Meeting the challenges of training more medical students: Lessons from Flinders University's distributed medical education program

Objective: To use data from an evaluation of the Flinders University Parallel Rural Community Curriculum (PRCC) to inform four immediate challenges facing medical education in Australia as medical student numbers increase. Design, setting and participants: Thematic analysis of data obtained from focus groups with medical students undertaking the PRCC, a year-long undergraduate clinical curriculum based in rural general practice; and individual interviews with key faculty members, clinicians, health service managers and community representatives from 13 rural general practices and one urban tertiary teaching hospital in South Australia. Data were collected in 2006 and re-analysed for this study in January 2009. Main outcome measures: Participants' views grouped around the themes of the four identified challenges: how to expand the venues for clinical training without compromising the quality of clinical education; how to encourage graduates to practise in under-served rural, remote and outer metropolitan regions; how to engage in a sustainable way with teaching in the private sector; and how to reverse the current decline in altruism and humanism in medical students during medical school. Results: Participants' views supported the PRCC approach as a solution to the challenges facing Australian medical education. The enabling capacity of the PRCC's longitudinal integrated approach to clinical attachments was revealed as a key factor that was common to each of the four themes. Conclusions: The continuity provided by longitudinal integrated clinical attachments enables an expansion of clinical training sites, including into primary care and the private sector. This approach to clinical training also enables students to develop the skills and personal qualities required to practise in areas of need.