Let’s talk about sex

Yoshi Bandara Yoshi Bandara, medical student at Monash University.

Sexual health has been brought to the fore this week with the 20th International AIDS Conference taking place in Melbourne. Indeed, safe sex practices are central to the reduction of transmission and new infections of HIV. But more than this, AIDS 2014 championed the concept of sexual rights – the intersection of human rights and sexual health.


The World Health Organisation puts forward a number of sexual rights: rights critical to the realisation of sexual health, to which every person is entitled. Among these, and perhaps most relevant to health professionals, are the rights to the highest attainable standard of health (including sexual health); the right to decide the number and spacing of one’s children; and the rights to information, as well as education.

The proposition that these are fundamental human rights and the fact that fulfilment of these rights is mediated largely by health professionals begs the question: are doctors in general adequately trained to respect these rights?

Are they able to provide the highest attainable standard of sexual health services to their patients? Do they have comprehensive information on hand to educate patients according to their specific sexual health needs? Does our medical education equip us with appropriate and effective strategies to achieve this?

Sexual health is an integral part of overall physical, psychological and social health. Yet it is often ignored, dismissed or disrespected both in medical education and in consultations.

It’s a topic that interacts with complex and difficult concepts like gender, sexuality and sexual orientation, and that exists within the context of a vast range of cultural, religious and ethical frameworks.

For this and other reasons, it’s a topic that makes patients and doctors alike feel uncomfortable and this can have serious implications for a patient’s sexual health. At times, this discomfort can translate into awkwardness, clumsy language and embarrassment when the topic of sex is raised in a clinical setting. At other times, a patient’s sexual orientation, gender identity or HIV status can be discussed in a way that offends, disrespects and disempowers them. The harm caused by such doctor-patient interactions can be significant, and the lost trust difficult to replace.

As future health professionals, we must be able to ask questions about sexual health in a sensitive and appropriate manner. We must have a meaningful, knowledgable and respectful approach to the specific sexual health needs of lesbian, gay, bisexual, transgender, gender diverse, intersex, queer/questioning and asexual patients. We have a duty to know what constitutes sexual wellbeing; to talk comfortably about sexual acts, pleasure and difficulties; and to have the language and skills to deliver the highest level of care possible. We have a responsibility to our patients to ensure that their sexual rights are upheld.

Screen Shot 2014-07-26 at 5.02.21 pm

In his address at AIDS 2014, Bill Clinton said “They call this a conference, but really, it’s a movement”. One part of this movement is to advocate the sexual rights of all human beings. It perhaps comes as a timely reminder of the part we as medical students are all going to play in the actualization of our patient’s sexual rights. It is up to us to make sure that the next generation of doctors is one that takes the sexual health of our patients seriously and does everything it can to uphold their fundamental human rights.

Interested in sexual health? Registration for “Let’s talk about sex“, AMSA Academy’s sexual health short course, closes July 26th at 11.59pm. (PS: There’s also a mental health short course if that’s more your thing)

Register now: http://academy.amsa.org.au


GlobalEx launches – Medical students putting health on the agenda of social change

The Australian Medical Students’ Association (AMSA) is proud to be launching its inaugural global health leadership seminar, GlobalEx, this weekend in Melbourne. 50 of Australia’s medical students, handpicked from 17 medical schools around the nation, will gather to put health on the agenda of social change.

As our world becomes increasingly interconnected, doctors are required to broaden their skills out of the purely medical domain. AMSA is leading the charge to provide medical students with the experiences required to become advocates for their patients, and advocates for change

The seminar, set to coincide with AIDS 2014 in Melbourne, will seek to develop solutions to a broad range of health inequities. Students will cultivate and iterate an idea for change before pitching to a panel of expert judges.

Please see here for the full media release.

Call for AMSA delegation to the IFMSA Asia-Pacific Regional Meeting

Applications for the International Federation of Medical Students’ Associations Asia-Pacific Regional Meeting (APRM) are now open. APRM provides opportunities for medical students to learn about global health while networking, and making friends with other students from around the region.

This year’s APRM will take place in Dhaka, Bangladesh between the 17th and the 22nd of September. The theme of the event is Disaster Risk Management, however there will also be plenty of opportunities to learn about other aspects of global health through trainings, standing committee sessions and workshops.

