Safeguard or mollycoddle? Medical student placements in Aboriginal communities

Andrew W Nielsen
Med J Aust 2011; 195 (2): 102-104. || doi: 10.5694/j.1326-5377.2011.tb03230.x
Published online: 18 July 2011

To the Editor: In their editorial about risks to medical students in rural and remote placements, Peachey and McBain-Rigg stated:

But there is a danger that, in focusing only on possible harms, we underestimate the power of difficult circumstances to enhance the very attributes that are required for the long haul in rural and remote practice.1

They referred to such issues as a “philosophical quandary” and went on to use a metaphor about a breaking bungee rope. The editorial conflated two important issues: safety and character-building experiences. The safety of visiting medical students and workers is not a philosophical quandary. Requirements of occupational safety are a practicable matter and a matter of law. Employers are required to assess and manage risks. The editorial’s authors are from Queensland, where the current relevant legislation is the Workplace Health and Safety Act 1995. Assistance is available from state workplace safety bodies, such as Workplace Health and Safety Queensland.

Patel and colleagues made a good empirical assessment of adverse events that have happened to medical students in remote areas.2 Such an assessment could contribute to a safety management plan and system. Patel et al stated that “a ‘distressing’ incident does not necessarily lead to an overall negative placement and may in fact be a powerful learning experience”. They gave the example of a female student who was not met when she got off a bus at a remote community at 3 am, which concluded with the student’s words that the placement was a “good placement medically”. A worker might implicitly or explicitly approve of any risk that he or she is exposed to, but this does not relieve the employer of its obligations to the worker’s safety.

Inviting readers to look on the bright side of safety shortcomings is not in the best interests of medical students, the permanent workforce or the population of rural and remote areas.

  • Andrew W Nielsen

  • Toowong Specialist Centre, Brisbane, QLD.


Competing interests:

I have received payment for providing expert testimony for workers compensation reports.

  • 1. Peachey LG, McBain-Rigg KE. The challenges of remote area medical education [editorial]. Med J Aust 2011; 194: 495-496. <MJA full text>
  • 2. Patel A, Underwood P, Nguyen HT, Vigants M. Safeguard or mollycoddle? An exploratory study describing potentially harmful incidents during medical student placements in Aboriginal communities in Central Australia. Med J Aust 2011; 194: 497-500. <MJA full text>


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