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12but many reported that formal mentoring was ad hoc and mostly left up to theindividual to organise.The most notable comments about mentoring related not to Indigenous culturalsupport, but rather to support within the professional culture of medicine, and thepathway of the trainee.My mentors have been really good… being able to help me through some of thosebarrier times and those difficult times and being quite supportive and also helpingme do all the paperwork, ‘cause there’s an extraordinary amount of paperworkand bureaucracy… Indigenous specialist commenting on their mentoringexperienceJust learn the rules of the game and you know to keep you focused on what youneed to do because I think sometimes you can be distracted so I think having theparticularly training mentors… is really important and then you know you needthem for survival and being able to cope with being in the health sector at timesor being in medicine, being in training. Dr Tamara MackeanMentoring programs that have specifically focused on cultural or ethnic differencesand support have generally been successful in meeting their articulated aims(Coleman et al, 2005). Mentoring with Indigenous trainees should take a strengthsbasedapproach, not a deficit approach… Aboriginality [should be seen] as a strength rather as a weakness. IndigenousspecialistSome mentoring initiatives already exist, such as the RACP mentoring project withAIDA (see Fellows paper), and the RACS ‘cutting clubs’ mentoring project. Mentoringprograms need to have their objectives clearly identified so that their achievementscan be documented against their aspirations.Recommendation: CPMC to develop and fund scholarships to support Indigenoustrainees. This would help overcome financial barriers. The Puggy Hunter MemorialScholarship is an example of such a scholarship for Indigenous health scienceundergraduates.Recommendation: That Colleges provide the opportunity for their entire staff toundertake cross‐cultural training in Indigenous issues.Recommendation: Utilising Continuing Medical Education, Collegesencourage Fellows to attend cultural competence training related to Indigenoushealth.Recommendation: CPMC to implement the recommendations of the AIDA Pathwaysinto Specialties paper in all its member Colleges. Currently, initiatives are in place atRACP and RACS.Recommendation: CPMC to implement an Indigenous Employment Strategy withinits own organisation, at all levels.
13Section 2: CurriculumThere are two primary reasons for inclusion of Indigenous health, informed byIndigenous perspectives in training programs. The first is to ensure that all Fellows inAustralia are adequately trained to be able to work positively with Indigenous peopleand communities. The second is to ensure that the training curriculum doesn’talienate Indigenous trainees, and that Indigenous people are not further marginalisedin Australian society through invisibility in the curriculum. Central to curriculumdevelopment and delivery are Indigenous community priorities and Indigenousleadership.Most faculty appear open to cultural training, but desire a clear understandingof exactly what that would entail and how it can be taught (Chun 2009).EvaluationExisting curricula and training opportunities vary across Colleges, but consistent is thelack of longitudinal evaluation of curricula. There are many varieties of culturaltraining within medicine worldwide. Reasons for inclusion and expected outcomesvary and need to be considered at the outset so that realistic and relevant approachescan be implemented.Despite progress in the field of cross‐cultural medical education, severalchallenges exist. Foremost among these is the need to develop strategies toevaluate the impact of these curricular interventions (Betancourt 2003).There are a variety of initiatives already in place across specialist Colleges (see page 12for an exemplar from RACGP), but similar to many examples locally andinternationally, longitudinal evaluation of such modules is rare. A development in theAustralian basic medical education context is the National Indigenous HealthCurriculum Framework (see Appendix 1 for outline of key subject areas). Whilst mostrecent medical graduates should have had some teaching in Indigenous health, thedepth of learning and sophistication of approaches will vary. Many current specialiststrainees may have had very little Indigenous health teaching, and internationalmedical graduates may have had none. Others may have significant knowledge,exposure and understanding of Indigenous health. The challenge is to develop acurriculum that is flexible and which builds upon current levels of trainee knowledgeyet is introductory enough to ensure that every trainee is exposed to the basics(without being repetitive). Further, in specialist training, the learning opportunitiesneed to be relevant to the particular strand of interest of the trainees, and clinicallyoriented.A confluence of Indigenous health‐specific training, and cultural competency andsafety is common. Yet it should not be the sole responsibility of the ‘close the gap’initiative to address deficiencies in cultural competence and safety training in collegecurricula. Whilst there is some overlap with Indigenous health training, they are notthe same thing. Nevertheless, Indigenous health training may provide an opportunityfor evaluation of cultural competence and safety initiatives across college curricula.
Page 1: National Aboriginal andTorres Strai
Page 5 and 6: 1Executive SummaryThe framework was
Page 7: 3and Psychiatry and consistent with
Page 11 and 12: 7Section 1: Pathways, Recruitment,
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Page 19 and 20: 15environment for trainees to learn
Page 21 and 22: 17Section 3: Action for ChangeHow c
Page 23: SummaryThe commissioning of this re
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Page 43: 39Appendix 3Indigenous Health Posit
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4Aboriginal HealthCurriculum Statem
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71Appendix 6Heads of AgreementNatio
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PrinciplesThe RACP and NACCHO will:
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