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Otago Waikato Medical School

DrDrLMG!

Resident Medical Officer
Administrator
As it happens sick people who should be in hospital not infrequently turn up to the GP clinic, and having that acute medicine experience becomes all the more relevant when the nearest hospital is 2 hours away.

While I don't know a great deal about the general state of play re. this topic in NZ, I do think the above hits the nail on the head of one really significant point. Separate training paths for city and rural docs surely just serves to widen the already (at least in Aus, and I presume similar in NZ) huge service gap that exists between the two (or more if we start to add in 'remote' regions) areas. And that is a very slippery slope with an ultimate message that I believe says 'your health is not as important to us as the health of those in the cities', therefore your doctors won't be as broadly trained or as widely experienced. And while I acknowledge funding and population distribution is a really big issue (and is only going to get bigger), I wholeheartedly don't believe pushing something 'lesser' (which is what I feel this Waikato proposal amounts to, no matter how many fancy words are used to suggest otherwise) is an appropriate way to deal with it.

And obviously this doesn't touch upon the other issues already mentioned, such as graduates having to work in hospitals, and/or not taking up positions as rural GPs in the end, anyway. Though, given the training path crushes that already exist, would a Waikato trained graduate possibly find it more difficult than their Otago/Auckland counterparts to get onto a non-GP training path, and be somewhat forced in that direction anyway?
 

Kiwiology

MSO Lawyer
@Pump here you go http://www.waikato.ac.nz/__data/assets/pdf_file/0016/331342/GEM-Business-Case.pdf

And obviously this doesn't touch upon the other issues already mentioned, such as graduates having to work in hospitals, and/or not taking up positions as rural GPs in the end, anyway. Though, given the training path crushes that already exist, would a Waikato trained graduate possibly find it more difficult than their Otago/Auckland counterparts to get onto a non-GP training path, and be somewhat forced in that direction anyway?

Possibly. Certainly the first few cohorts of WMS grads would get sh!t for being from what is already perceived as a bit of a shonky sounding institution (re med - not UOW in general) but who knows ... when the joint venture head (CEO of WDHB) says he wants these medical students trained in primary care clinics and small rural hospitals (10 or so beds) at what sounds like at least some expense of large tertiary centre training that can only be a bad thing in totality.
 
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Kiwiology

MSO Lawyer

Rob

House Officer
Emeritus Staff
Oh no, looks like Worrykato Medical School is a step closer A School of Rural Medicine to be established

I hope UOO/UOA and the NZMSA plus possibly the NZMA get their lobbying machine cranked up ....

Interesting that they are happy to invest $300 million into producing an excess of doctors, but aren't interested in investing far less than this to allow existing medical students to be able to afford to complete their degrees.
 

Kiwiology

MSO Lawyer
Interesting that they are happy to invest $300 million into producing an excess of doctors, but aren't interested in investing far less than this to allow existing medical students to be able to afford to complete their degrees.

A very good point, but, it points to the heart of the National Party conservative ideology; Paul Goldsmith is on record as stating he wants people to finish their study as efficiently as possible and make efficient decisions (warning: Neolibber speak) so, naturally, their argument will be something like "a Bachelor + MBChB is 8 years, they have 8 EFTS, if they are choosing to do an (Hons) year or postgrad study beforehand, then should have made an efficient decision and chosen more wisely; and if they needed to do so to boost their GPA, well, that is a failure of individual responsibility for not working hard enough to achieve good GPA in three years, so humbug, too bad for them"

Honestly; we do not need more medical students or junior docs (in general) in a system which can barely seem to accommodate them; we desperately need more GP Registrars and experienced GPs, particularly, but not exclusively, in regional NZ. This could be an opportunity to get some Physician Associates trained up from experienced Nurses, Paramedics, OTs etc ... I do not think every clinic in every place everywhere needs a Doctor.

If there are say, 60 places, divide them 30:30 between UOA and UOO and perhaps have an extra bunch of RRAS applicants who are guaranteed a seat if they do some sort of rural work after graduation or the rural immersion program, and perhaps train up some PAs as well or something. I think that'd be reasonable ...

Add to this, the fact Wonkykato haven't even proven to us their graduates will be of sufficient calibre to function as House Surgeons; being trained in Te Awamutu or Thames for most of your degree isn't going to cut it when you're clerking a ward full of patients in a large hospital as a PGY1 ....
 

Kiwiology

MSO Lawyer
Universities to compete for new School of Rural Medicine

Good Radio NZ interview between UOW Vice Chancellor and UOO Head of Medical School.

In a nutshell: UOW says "just train more medical students rurally and viola, more rural GPs" and UOO says "Hmm, good idea, but a way more complex issue, particularly about limited specialty training places and that rural GP is not attractive".

Winner? UOO cos they don't seem to be living in fairy tale land like UOW.
 

biom

Regular Member
Supreme Overlord of the Chatbox
If a School of Rural Medicine is established would that mean that they would
1. have a tailored course with graduates specifically trained for rural (only) practice and
2. graduates would be bonded to work in rural only areas?

