Australia needs to value Indigenous knowledge in medical education

I’m a proud Biripi man. My family hails from the Taree area in the mid-north coast of New South Wales, with my grandfather relocating to Sydney during his childhood.

I’ve always had a strong connection to community, and I’m proud of the fact that the work I do is based on community need, working with local Aboriginal medical services to determine the most needed research directions.

When I was in clinical practice, it became clear to me that what was really required couldn’t be fulfilled while working as a practitioner. As many know, the statistics are quite poor in terms of Indigenous health care, patient experiences and outcomes. That’s what motivated me to move into the research space – to effect change at a system and policy level.

Doctors must be able to practice in a way that aligns with Indigenous community expectations. My PhD is looking at the Aboriginal and Torres Strait Islander inter-cultural capabilities of non-Indigenous students within the medical program. I want to explore what this might look like across the east coast of Australia, where there’s great diversity across different communities.

There also needs to be a generational change within the medical workforce rather than piecemeal change. And I’m proud that my PhD will contribute to informing medical students of how to work appropriately with Aboriginal communities within the medical care setting.

We must create the capabilities required before medical practitioners enter a clinical setting to minimise the harm for Indigenous patients. Primary medical education is a good starting point to ensure that medical students, who are our future doctors, are able to practice culturally responsive work which then impacts positively on cultural safety as we know it.

My PhD supervisor Aunty Kerrie Doyle encouraged me to undertake the Professional Certificate of Indigenous Research as a way to support my research and leadership goals. She had taken the course herself in 2011 and there’s quite a number of Indigenous higher degree by research (HDR) students at Western Sydney University taking part in the program.

There’s a need for what Aboriginal education specialist Lester-Irabinna Rigney describes as a means of self-determination within research and means of Indigenous control over Indigenous research. The Certificate helps to do this – along with an introduction to Indigenous research, different types of Indigenous methodologies and their benefits as well as their limitations in certain aspects and contexts.

It also explores Indigenous research within Western frameworks and institutions. Ultimately, it educates Indigenous students to ensure that they know how to navigate the Western research system while still centring and implementing Indigenous ways of conducting research and Indigenous methods of inquiry.

Critiquing the Western framing of research is important, particularly around its limitations. While it holds great value, so do Indigenous research methodologies – like yarning. Through the program, I’ve learnt how to identify these limitations and what to use, when. One of the great benefits of being in the professional certificate program, is to have Indigenous research and methodologies validated by colleagues, other students and supervisors.

My research incorporates yarning through the qualitative aspect. A survey covers the quantitative side, merging both Western and Indigenous methods. I’m employing a convergent parallel research design, which means I’m applying both methods at the same time, bringing them together and triangulating the findings. I then interpret this through an Indigenous lens. My approach applies Western research methodologies, but it also applies an Indigenous perspective to interpret the data and the findings, an approach referred to as Indigenist research.

Indigenous leadership is a crucial part of the program. After completing the Professional Certificate, I went on to study the Graduate Certificate in Indigenous Research and Leadership which is more focused on what Indigenous leadership looks like within Western academies. The certificate explores Indigenous conceptualisations of leadership and research – how these qualities can be optimised and navigated within Western institutions.

Within an Indigenous context, leadership is not a hierarchical structure. It’s community-informed and centred around a collective approach where there’s not just one leader but, rather, everyone has input into the way that leadership should look.

The biggest difference between Western leadership and Indigenous leadership is that ours is a ground-up approach rather than the top-down one. Leadership needs to come from the people who inform the way in which leadership occurs as opposed to the hierarchical structure where there is one person at the top who sends information down.

Both the professional and graduate programs encouraged me to understand not just my research, but my reason for doing it. The combination of critical reflection, dialogue with the other students and different perspectives and methods from guest speakers helped me come to the decision to take an iterative approach to my methods and methodology.

I’m dedicated to driving systemic change, despite the numerous barriers we face. Fundamentally, the public structures that were introduced during colonisation have informed the systems in which we operate. As is true in medical care, there needs to be systematic reform and that reform must be directed by the local communities.

My experiences have taught me the significance of a grassroots approach. Indigenous communities excel at building from the ground up and fostering community-informed leadership, because that’s the way our social structures have worked for tens of thousands of years.

Aligning with the community ensures that this work is meaningful and purposeful. It creates a sense of accomplishment by serving the community’s needs. That’s something that I’ve always been aware of throughout my journey. Regardless of how far I advance in any sector, it’s essential to ensure that I am contributing meaningfully to community aspirations and wellbeing.

My experience is that medical education still fails to fully recognise or appreciate Indigenous ways of knowing, being and doing. It’s unfortunate that the inter-cultural aspects of medical education are often seen as supplementary, rather than integral to becoming an effective practitioner. This is despite the fact that evidence suggests it leads to better care through a critical and holistic approach.

My goal is to acknowledge the intrinsic value of Indigenous knowledge in medical education and across all education disciplines. We can already see promising developments in some areas, like bushfire control, where Indigenous approaches are now accepted, valued and integrated.

I want to drive positive change. Like many others, I want to leave the world in a better state than I found it.

• As told to Scarlet Barnett

If you’re interested in more information, please visit the Indigenous Research and Leadership Development programs at the University of Melbourne.