Australian – Indigenous Surgical Pathways (AISP)

For many decades our members have demonstrated a desire to contribute  to improving the general health and wellbeing of First Australians.

In recent years, we have formalised our ongoing commitment to Indigenous health. This has included a multifaceted  approach to First Nation health encompassing areas such as:

• increasing the surgical workforce
• awareness by the Fellowship of the disparity between Indigenous and non-Indigenous health
• using our leadership position for positive influence, starting from within the College.

The Indigenous Surgeons Pathway Program Australia is a long-term, multi-pronged initiative that recognises the need to support those wishing  to contribute to health equity for  First Australians.

The solution is, in part, changing the culture within our  institution to honour the rights and value the amazing contributions First Australians have to offer. 

The pilot project for the ISPP is being led  by the Royal Darwin Hospital. Health service, departmental and mentorship  standards will be defined and, ultimately, a package will be developed to be introduced and applied Australia-wide.

The Indigenous Surgical Pathway Program aims to:

• inspire First Australians (school students, medical students, those in other health careers) to consider a career in surgery
• support them through preparation for (JDocs), application to and completion of Surgical Education and Training (SET)
• develop a mentor program to support RACS Fellows who  wish to support the program
• coordinate and facilitate collaboration between stakeholders; and support our current SET Trainees.

The Australian - ISP is partly funded by the Australian Government Department of Health through the Specialist Training Program (STP).

RACS is among the leading Australian institutions in this field, contributing to solution-driven policies and actions that impact First Australians.

One significant example of this commitment is expressed in the RACS  2013 Indigenous Health position paper,  which recognises that Indigenous people are more likely to present for, and comply with, treatment guidelines if increased numbers of Indigenous people were represented in the medical workforce at all levels of care.

According to 2016 Australian Bureau of Statistics data, there are approximately  800,000 First Australians. To achieve the same ratio of doctors to patients as non-Indigenous Australians there need to be 3200 First Australian registered doctors. According to available data, there are approximately 400 First Australian registered doctors.

There are currently almost 7000 active RACS Fellows, Trainees and SIMGs. This translates to roughly 3500 patients per surgeon in Australia. If applying the same  ‘population per surgeon’ formula to First  Australians, we should have 219 First  Australian surgeons. Currently, we have three.

This (rather simplified) demographic breakdown helps puts into perspective  the unique circumstances and challenges faced by the Indigenous Health Committee (IHC) when implementing the RACS 2013 Indigenous Health position  paper to help rectify this inequity.

Converting policy into action, and then ensuring such action produces the  desired outcome is challenging at the best of times. There are so many international  achievements from a minority population  of 800,000 within a world population of  8 billion (such as CNN anchor Stan Grant and Captain Reginald Saunders, recipient  of a United States Presidential citation) despite historical government policies relegating First Australians to the fringe of mainstream Australian society. In fact, the only impediment to more success is the power differential created by racism, limiting their ability to reach critical mass in the number of doctors and surgeons.

We look forward to the collective support and contribution from RACS, as a whole, and hope to be able to demonstrate our ongoing leadership, innovation and professionalism when contributing to Australia’s wellbeing as a complete community.

RACS and First Australians – the Indigenous Surgical Pathway Program 
Surgical News, Volume 22 Issue 1 (p16)