong focus on transition to internship. Students will primarily act as student interns in a range of environments. They will undertake a series of clinical attachments which they choose from a range of relevant placement options (rotations). Students also undertake one elective rotation which provides an opportunity to pursue studies in an area of interest, to broaden or deepen their knowledge and skills in a variety of community, health and medicine-related fields. During each of the rotations, students complete concurrently, five designated activities or learning modules. The modules are designed to guide student learning in the clinical environment and are aligned with each rotation to reflect the type of experience the student is most likely to encounter in that particular rotation.

In addition to the rotations program, students undertake a specific program, the Patient Safety Unit, which provides targeted teaching and learning experiences in patient safety. This provides a systematic introduction to essential components of risk management and quality improvement and equips the students with the skills necessary to become a safe intern.

Year D equips students to build on their clinical experiences in Years B and C. Overall, the structure and curriculum of Year D is designed to facilitate consolidation and enhancement of clinical skills, and provide opportunities for students to undertake a program that reflects their interests. Students will be able to choose their selective rotations from the total pool of options offered by the Central, Gippsland and Malaysia Medical Schools. Students in Year D will be encouraged to exercise maximum flexibility in choosing their placements to meet the curriculum requirements in a variety of learning situations. Limitations to that choice will, of course, apply in situations of poor assessment outcomes in previous learning activities, requiring directed Year D activities, or in the event that a potential placement becomes politically or geographically unsafe (Department of Foreign Affairs and Trade (DFAT) regulations apply).

The conferring of this award with honours is based on academic achievement.

Year A

First semester

• GMA1011 Medicine 1

Second semester

• GMA2000 Final grade
• GMA2022 Medicine 2

Year B

First semester

• GMB3031 Medicine and surgery 1

Second semester

• GMB3042 Medicine and surgery 2

Year C

First semester

• GMC4051 General practice/psychological medicine

Second semester

• GMC4000 Final grade
• GMC4062 Women's health and children's health

Year D

First semester

• GMD5071 Advanced clinical practice I

Second semester

• GMD5000 Final grade
• GMD5082 Advanced clinical practice II
• GMD5102 Contemporary developments in clinical practice: Patient safety

The Bachelor of Human Sciences is an exit award for students enrolled in this course, who have successfully completed at least 144 points of study, but who cannot or do not wish to progress through their degree.

Bachelor of Medicine and Bachelor of Surgery

Bachelor of Medicine and Bachelor of Surgery (with Honours)

Where more than one award is listed the actual award conferred may depend on units/majors/streams/specialisations studied, the level of academic merit achieved, or other factors relevant to the individual student's program of study.