For more information, and to access the registration link, visit:

Deadline: 5th August 2014

Internship Crisis Update

A breaking update on the internship crisis from AMSA President Jessica Dean

Jessica Dean

Interest and concern regarding the number of internships being offered in 2015 is not limited to Australian Medical students. The discussion has reached the level of Senate Estimates, where medical graduate numbers and 2015 internship numbers have been raised as a national health issue multiple times already this year.

SA MET (South Australian Medical Education and Training) recently announced that the Government’s decision to abolish the PGPPP (Prevocational General Practice Placements Program) would result in a decrease in the number of internships being offered in South Australia for 2015. The PGPPP funded 23 of South Australia’s 278 intern positions in 2014. There were concerns that other states may have also been using the PGPPP program to fund internship rotations, and would experience similar fiscal pressure to decrease proportionately the number of internships offered by the state. The AMSA advocacy team has therefore been liaising with FMSS and AMSS, SA MET, and other state PMCs (postgraduate medical councils) to identify the potential for similar circumstances around the country.

In this context, the current intern numbers are somewhat reassuring.

The 2015 numbers

We are pleased to announce that we finally have some figures to share with you.

This year there were 3676 applicants for internships. Of this number, there are 3004 domestic medical graduates, 480 international full fee paying medical graduates of Australian universities and 192 other applicants. Please keep in mind that experience from previous intern recruitment suggests that the number of applicants able to accept and commence an internship may be less than those who applied due to failure to complete their course, or acceptance of overseas offers.

As at June 2014 there are approximately 3210 state and territory intern positions available for 2015 (some positions still subject to accreditation) and up to 100 Commonwealth funded intern positions. We are working with the Commonwealth department to identify exactly how many positions will be offered as part of the Commonwealth Medical Internships (CMI) initiative this year, and are optimistic that it will be more than the 76 offered last year. We will advise you as soon as the Department makes the number of positions in the CMI initiative available.

To provide some perspective, in 2013 there were 3430 Australian-trained graduate applicants and 3190 offers accepted. This left 240 applicants unplaced by state offers. The Commonwealth received 185 applications for the CMI positions, but only 76 were ultimately offered. Therefore, potentially 55 graduates did not apply for the CMI and did not get an internship.

We will continue to work with the States and the Commonwealth, and provide you with relevant updates over the coming months.

If you have queries, please feel free to get in touch with AMSA President Jessica Dean at president@amsa.org.au.

Read more on the AMSA Blog here.

AMSA Global Health 2015 Management Team Elections

Applications for the 2015 AMSA Global Health (AGH) Management Team and other AGH positions are now open.

The AGH is a sub-committee of AMSA dedicated to engaging and empowering medical students interested in Global Health. The AGH Management Team is responsible for the day-to-day management of the AGH including organising AGH council, engaging with Global Health Groups (GHGs) and running projects and campaigns on a number of Global Health Issues. These include campaigns such as AFRAM, projects such as Crossing Borders, Code Green and Red Party and educational opportunities such as AMSA Global Academy.

The Management team consists of 12 positions, which include:

  • Chair
  • Vice Chair (Internal)
  • Vice Chair (External)
  • National Coordinator
  • Treasurer
  • Education Officer
  • Policy Officer
  • IT & Publicity Officer
  • Vector Editor
  • Partnerships Officer
  • Training Coordinator
  • International Liaison Officer

There are a number of additional positions which report to AGH MT portfolios and are open:

  • Code Green National Project Coordinators
  • Red Party National Project Coordinators
  • Crossing Borders National Project Coordinators
  • National Exchange Officers
  • Asian Medical Students’ Association Australian Regional Chairperson

Details about the application process and portfolio descriptions can be found here.

The deadline for most (but not all) applications is July 14th, 2014 at 2359 AEST.

Autonomy is a dish best served with humility

Hui Ling Yeoh Hui Ling Yeoh, AFRAM Campaign Coordinator and Ignite’s representative to AMSA Global Health.

[I made the decision] for everyone concerned. For the people around me, for myself, for the person-to-be, the child, you know, and for the planet. All, for all these reasons, it can be a decision that’s – even though it’s an awful decision to make, it can be the greatest, the greatest way to show your love.

It’s a truth universally acknowledged that people have sex. I say this in a deliberately matter-of-fact way because it’s true.

People have sex for many different reasons, in many different ways: sometimes by choice, sometimes with contraception, sometimes leading to conception (even with use of contraception).

But, ultimately, we know that we’re all entitled to decide when and with whom we have sex.

