Ian Anderson: transforming Indigenous medicine and education

Abstract

Ian Anderson's trailblazing endeavours began long before he became well known for his work with Australia's Indigenous communities. Born in Tasmania, his father was an agricultural labourer and his mother's Indigenous Australian family have links to the northeast of the island. The family moved around rural Australia frequently, and when they settled in Bendigo, Victoria, he became one of the first in his family to finish high school. Now Pro Vice-Chancellor of Engagement at the University of Melbourne, Anderson has seen first-hand the challenges that Indigenous communities face in both services received and development opportunities.It was work experience as a physiotherapist that led him to study medicine at the University of Melbourne, which had only about a dozen Indigenous Australians on all courses at that time. He became more aware of the hardships faced by Indigenous Australians during his studies, especially his time at Melbourne's Victorian Aboriginal Health Service (VAHS). “I started understanding why primary health care for Indigenous Australians was so important, and the experience inspired me to finish my medical degree”, he says. “People began to connect with me, and I feel it was a turning point as there was only one Aboriginal doctor in Australia back then.”After graduation, he worked as a clinician in general practice, emergency medicine, and again at VAHS. “I was seeing lots of chronic diseases at younger ages in Indigenous Australians, sadly still the case today”, he says. “There are also high degrees of social distress, mental health, drug and alcohol problems, as well as child health issues—very challenging for primary health.” At age 29, he became the Chief Executive of VAHS, which led him into health service management and development. Later, he worked for Australia's Federal Government, encouraging it to take a stronger focus on Aboriginal health policy and service development, which saw the country's first national strategy on Indigenous sexual health in 1997. “As Principal Medical Adviser in the Australian Government Office of Aboriginal and Torres Strait Islander Health, Ian was responsible for installing evidence at the heart of public health strategy”, says Robert Griew, Associate Secretary for Higher Education for the Australian Government.Anderson's interest in policy initiatives began to grow. “I saw there were just a handful of universities that played a role in producing graduates that had influence in health and medical policy”, he says. “I realised Australia needed to change how professional values were created in the classroom.” On returning to the University of Melbourne, he set up a programme with Indigenous Australian communities that addressed medical education and research in a way that would lead to meaningful impact. “Indigenous health had to be taught as part of all health, not in isolation”, he says. Advocacy work by the Australian Indigenous Doctors' Association, the Australian Medical Association, and other professional bodies in the late 1990s encouraged university deans to take ownership of Indigenous health, creating a context in which Anderson and his team could lead on a national curriculum framework, launched in 2004. “Institutions such as the University of Newcastle, NSW, led the way here”, says Anderson. His team worked with the Australian Medical Council to develop standards to give accreditation to Australian medical schools, forcing them to take Indigenous health seriously. These standards have influenced the development of an Indigenous health curriculum and have driven initiatives to support the enrolment of Indigenous Australian students into medicine. “He was in the vanguard of the Indigenous doctors' movement, saw the transformative power of the creation of Indigenous professionals”, says Griew.In 2007, the Leaders in Indigenous Medical Education Network was developed through Anderson's leadership, fostering collaboration between medical schools in Australia and New Zealand. A milestone was reached in 2012 when the proportion of first-year Indigenous Australian medical students reached 2·6% of all Australian medical students—the same proportion of Indigenous people in the general population. There are now about 200 qualified Indigenous doctors and 310 enrolled medical students in Australia. “We have a long way to go to reach workforce parity—but this shows that change is possible”, says Anderson. These achievements are important says Malcolm King, Director of the Canadian Institutes of Health Research Institute of Aboriginal Peoples' Health at Simon Fraser University: “Ian has worked tirelessly to ensure that other Indigenous Australians have opportunities for health professional training. A leader in his field, a pioneer in Indigenous medical education and health research, Ian has been a role model for us all.”Another of his concerns is Indigenous health worldwide, and he's currently coordinating a global report card on the health of Indigenous and tribal peoples on the behalf of The Lancet and the Lowitja Institute in Australia. It's challenging work since, as he explains, “in some regions, there are significant problems with a lack of data availability, while others, such as Sweden, have restrictions on the collection of ethnicity data.”In his current role with colleagues across the university including Murrup Barak, the Melbourne Institute for Indigenous Development which he directs, Anderson is building a broader revolution in Indigenous education with the aim of increasing Indigenous representation in all professions. He hopes the strategy he's developing will see Indigenous students flourish: “We need to build the Indigenous economy, and this cannot be established without