Rapid Implementation of a Novel Embedded Senior Medical Student Program, as a Response to the Educational Challenges of COVID-19

As with many OECD countries, graduating medical students have been choosing specialist careers at a greater rate than ever before. Generalism in the form of family (general practice) and more generalist medical specialties have been trending down resulting in distributional geographic challenges. With the advent of COVID-19 in March 2020, medical schools and in particular the Joint Medical Program situated in a regional and rural area in NSW Australia had the unique opportunity to rethink the penultimate year curriculum when the previous rapid rotation model through numerous medical specialities became untenable. The need to vision a new practical pragmatic curriculum spurred a rapid revaluation of assessment, placement length and model with a pivot to an “embedded senior student placement” agnostic of discipline and supported by a competency-based learning portfolio. This article explores the barriers and enablers and identifies the potential elements of this type of placement which can be adapted to community and smaller rural sites. The positive student and supervisor experience also enabled an employment model to be woven into the students learning and ensured on hand medical student workforce for hospitals throughout the rural footprint. The capacity of these placements to celebrate variation in experience and support students to learn on the job have now caused a revision of the penultimate year with expectation of gains in students’ satisfaction and in employability. It has also opened up options to deliver and increase the inherent value of generalist placements with likely long term workforce benefit

HPV vaccine catch up schedule: an opportunity for chlamydia screening

The human papillomavirus vaccine (Gardasil) catch up schedule in general practice provides a unique opportunity for sexual health screening in females not in school and up to 27 years of age. Chlamydia is a priority in this age group. This article presents a case for the value of opportunistic testing for chlamydia in patients presenting for Gardasil vaccination

Caring for patients who have sexually transmitted infections: getting the team on board

The quality, resourcing and accessibility of healthcare is a key issue facing societies in the 21st century. Despite the system delivery focus of these factors it is critical to remember that healthcare is a human service and as such, people need to be placed at the centre of healthcare systems and processes. To do this we need to improve the way that people are valued and involved in healthcare practices. Professional relationships lie at the heart of such practices. This book illuminates and challenges professional healthcare relationships. The authors examine the nature, context and purpose of healthcare relationships, explore models through which these relationships are enacted, developed and critiqued, and provide narratives of health practice relationships in action. These narratives reveal how health practice relationships are experienced and created in real-world situations. The various chapters generate a range of implications and recommendations for healthcare practice and systems and for the education of health professionals. This is a book for practitioners, educators, clients, members of the community, advocacy and agency groups, regulatory bodies and those with power to shape the future direction of healthcare

Interprofessional relationships in healthcare practice

The quality, resourcing and accessibility of healthcare is a key issue facing societies in the 21st century. Despite the system delivery focus of these factors it is critical to remember that healthcare is a human service and as such, people need to be placed at the centre of healthcare systems and processes. To do this we need to improve the way that people are valued and involved in healthcare practices. Professional relationships lie at the heart of such practices. This book illuminates and challenges professional healthcare relationships. The authors examine the nature, context and purpose of healthcare relationships, explore models through which these relationships are enacted, developed and critiqued, and provide narratives of health practice relationships in action. These narratives reveal how health practice relationships are experienced and created in real-world situations. The various chapters generate a range of implications and recommendations for healthcare practice and systems and for the education of health professionals. This is a book for practitioners, educators, clients, members of the community, advocacy and agency groups, regulatory bodies and those with power to shape the future direction of healthcare

Risk factors associated with incident sexually transmitted infections in HIV-positive patients in the Australian HIV Observational Database: a prospective cohort study

Objectives We established a subcohort of HIV-positive individuals from 10 sexual health clinics within the Australian HIV Observational Database (AHOD). The aim of this study was to assess demographic and other factors that might be associated with an incident sexually transmitted infection (STI). Methods The cohort follow-up was from March 2010 to March 2013, and included patients screened at least once for an STI. We used survival methods to determine time to first new and confirmed incident STI infection (chlamydia, gonorrhoea, syphilis or genital warts). Factors evaluated included sex, age, mode of HIV exposure, year of AHOD enrolment, hepatitis B or C coinfection, time-updated CD4 cell count, time-updated HIV RNA viral load, and prior STI diagnosis. Results There were 110 first incident STI diagnoses observed over 1015 person-years of follow-up, a crude rate of 10.8 [95% confidence interval (CI) 9.0-13.0] per 100 person-years. Factors independently associated with increased risk of incident STI included younger age [≥ 50 vs. 30-39 years old, adjusted hazards ratio (aHR) 0.4; 95% CI 0.2-0.8; P \u3c 0.0001]; prior STI infection (aHR 2.5; 95% CI 1.6-3.8; P \u3c 0.001), and heterosexual vs. men who have sex with men (MSM) as the likely route of exposure (aHR 0.2; 95% CI 0.1-0.6; P \u3c 0.001). Conclusions In this cohort of individualsbeing treated with antiretroviral drugs, those who were MSM, who were 30-39 years old, and who had a prior history of STI, were at highest risk of a further STI diagnosis