David McCredie: Another thing that happened in the '80s was the introduction of advanced study units. Students came in their second and third years for a six week course. I know I ran one for a number of years on fluid and electrolyte metabolism, Ian Hopkins ran one on neurology,[117] Henry [Ekert] did one, as did Kester [Brown]. This was a terrific introduction, because it integrated what they were learning in their physiology and anatomy with clinical medicine and showed that it was important to learn how things worked and to understand how it related to disease. I found these sessions very satisfactory from the point of view of teaching, and many of the students kept in touch for some time afterwards and said how much they enjoyed these sessions.

Peter Phelan: Two other things that were innovations. By about 1994 there was clearly widespread dissatisfaction among the student body about the lack of any clinical exposure in the early years of the course. When I talked to the Dean of the day, Graeme Ryan[118] he said, what would you think of having first year students spending a half day or a day in the wards of the Children's Hospital. And so, that went on for a number of years until the new curriculum came in which then formally had clinical experience.

The other thing that developed in the late '80s was a series of postgraduate diplomas which were first, important financially and second, gave opportunities to extend the teaching areas beyond the traditional paediatric graduate diplomas. There was one in adolescent health, genetic counseling, infant mental health. There were six or seven of them and they attracted large numbers of people.

Susan Sawyer: I'd just like to comment on the benevolent dictator notion because I think that while we clearly recognise the strengths of that model, I continue to be impressed by Peter’s vision in being able to identify gaps that were clearly emerging in terms of new service models and new areas of specialisation. But I think from the mid-1980s there was a period of about five years where the changing demographic of paediatrics - with an increasing number of women entering the specialty - was not reflected in appointments. So, for example, 1987 was the first year at the Children’s Hospital when there were equal numbers of male and female trainees in paediatrics. A lot of women had gone through beforehand but, at that time, if you looked at the appointments and the staff profile at the Children’s Hospital it was overwhelmingly male dominated. And, into the 90s, although there were changes, I think we need to recognise that there was quite a lag and a level of dissatisfaction amongst female trainees in terms of career opportunities.

Jim Keipert: In regard to teaching by clinicians, when one was appointed to the Hospital, presumably on merit, I always thought it rather quaint that you were automatically appointed as a teacher without any assessment of your ability in that regard. I always thought it would be desirable if the University assessed our abilities as teachers and, if necessary, taught the teachers how to teach. I thought I was a pretty good teacher but that was what you might call a somewhat biased opinion. So I pestered the Department [of Paediatrics] during my years there to get somebody to assess how good we were as teachers. Eventually, they got somebody from the University Department of Education to come and sit in on one of my sessions and they were going to do it on a lot of the other outpatient sessions. After that, they gave me verbal feedback. And they were going to give me a full report. But unfortunately there was a very regrettable upset in the Department of Education and we never heard anything further.

The other thing, when I was at Monash with Arthur [Clark], we used to get feedback from students in questionnaire form at the end of their term. I thought this was very helpful. It probably helped the students as much as the teachers but after some years it gradually died out.

During my time as a teacher at the Children's I found by far the most satisfactory form of teaching I had was in the general clinic area where Residents or Registrars brought cases that they were worried about. We gave them help with diagnosis and talked about management, prognosis and treatment. We also gave service to the patient. That seemed to me to be the most satisfactory form of teaching that I had because it was a small group and it consisted of parents, patients and, of course, students.

Ann Westmore: Does that continue?

Jim Keipert: I don't know.

Witness to the History of Australian Medicine