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Be better prepared to respond to disclosures of intimate partner violence

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BY VICTORIA COOK, VICE PRESIDENT, AUSTRALIAN MEDICAL STUDENTS’ ASSOCIATION

This year, like the ones before it, Australia has been shocked by stories of horrific violence against women reported in the media. Yet for every story that is reported, many go unmentioned. Women die by violence in Australia at a rate of more than one per week. The organisation Destroy the Joint which ‘counts dead women’ holds this year’s total at 47 women killed in Australia by September 14. There are another 13 weeks left in 2018, meaning we can expect that at least 13 more Australian women will be killed by the end of this year alone.

We know that healthcare professionals are often first responders in disclosures of domestic violence. Health professionals are the second most commonly sought source of support for women experiencing domestic violence, after family and friends. Of women experiencing domestic violence, 30 per cent will seek advice from a general practitioner and 20 per cent from another health professional. On average, eight women are hospitalised each day due to intimate partner violence, and the rate is rising. The person that a woman reaches out to, to disclose violence at home, will likely be one of us. Yet, medical students don’t feel as if medical school adequately prepares them to respond to disclosures of intimate partner violence.

Medical student representatives across Australia recently unanimously endorsed a position calling for improved access to education and training around intimate partner violence. In 2015, a study showed that the median time spent on intimate partner violence in Australian medical schools, across all years of the curriculum, was only two hours¹. One can only assume that access to education in this area after medical school is less again. Intimate partner violence is the greatest contributor to mortality and morbidity among women aged 18 to 44 in Australia. It outranks smoking, illicit drugs, and obesity. Yet the burden of illness is not reflected in the time dedicated in medical curricula or training.

Intimate partner violence is a complex and distressing topic, making it hard to teach but even more difficult for professionals to respond to without adequate training. Students must be taught to recognise intimate partner violence, assess risk, document disclosures, record evidence and understand legal implications. Medical practitioners are under-prepared to respond appropriately, which risks reinforcing women’s feelings of powerlessness and violation. This is a whole society issue, and action is needed not only from medical schools, but from medical training colleges, health services, Governments (Federal, State and Territory), and individual practitioners and students. When a woman reaches out she must find someone who is equipped to help. As future doctors we know we will be faced with disclosures, and when we are, we want to be prepared.

In the wake of the tragic death of Eurydice Dixon, students and young women reckoned with an awful paradox; despite entreaties to be safe and stay home, they often aren’t safer at home at all. One medical student told me she began university in Melbourne when Jill Meagher was murdered, and is graduating as Eurydice Dixon was killed. These seemingly random acts of violence remind us to fear what we do not know, whilst distracting us from the facts we do; most women who die by violence will be killed by a man that they know. Our medical education must prepare us to help prevent that.

 

References

  1. Valpied J, Aprico K, Clewett J, Hegarty K. Are future doctors taught to respond to intimate partner violence? A study of Australian medical schools. Journal of interpersonal violence. 2017;32(16):2419-32.

 

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