Indigenous university graduates.” Ian Anderson's trailblazing endeavours began long before he became well known for his work with Australia's Indigenous communities. Born in Tasmania, his father was an agricultural labourer and his mother's Indigenous Australian family have links to the northeast of the island. The family moved around rural Australia frequently, and when they settled in Bendigo, Victoria, he became one of the first in his family to finish high school. Now Pro Vice-Chancellor of Engagement at the University of Melbourne, Anderson has seen first-hand the challenges that Indigenous communities face in both services received and development opportunities. It was work experience as a physiotherapist that led him to study medicine at the University of Melbourne, which had only about a dozen Indigenous Australians on all courses at that time. He became more aware of the hardships faced by Indigenous Australians during his studies, especially his time at Melbourne's Victorian Aboriginal Health Service (VAHS). “I started understanding why primary health care for Indigenous Australians was so important, and the experience inspired me to finish my medical degree”, he says. “People began to connect with me, and I feel it was a turning point as there was only one Aboriginal doctor in Australia back then.” After graduation, he worked as a clinician in general practice, emergency medicine, and again at VAHS. “I was seeing lots of chronic diseases at younger ages in Indigenous Australians, sadly still the case today”, he says. “There are also high degrees of social distress, mental health, drug and alcohol problems, as well as child health issues—very challenging for primary health.” At age 29, he became the Chief Executive of VAHS, which led him into health service management and development. Later, he worked for Australia's Federal Government, encouraging it to take a stronger focus on Aboriginal health policy and service development, which saw the country's first national strategy on Indigenous sexual health in 1997. “As Principal Medical Adviser in the Australian Government Office of Aboriginal and Torres Strait Islander Health, Ian was responsible for installing evidence at the heart of public health strategy”, says Robert Griew, Associate Secretary for Higher Education for the Australian Government. Anderson's interest in policy initiatives began to grow. “I saw there were just a handful of universities that played a role in producing graduates that had influence in health and medical policy”, he says. “I realised Australia needed to change how professional values were created in the classroom.” On returning to the University of Melbourne, he set up a programme with Indigenous Australian communities that addressed medical education and research in a way that would lead to meaningful impact. “Indigenous health had to be taught as part of all health, not in isolation”, he says. Advocacy work by the Australian Indigenous Doctors' Association, the Australian Medical Association, and other professional bodies in the late 1990s encouraged university deans to take ownership of Indigenous health, creating a context in which Anderson and his team could lead on a national curriculum framework, launched in 2004. “Institutions such as the University of Newcastle, NSW, led the way here”, says Anderson. His team worked with the Australian Medical Council to develop standards to give accreditation to Australian medical schools, forcing them to take Indigenous health seriously. These standards have influenced the development of an Indigenous health curriculum and have driven initiatives to support the enrolment of Indigenous Australian students into medicine. “He was in the vanguard of the Indigenous doctors' movement, saw the transformative power of the creation of Indigenous professionals”, says Griew. In 2007, the Leaders in Indigenous Medical Education Network was developed through Anderson's leadership, fostering collaboration between medical schools in Australia and New Zealand. A milestone was reached in 2012 when the proportion of first-year Indigenous Australian medical students reached 2·6% of all Australian medical students—the same proportion of Indigenous people in the general population. There are now about 200 qualified Indigenous doctors and 310 enrolled medical students in Australia. “We have a long way to go to reach workforce parity—but this shows that change is possible”, says Anderson. These achievements are important says Malcolm King, Director of the Canadian Institutes of Health Research Institute of Aboriginal Peoples' Health at Simon Fraser University: “Ian has worked tirelessly to ensure that other Indigenous Australians have opportunities for health professional training. A leader in his field, a pioneer in Indigenous medical education and health research, Ian has been a role model for us all.” Another of his concerns is Indigenous health worldwide, and he's currently coordinating a global report card on the health of Indigenous and tribal peoples on the behalf of The Lancet and the Lowitja Institute in Australia. It's challenging work since, as he explains, “in some regions, there are significant problems with a lack of data availability, while others, such as Sweden, have restrictions on the collection of ethnicity data.” In his current role with colleagues across the university including Murrup Barak, the Melbourne Institute for Indigenous Development which he directs, Anderson is building a broader revolution in Indigenous education with the aim of increasing Indigenous representation in all professions. He hopes the strategy he's developing will see Indigenous students flourish: “We need to build the Indigenous economy, and this cannot be established without Indigenous university graduates.”