Rebuilding a system worthy of being called ‘world-class’
Andrew Chang
President, The Western Australian Medical Students’ Society (WAMSS)
As I finish my second and final term as the President of the Western Australian Medical Students’ Society, I find myself in a rare position to comment on both the struggles of this generation of medical students, our pleas and our hopes, as well as the needs of a health system that is buckling under enormous pressure.
Australia’s healthcare system enjoys a world-class reputation internationally. And in many respects, it is well-earned. We have one of the highest life expectancies in the world, and access to subsidised healthcare. You can receive lifesaving surgery if you were in a catastrophic accident without spending a cent, or deliver a baby without receiving an itemised list of essential items that providers charge for.
The system yields incredible results, but its foundations are cracking. Beyond the heroics of a world-class system, our emergency departments are over capacity; our hospitals are riddled with bed block; and WA has some of the worst ED and elective surgery wait times in the country. And there is no need to introduce the fact that we are simply not training enough GPs and rural generalists.
As students, we are drilled on the fundamentals. History and examination are king. We learn Talley & O’Connor like it’s scripture. But in the real world, role substitution is accelerating. Pharmacists and nurse practitioners are stepping in to fill workforce gaps, often out of necessity. And in that process, care becomes fragmented and transactional. Quicker? Perhaps. But shallower too.
“ Even though our system is imperfect, patients still need us. So, we show up. We show up for the patient in the corridor who is not waiting for a system to be perfect; just for someone to care.
What happens to clinical depth when there is no time for curiosity and no space for reflection? How do we protect the art of medicine, when its most human elements are the first to be lost?
So, we are met with an uncomfortable truth: many students are struggling to believe in the system. We tell ourselves it is world class. We tell ourselves there is room for everyone. But some days, it feels like a race to the top of a sinking ship.
Systems are failing, some training pathways seem unreachable, role boundaries are blurring – and we wonder whether our training prepares us for what lies ahead. We ultimately spend so much time just trying to be noticed in the crowd, chasing material achievements to find our place in the hierarchy of it all.
Even though our system is imperfect, and even if we feel our efforts may be futile, patients still need us. We still carry the compassion, curiosity and thirst for knowledge that got us here in the first place. So, we show up. We show up for the patient in the corridor who is not waiting for a system to be perfect; just for someone to care.
Maybe the challenge of my generation of students is not just to become doctors who can treat and diagnose; but to become doctors who can grapple with these contradictions. Doctors who understand the inadequacies in our health system, but still choose to show up. This belief, perhaps, is how we rebuild a system worthy of being called world-class again.