If the objective is rural medicos then the above conditions would seem to be necessary. Applicants would know the rules when they applied.
 

frootloop

Doctor
Moderator
If a School of Rural Medicine is established would that mean that they would
1. have a tailored course with graduates specifically trained for rural (only) practice
We've been through this - they literally cannot do that. If you want to produce graduates who are recognized as doctors in New Zealand/Australia, you have to get your medical school registered with the AMC. The AMC will not register your proposed school if the graduates you produce aren't reasonably interchangeable with those of every existing NZ/AU medical school.

Your thoughts on how medical training 'should' work aside, this simply is not an option available to Waikato University.

Although admittedly, that Beehive press release doesn't read as though it understands this either. But that's hardly surprising, the current New Zealand government is very keen on making plans which are impossible, illegal or straight-up immoral (such as their latest hit: 'Drug dealers aren't entitled to basic human rights')
 

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Kiwiology

MSO Lawyer
I am thinking this new "School of Rural Medicine" will probably end up increasing existing student numbers (say 30:30 each at UOO and UOA) and somehow streaming them into an enhanced rural immersion program; I mean, these people still have to be trained to become docs in general (not that UOW seems to understand that) and you can't send them out to the boondocks for too long because of it (again, not that UOW seems to understand that) ....

...the current New Zealand government is very keen on making plans which are impossible, illegal or straight-up immoral (such as their latest hit: 'Drug dealers aren't entitled to basic human rights')

They also like to make these illegal or immoral ideas into laws too! Many of their amendments to the Social Security Act are blatantly illegal on the basis they discriminate against amongst the disabled, parents, working persons, and/or the aged and/or restrict movement of persons; i.e. not allowed under either the Bill of Rights or the Human Rights Act. The answer? We basically do not care.
 

rustyedges

Moderator
Moderator
I wonder how they're planning to stop all the Waikato graduates jumping ship and applying to RACS once they have their letters.
 

Kiwiology

MSO Lawyer
I wonder how they're planning to stop all the Waikato graduates jumping ship and applying to RACS once they have their letters.

They can't ... and it's a huge flaw with their idea, although to be fair to Worrykato, it's an inherent problem with medical education proper.

I'm more worried about how some UOW grad is going to fare as a House Officer clerking a ward of surgical pts having spent a goodly portion of their training in small cottage hospitals and GP clinics ....
 

Kiwiology

MSO Lawyer

Probably won't change much TBH. If anything, a change in Government post-election would be WMS' biggest problem.

Besides, this "rural medical school" idea is essentially a complete waste of valuable money which could be spent increasing spots for GPEP Registrars rather than worrying about pouring good money after <question mark here/probably bad> ....
 

acbard9

Auckland MBChB
I would assume it would be most sensible to divide those places for a rural Med school to Otago and Auckland (if only they had it in place earlier... :( I'd love to work as a rural GP!), but what if, instead, they don't increase the number of medical places, and tried for a "rural immersion programme" with current students?

What sort of programs do they have currently at Auckland and Otago to increase the desire to work in rural regions? :)
 

heartley

Member
Probably won't change much TBH. If anything, a change in Government post-election would be WMS' biggest problem.

Besides, this "rural medical school" idea is essentially a complete waste of valuable money which could be spent increasing spots for GPEP Registrars rather than worrying about pouring good money after <question mark here/probably bad> ....

Was more of a statement about the current state of the Waikato DHB. It's definitely a waste of money when the existing system just needs more funding. Also, being a rural GP is not 'financially attractive' when compared to other specialties.

UoA also has their Pukawakawa Rural Programme.
 

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Kiwiology

MSO Lawyer
Waikato isn't that bad ... could always be Southern DHB :p

Frankly, the Government has just got this wrong; want of some medical student placements is not the problem of people not becoming rural GPs; there are more applicants for GP training than there are GPEP posts, and somebody essentially said it's difficult to attract younger people to the boondocks because of a lack of social and technological infrastructure, and I'd say that's about right, as well as the hugely important workload problems.

If they really want good results for this money, increase the number of GPEP Registrars and look at paying for some more Nurse Practitioners in primary care to be trained or perhaps do something about the PA pilot scheme rather than the current .... nothing. I firmly believe not every clinic in small town New Zealand needs a doc; they're expensive, hard to attract and difficult to retain. That doesn't mean not to try, but perhaps try something a bit different? It's honestly like the current Govt are a bit thick or something ...
 

travellingspaceman

Regular Member
Otago has a rural immersion programme for 20 students each year and there was already a difficulty finding placements as Dannevirke(pretty sure this is right) is no longer a placement possibly (retirements etc). I would say that at least 10 students missed out of this program for next year so it's not like the demand isn't there to spend time rural
 

Kiwiology

MSO Lawyer
I know Pukawakawa is quite popular. My friend did it and she really enjoyed it. I'd be keen as well.

The guts of the issue is not 'spending time' as a medical student rurally (although, sure, that probably helps) it is about being able to attract and retain a sufficient medical workforce in provincial and rural areas; even some places like Hastings and Palmerston North can't get enough GPs.

Some more medical students won't solve this problem, and the Government seems blind to the issue .... almost entirely.
 

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