Why? Because it’s ours, this body – It’s us who live our lives, who live in our bodies day after day; we know what’s best for us because we know where we’ve come from and because we’re the ones who have to bear our future. This is autonomy.

The morality of abortion (the termination of pregnancy) is notoriously controversial. And rightly so.

How we define a life, and how we decide what rights lives are entitled to, are subject to a myriad of deeply personal and complex factors that are informed by individual cultural, spiritual and ethical frameworks and social circumstances, all of which are wholly unpredictable.

That’s the beauty of humanity.

We cannot make decisions for other people, especially for strangers – but, realistically, that’s exactly what health policy does to some degree: it makes decisions on what people can and can’t access, and so it has the power to liberate or limit.

Therefore, the morality of access to safe termination of pregnancy is a wholly different issue, and one that inherently necessitates consensus as a community.

AMSA proposes that public health policy should be created on health-focussed and evidence-based grounds, and allow for the diversity of personal ethics to thrive in our secular democracy.

And that is what AMSA’s policy on the Access to Safe Termination of Pregnancy is founded on – the clear moral imperative for the accessibility of safe abortion to be universal.

Because: we know that where safe and reliable access to termination of pregnancy and methods of fertility control are available, the life-long health outcomes of women and their children are improved [1].

Australia boasts relatively permissive access to safe termination of pregnancy, but before we get complacent, there are serious limitations that threaten this accessibility. Broadly speaking, these barriers are:

1.    The insufficiency and lack of sustainability of public health services [2,3]

2.    The lack of uniformity of legislation across the States and Territories resulting in inequitable service provision, [2]; and

3.    Social stigma, which restricts access even where services are available, in spite of research demonstrating majority support for the legal access to termination of pregnancy in Australia [4,5].

Inherent in this policy is AMSA’s celebration of conscientious objection, which upholds doctors’ own rights to autonomy whilst safeguarding the health of the community.

In March, AMSA presented this policy at the International Federation of Medical Students’ Associations (IFMSA) general assembly in Tunisia, and it was adopted. It means that the majority of 1.2 million medical students with diverse and complex ethical frameworks from around the world, agree that this is the best way to protect everyone’s right to make decisions about their health.

When we talk about abortion or unwanted pregnancies, there sometimes seems to be an unapologetic culture of blame. It may be easy for us to think that women who choose to terminate a pregnancy are a “certain type of girl” who has put herself in the situation where she has an unwanted pregnancy. Whether we blame a woman for being too irresponsible, or for being too ambitious, we see her decision in one dimension – her reasons as one reason. And whatever that reason(s) may be, ultimately, it seems as though we blame her simply for having made a choice.

The reality is that the decision whether to continue or terminate a pregnancy is never simple. And as future health professionals, we need to accept this with humility.

Hui Ling Yeoh is AFRAM Campaign Coordinator and Ignite’s representative to AMSA Global Health. You can follow her on twitter @HuiLingYeoh or contact her here.

You can find AMSA’s policy on safe access to termination of pregnancy here.

Check out other articles on the AMSA blog or subscribe to Embolus for more AMSA goodness.


1.     World Health Organization. Safe Abortion: technical and policy guidance for health systems. 2nd ed; 2012. 132p. Retrieved: http://apps.who.int/iris/bitstream/10665/70914/1/9789241548434_eng.pdf?ua=1, Accessed 27 Jan 2014.

2.     Public Health Association of Australia. Abortion in Australia: Public Health Perspectives. Curtin, ACT: Public Health Association of Australia; 2005. 20 pages. Report No. 3

3.     Rosenthal D, Rowe H, Mallett S et al. Understanding Women’s Experience of Unplanned Pregnancy and Abortion. Melbourne School of Population Health, the University of Melbourne, Australia: 2009. [cited 2014 March 14] Available from: http://cwhgs.unimelb.edu.au/__data/assets/pdf_file/0006/135834/UPAP_Final_Report.pdf

4.     State Government of Victoria. Abortion [Internet]. Victoria: State Government of Victoria; [Updated 2013 May; cited 2014 February 12]. Available from: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Abortion_in_Australia

5.     Family Planning Victoria. Abortion [Internet]. Victoria: Family Planning Victoria; [cited 2013 Feb 12] Available from: http://www.fpv.org.au/sexual-health-info/sex-and-the-law/abortion-in-victoria/

A Good Ally

Asiel Adan

Asiel Adan, AMSA LGBTIQ Officer & medical student at the University of Melbourne

Allies are essential to any human rights movement as they help bring more voices and momentum to the issue at hand. Similarly, the health of lesbian, gay, bisexual, transgender, intersex and queer individuals cannot be left in the hands of just a few doctors; we need allies to ensure LGBTIQ patients are treated with respect and dignity in all clinical settings. From big metropolitan hospitals, to the smallest of rural communities, the presence of an ally doctor can make a huge impact on someone’s health.

