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Cultural Safety In Vocational Medical Training

The Council of Medical Colleges in New Zealand (CMC), in partnership with Te Ohu Rata o Aotearoa (Te ORA), has released a research report looking at cultural safety training in vocational medical training. The report draws on the experiences of Māori doctors across different medical specialities and includes recommendations on how to make medical training culturally safe.

Professor David Tipene-Leach, says that in 2019, the Medical Council made it clear that the medical profession needs to move from cultural competence to cultural safety. “Cultural competence is about having skills and knowledge to work with people from different cultural backgrounds. Cultural safety however, is asking the medical community and its individual practitioners to reflect on their own behaviour and their clinical outcomes and to ask themselves “what are my own cultural views, what biases do I hold because of them and how does this impact the patient in front of me?”

Dr John Bonning, Chair of CMC, says medical colleges are committed to training a culturally safe medical workforce, to support equitable health outcomes for Māori and non-Māori in Aotearoa New Zealand. But, he says, colleges are at the beginning of this journey and there’s a lot of work to be done. “So where do we start? First off, let’s look at our own training programmes. How are we doing? Do we train in a culturally safe way? What are the experiences of Māori doctors who have been through our training programmes?”

“This report helps answer those questions. It also gives us a baseline so we can reassess in a couple of years, and ask are we doing better? Have we made meaningful change and what impact has that change had?”

Professor Tipene-Leach agrees. “The report gives insight into challenges Māori doctors have experienced within medical training, including trainers with no experience of cultural safety and an across-the-board experience of cultural loading. They are expected to be go-to people for advice on all things Māori and are often expected to help navigate the problems other practitioners are experiencing with Māori patients on top of their own clinical duties.”

“Māori doctors noted that medical specialty training presently tends to focus on cultural competency elements like tikanga and understanding te ao Māori, but what is needed is a much deeper reflection on colonisation, racism, and systemic biases and how these contribute to poor health outcomes for Māori patients.”

“We’ve got a long way to go” says Dr Bonning, “but this report tells us that we have started and gives us a roadmap.”

The report, released today, is available on CMC's website.

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