On Friday, Feb 7, 2003, at 05:00 Australia/Perth, Naomi Bar-Yam wrote:

> If that is the problem, it seems to me that making lactation an
> integral part of medical education (in med. school, not just
> for specialist training) should be a goal.
> It should also be part of continuing ed. requirements for
> pedis, obs., GPs (does anyone call them GPs anymore or am
> I dating myself?)
> How does that happen? Are there models from other countries
> that we could all learn from?

I clearly remember attending a lactation & breastfeeding course in
undergraduate medical school - but then, I went to the University of
Western Australia (we were taught by Peter Hartmann). This included not
just lectures and tutorials but also attending a Nursing Mothers'
Association (now ABA) meeting.

Looking through the current curriculum, it seems that knowledge about
breastfeeding is still part of the core clinical curriculum also:
http://www.meddent.uwa.edu.au/obgyn/etc/
pageview.cfm?PageID=3&SectionID=2
though as with almost every topic in medical school, I imagine there is
never enough time to devote to it! Management of common breastfeeding
problems (examples given are cracked nipples and mastitis) is also
included in the "Breast Disease" part of the core curriculum:
http://www.meddent.uwa.edu.au/tnl/etc/subview.cfm/SectionID/2/PageID/
24/SubpageID/107

Unfortunately it was my experience that the subject of breastfeeding
was completely ignored in the postgraduate general practice training
programme. Without reinforcement, knowledge and skills rapidly decay.

One effective way of getting GPs back into the breastfeeding "fold", as
it were, might be to apply for Continuing Medical Education points for
various lactation-related education exercises. In Australia, GPs have
to accumulate a certain number of points per year, and as women's
health and paeds are such an integral part of family medicine I would
hope there would be a certain amount of interest in a well-marketed
programme, even if you're only upskilling the converted. If an
educational event is held but there are no CME points allocated, GPs
who are sorely pressed for time and roped unwillingly into the
points-chasing bandwagon will pass over it in favour of an event which
serves a dual purpose (education and points). A sad fact of life, but
there it is.

Another way of publicising breastfeeding professional education would
be to get involved in Divisions of General Practice, or whatever the
local equivalent is. Divisions are regional organisations of Australian
GPs which serve various purposes including peer support and networking,
co-ordination and organisation of educational events, and public health
initiatives as well as community promotion of general practice.

Lara
family doc, Western Australia

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