Whether you know the makings of a good ally or aren’t too sure of how to get started, below are 5 tips for being an ally in healthcare:

  1. A good ally creates a safe space for LGBTIQ individuals.

The best thing an ally can do for LGBTIQ patients is to let them speak in their own words. Ask for preferred pronouns and preferred terms, if you’re unsure. Some patients may wish to be identified as gay or transgender, while others would rather avoid those labels. Some patients prefer gender-neutral pronouns, some identify strongly as male or female. Best practice is giving LGBTIQ patients the opportunity to disclose their sexual orientation, gender identity or intersex status without pressuring them to do so.

  1. A good ally keeps an open mind.

Many of the difficulties LGBTIQ individuals face come from challenging society’s ideas of sexuality, gender and sex. Some LGBTIQ individuals might present with bodies, relationships, experiences and identities you may never have encountered before. Avoiding assumptions about a patient’s body, sexuality and gender identity is the best way forward. Keeping an open mind and a non-judgemental attitude will ensure you see the person behind the label.

  1. A good ally knows how much they don’t know.

A good place to start is considering how little we know of others’ lived experiences. Education is essential, but at the same time don’t feel intimidated by all the knowledge out there. It’s ok not to know and it’s ok to ask. Humility in the face of ignorance is always a good guide: “I’m sorry, I don’t know much about your gender identity, but I’d really like to be respectful, would you mind telling me more about it?”

A simple phrase can do wonders.

  1. A good ally considers the struggles of LGBTIQ individuals.

Nowhere does this apply best than in the clinical setting, and nowhere else do allies have the biggest opportunity to make a difference. Try to see how indirect discrimination occurs in healthcare systems and how you can improve this in your future practice. Are gay and lesbian families acknowledged in social histories? Can transmen access gynaecological screening services? Do medical forms include genders beyond man and woman?

rainbow LGBTIQ flag

  1. A good ally knows how to ask for help.

There are a number of organisations that can help you create more safe and inclusive clinical spaces. An ally doesn’t have to be an expert or speak on behalf of LGBTIQ individuals – the best thing you can do as an ally is keep LGBTIQ individuals in mind and get in touch with your friendly LGBTIQ Health Officer to work out how to best help out!

The help of allies is invaluable to LGBTIQ health!

You can read AMSA’s policy on LGBTIQ health here.

If you have any questions, ideas or comments, please don’t hesitate to get in touch with Asiel, AMSA’s LGBTIQ Officer, at lgbtiq@amsa.org.au.

Read more on the AMSA blog: https://www.amsa.org.au/advocacy/amsa-blog/

Further resources:

Medical students warn of the effects of unprecedented education debt

The Australian Medical Students’ Association (AMSA) has expressed alarm over the impact that a huge educational debt will have on the medical workforce.

AMSA President, Ms Jessica Dean, today cited evidence suggesting the prospect of incurring high levels of debt will deter disadvantaged groups from pursuing higher education, skewing the medical workforce for years to come.

“There is data from the United Kingdom suggesting students from lower socioeconomic backgrounds are less likely to enter higher education due to the prospect of high levels of debt, irrespective of loan schemes,” Ms Dean said.

“This is particularly problematic in medicine, given students from these disadvantaged groups, including rural and remote background students, and Aboriginal and Torres Strait Islander students, are more likely to return to work in areas of need following graduation.”

It is predicted that university fee deregulation may cause medical school fees to rise in excess of $37,000 per year. For many postgraduate students, these fees would add to already accumulated debt from previous courses, and may result in a total debt up to half a million dollars

“The prospect of debt will deter some potentially excellent doctors from medicine. This will include middle aged postgraduate students who have to consider mortgages, the costs associated with raising children, and the possibility of entering the workforce.”

“Among those who do graduate, the debt will affect major life decisions, including the decision to have children. Women in medicine will be driven to delay having children, or else accrue significant interest on their unrepaid student loan.”

