For Reconciliation Week 2023, the Monash Rural Health’s North West Victorian Regional Training Hub hosted a forum with more than 50 local doctors, representatives from speciality training colleges and health services, the Australian Indigenous Doctors Association, Joint Colleges Training Services and Dja Dja Wurrung traditional owners.
The event commenced outside in the dark wintery rains with a smoking ceremony performed by Dja Dja Wurrung representative Troy Firebrace, moving inside to a warm Welcome to Country. David Byrnes, Monash Rural Health’s newly appointed Aboriginal Community Engagement Lead, a proud Kokatha man, born and bred on Latji Latji country in Mildura, took guests through the School’s Aboriginal and Torres Strait Islander Framework 2021-2030. Key pillars of the framework include upholding Aboriginal and Torres Strait Islander knowledge and including this in the curriculum, increasing participation and success of Aboriginal and Torres Strait Islander students, and developing research to serve the local Aboriginal communities in the School’s footprint.
Stephanie May, specialist trainee support program coordinator from the Australian Indigenous Doctors Association (AIDA), spoke about the organisation’s groundbreaking work in building pathways and support for Indigenous doctors and revealed positive trends. Since AIDA’s establishment in 1998 with 14 Indigenous doctors, there are now 757 doctors and 434 medical students registered with AIDA as of December 2022, with numbers doubling in the last seven years. Stephanie then illustrated the need for all health services to improve their cultural safety, with the most recent statistics from the 2022 National Medical Training Survey revealing 39% of Aboriginal and Torres Strait Islander doctors in training experienced bullying, harassment, discrimination or racism in the last 12 months, as opposed to 22% for all doctors in training combined.
Anthony Paulson Interim General Manager of the Joint Colleges Training Service (JCTS) travelled to Bendigo from regional NSW specifically for the event, and introduced guests to the innovative work being undertaken to provide Aboriginal and Torres Strait Islander cultural awareness and support for GPs across Australia. Commencing operations only at the start of this year, JCTS is a joint venture of ACRRM and RACGP and is bringing together the knowledge of the previous Registered Training Organisations providing GP training across Australia to ensure GPs have the best possible training and understanding of Aboriginal and Torres Strait Islander people. Anthony spoke about the need to understand how cultural safety is defined.
“The principles of cultural safety are not about what you think, but about the other person you are providing the services to [or working with]. How do they receive your services? They are the ones who can tell you if you are culturally safe or not.”
Auntie Nellie Flagg, a cultural educator with JCTS, and Dja Dja Wurrung, Yorta Yorta and Bunurong Elder spoke about culturally appropriate health care, recalling past traumatic experiences of the stolen generation with health services and the intergenerational impact that continues today. Auntie Nellie acknowledged the efforts to improve, and the need to keep working on this as individuals and institutions throughout the year not just for Reconciliation Week.
In the probing discussion that followed, some of the key blockers and enablers for providing culturally safe spaces included
- enabling family support at the bedside,
- adopting a more reflective approach considering the diversity of Indigenous patients experience and past traumas,
- taking time to build relationships and listen before providing care
- supporting Indigenous trainees in the workplace to make it more culturally safe
- undertaking localised, personal cultural awareness training with meaningful engagement
- learn about Indigenous medicine, local bush medicine
- consider taking service provision to safe places for Indigenous people
- cultural awareness training is not one off, needs to be ongoing and regular
- ensure there is continuity of care
- ensure patients know about any change in care provider/training requirements for doctors moving practices
Guests left the event with a letter to themselves to read next year and reflect on their efforts in this space.
Head of School, Professor Shane Bullock, spoke about the importance of the event and how it can inform the School’s practice.
“Hearing from key national stakeholders supporting Indigenous doctors in training and providing anti-racism and cultural awareness training provides us with a unique opportunity to self-reflect on how we can embed the important work of reconciliation and cultural safety in our local programs, and support the health care networks and supervisors that our students learn from. Thank you to the staff at Monash Rural Health, particularly David Byrnes, Associate Professor Janelle Brennan and Sophie Burke, for facilitating the discussion about this topic, which can often be uncomfortable to engage with, but is the foundation of the future.”