“THE Australian Dream is rooted in racism. It is the very foundation of the dream.” Stan Grant’s words have taken a permanent place in Australian identity.
In medicine, it is not just the health outcomes that demonstrate how far we are from that dream for Aboriginal and Torres Strait Islander people. Every year in graduation ceremonies across Australia, the lack of new Indigenous doctors walking across the stage has us questioning the health of the medical workforce itself.
In 2005, the Australian Indigenous Doctors’ Association authored the Healthy Futures report, setting out goals for building the Indigenous medical workforce in the years ahead. At that time there were just 160 Indigenous doctors across Australia, meaning that to achieve population parity the medical workforce required a further 1200 doctors to graduate.
In some parts of the journey, victories have been won.
In 2011, 2.5% of medical students starting medical school were Indigenous, equivalent to the 2.5% of the Australian population who are Indigenous. This 2011 milestone was a source of celebration, with a sense of hope for a more equal future.
Sadly, getting those students through medical school to graduation has proven to be another struggle entirely. Aboriginal and Torres Strait Islander medical students withdraw from medical school at far higher rates than non-Indigenous students, leaving the total enrolment of Indigenous students at just 1.8%.
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By graduation, the proportion of graduating students who are Aboriginal and Torres Strait Islander is just 1.2%. As a result, in 2014 only 35 Indigenous doctors graduated throughout Australia, and the year before, it was half that.
Cultural differences, marginalisation and racism from within our cohorts, faculties and hospital environments make medical school a very isolating place for our Aboriginal and Torres Strait medical students. Fear of prejudice, the threat of being questioned about identity and tokenistic or stereotypical expectations contribute to emotional and moral burnout in our Indigenous colleagues. Combined with economic circumstances and a lack of academic support, these factors are a potent discouragement to continuing medical study.
Eighty-six per cent of Aboriginal and Torres Strait Islander medical students denote family members and role models as their biggest support in overcoming these barriers and pursuing medicine.
While Indigenous Australians are living 10 years less than the rest of the population, our ability to produce skilled Indigenous doctors to provide best practice is compromised. Aboriginal and Torres Strait medical students and their families are losing grandparents, uncles, aunties and elders who love and support them throughout the many years at university.
A challenge delivered in 2005 by then Aboriginal and Torres Strait Islander Social Justice Commissioner Tom Calma here too holds true. “It is not credible to suggest that one of the wealthiest nations in the world cannot solve a health crisis affecting less than 3% of its citizens”.
It is not credible to suggest that delivering effective support to 310 Indigenous medical students nationwide is a task beyond the purview of universities, government and the medical profession itself, led by the Indigenous community.
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Universities need a firmer commitment to Indigenous student retention, and they need increased funding from the Australian government to do it.
Being Aboriginal or Torres Strait Islander is not just a risk factor, it is an identity; all too often, students see it portrayed solely as the former. Without the support of universities and the medical profession to counteract these stereotypes in medical education, we will continue to lose Indigenous students as a result.
Every day on the wards, the attitudes of their peers play a crucial role in creating an environment that either encourages Indigenous medical students to stay, or to leave.
Stan Grant’s speech was an indictment on the Australian dream. Every corner of our nation has its part to play in redefining that dream as one that innately supports our First Australians.
The 310 Indigenous students have put in the hard work to launch their dream of being a doctor. Let’s give them what they need to make that dream a reality.
Kersandra Begley is the student director of the Australian Indigenous Doctors’ Association and Elise Buisson is the president of the Australian Medical Students’ Association.