Australia’s health care system is aiming to support preventive medicine and primary care. Fee deregulation, however, is a backwards step in the long-term goal of attracting more doctors to general practice.

“There is evidence from North America suggesting that debt pushes graduates towards more lucrative specialties and is inversely correlated to desire to work in family practice.

“Fee deregulation in Australia will see more and more doctors turn away from becoming general practitioners.”

Media contact:

Ben O’Sullivan
0437 195 272

Follow AMSA on Twitter:

GHC is about you.

Brian and Rebecca Rebecca Moses and Brian Fernandes         Academic Convenors, AMSA Global Health Conference 2014

You dream big.
You hope the 10th Annual Global Health Conference will be remembered.
You think of turning the academic program on its head and making the program at night and social during the day, but quickly realise how foolish it would be.
You cut the usual lengths of plenaries in half and vow to make them short, sharp and interactive.
You swear that you’re not just copying TED.
You love hearing the stories behind the inspiration and would gleefully watch interesting people debate controversial topics.
You want delegates to meet their global health heroes and even have the chance to be mentored by them.
You design the academic themes around the lofty ideals of Change Your World, Change Your Community, and Change Your Focus, and wonder if delegates might even change themselves.
You search for speakers that deliver electrifying talks and not the typical university lectures you fall asleep in.
You nearly cry when you see the plenary hall.

GHC venue:  Sydney Masonic CentreYou send speaker invitations a year out from the conference.
You start with your dream speakers, delicately crafting an invitation that describes how dearly you want Atul Gawande to speak at the conference.
You also dream that he may even adopt you.
You spend nights searching for those elusive speaker contact details.
You pray you don’t come across as creepy when you direct message them on twitter.
You cope with speaker rejection through eating neapolitan ice cream and listening to Adele in the shower.
You rejoice in small victories when your childhood hero David Attenborough pens an eloquent rejection letter.
David Attenborough Letter

You debate with the GHC Academic Team why Giant Toilets, Bean Bags and Whiteboards are essential to the academic program.
You catch up on the latest team gossip and engage in fun, frivolity and feasting upon Gelato Messina in your fortnightly GHC Committee Meetings.
You gasp when you find out that the whole GHC program has carbon offsets.
You wonder how many other student run conferences are as sustainable as GHC.
You resort to Skype and Google Hangouts with your team in order to fill the lonely nights studying.
GHC team meeting

You talk to your academic co-convenor more than your parents.
You have to stop yourself from telling people about the plans for social, but know that they’re nothing like GHC has had before.
You admire the concept of the opening night Pink Party and having the audacity to donate ALL proceeds to the most effective charities in the world.
You keep silent about Saturday Night’s socials big surprise.
You dance the night away at the GHC Team Mixer overlooking Sydney Harbour knowing that you’ll be returning back here for the Nuit Blanche, the Tuesday Gala Night at the Museum of Contemporary Art.
You realise that it’s less than 100 days until the start of GHC.

GHC team

You get butterflies just imagining the star line-up of speakers talking at GHC2014.
You contemplate reaching the heights of Australian Doctor Rowan Gillies, the youngest ever International President of MSF and part of the first cohort of Harvard Global Health Surgical Fellows.
You predict TedXSydney star Stella Young will present the most memorable talk at an AMSA event in years.
You might ask Nobel Prize Laureate and Past East Timor President Jose Ramos-Horta to take a selfie with you.
You are secretly relieved that only medical students can attend GHC after your mum asks if she can attend.
You look forward to the 5th of June, a special day indeed.
You smile at the thought of delegates regaling family and friends of stories from GHC, telling about how memorable it was.
You discover that GHC is missing one thing.


GHC rego

Children in Immigration Detention – AMSA Submission

Today, AMSA made a submission to the Australian Human Rights Commission Inquiry into children in detention.

This is a snapshot of the submission:
AMSA is opposed to the indefinite mandatory detention and offshore processing of any individual, but particularly children. This is due to the clear causal association between mental illness and immigration detention, which is amplified in children because of their developmental stage. AMSA recommends that the Australian Government acts immediately to remove children from places of immigration detention, both onshore and offshore, and move children and families to community housing. Until such a time when this is possible, AMSA calls for an increase in health, educational and developmental services and opportunities such that the adverse mental health impacts of immigration detention are minimised.

As part of this submission, AMSA asked for personal submissions from medical students with experience and expertise in this area. Thank you to all those medical students who provided a personal submission.

The whole submission may be viewed here.