The Medical journal of Australia
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Comparative Study
Shift to earlier stage at diagnosis as a consequence of the National Bowel Cancer Screening Program.
To assess the impact of the National Bowel Cancer Screening Program (NBCSP) in South Australia. ⋯ CRCs were diagnosed at a significantly earlier stage in people invited to the NBCSP compared with those who were not invited, regardless of participation status or test result. The NBCSP should lead to reductions in CRC mortality in Australia.
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To quantify the risk of transmission of measles associated with infectious people who travelled on aeroplane flights to or within Australia. ⋯ Despite secondary measles transmission occurring on 19% of international flights carrying infectious people, risk was not clearly related to seating proximity, and contact tracing was ineffective, especially given delays in diagnosis, notification and accessing flight manifests. We recommend that direct contact tracing to identify susceptible people exposed to people infected with measles on aeroplane flights should not be undertaken routinely, and other strategies should be considered.
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To estimate the proportion of students in Australian medical schools who undertake international medical electives (IMEs), particularly in developing countries, and to ascertain which medical schools provide predeparture training and postelective debriefing. ⋯ A large proportion of Australian medical students undertake IMEs in developing countries. However, a considerable proportion of students do not undertake formal preparation for, or reflection on, their experiences. Predeparture training and postelective debriefing should be scaled up across Australian medical schools to provide students with the guidance and support to maximise the benefits and minimise risks associated with undertaking IMEs in developing countries.
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Global health (GH) training is well established overseas (particularly in North America) and reflects an increasing focus on social accountability in medical education. Despite significant interest among trainees, GH is poorly integrated with specialty training programs in Australia. ⋯ Safe and effective placements rely on firm ethical foundations as well as strong and durable partnerships between Australian and overseas health services, educational institutions and GH agencies. More formal systems of GH training in Australia have the potential to produce fellows with the skills and knowledge necessary to engage in regional health challenges in a global context.
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Internship selection is becoming more competitive due to substantial increases in numbers of medical graduates. Australian states operate a "priority system" for medical internship selection which discriminates against Australian interstate applicants. ⋯ The priority system should be reformed. It is inequitable and inconsistent with other aspects of medical training and regulation.