Americanisation of our medical schools

During World War II, John Curtin, our then Prime Minister, faced with the imminent threat of a Japanese invasion of Australia, severed our traditional ties with Britain and looked to the United States for help. This defining decision began the Americanisation of our society, and, of late, it has influenced our medical schools.

In the US, there are 125 medical schools with an enrolment of 68 280 students. All are graduate schools with uniform admission assessments, including interviews; a third of the schools are private. Each year, these schools graduate roughly one new MD per 183 000 US citizens.

The US News & World Report ranking of medical schools, according to research or training performance, exemplifies the fierce competition that exists between the schools. It also lists the schools’ fees. Finding information is not difficult, as each year, the Journal of the American Medical Association (JAMA) publishes comprehensive data on US medical schools.

In Australia, we have 19 medical schools; 12 are established and the rest in development. Eight are graduate medical schools with admission assessments similar to those of their US counterparts. There are two private schools. Significantly, almost all of our schools cater for Australian or international fee-paying students — in some schools, they account for nearly one in three students.

However, ask questions about the categories of student enrolment, the number of fee-paying students, fee structures, the precise number of doctors actually graduating each year, and league tables of our best research or all-round medical schools, and answers are not readily available.

It seems that the Americanisation of our medical schools, as manifested in competition and collective transparency, still has a way to go. A JAMA-like report published annually in the MJA would be a good start.