• ALL USERS: please familiarise yourself with the MSO Forum Rules (updated 03/08/20). The link to the rules is the first in the forum list.
  • UCAT PREP COMPANY DISCUSSION: Site administrators have implemented a rule that states there is to be NO mention of UCAT prep companies. This includes discussion, recommendations, questions, and reviews, and extends to allusions, acronyms, and other other attempts to get around the rule. Offending content will be deleted. Repeat offenders will be warned and may be banned.

Registered members with 100+ posts do not see Ads

Allied Health Degree Alternatives

acbard9

BBiomedSc(Hons) 2020
Thanks for your reply, LMG! and chinaski

I personally would love to work at a rural hospital or in a rural setting. I was wondering if the vast majority of those you listed have shortages in rural settings? e.g. I was reading up that Medical Physicists are almost entirely in cities, though I assume this is because larger hospitals are found in the cities / most populous areas.

NGO-type locations would appeal to me too :)
 

Registered members with 100+ posts do not see Ads

LMG!

Moderator
Staff Member of the Year 2019
Thanks for your reply, LMG! and chinaski

I personally would love to work at a rural hospital or in a rural setting. I was wondering if the vast majority of those you listed have shortages in rural settings? e.g. I was reading up that Medical Physicists are almost entirely in cities, though I assume this is because larger hospitals are found in the cities / most populous areas.

NGO-type locations would appeal to me too :)
I just spent a portion of summer in a rural hospital in NSW. They had physio (x1 person part time, plus occasionally a student), radiography (x1 person who was mostly a porter and might not have even been a radiographer at all, tbh), and pharmacy (x1 person part time) and that's it! It's not that there is a shortage, it's that there is no funding for positions to start with! This was a rural hospital with an ED and an attached nursing home, FYI.

ETA: It might be different in Kiwi-land?
 

chinaski

Regular Member
Thanks for your reply, LMG! and chinaski

I personally would love to work at a rural hospital or in a rural setting. I was wondering if the vast majority of those you listed have shortages in rural settings? e.g. I was reading up that Medical Physicists are almost entirely in cities, though I assume this is because larger hospitals are found in the cities / most populous areas.
You need to think about what these people do. Medical physicists congregate in work areas with a need for their services: so unless your hospital has a meaningful radiology department (ie diagnostic imaging of several modalities, nuclear med, interventional radiology), +/- radiation oncology services, there's not likely to be a need to have one on staff - ergo, many regional and rural centres, who may only have x-ray and a CT scanner, don't have the infrastructure to justify a medical physicist. Regional centres with a greater infrastructure may already have a physicist on staff, and therefore opportunities will be low in those areas. Compare and contrast allied health professionals who provide direct service to patients - rural centres would likely pounce on someone with skills that are commonly in demand for bread-and-butter clinical care (eg OT, physio, social work, speech path, podiatry etc etc).
 

Cathay

🚂Train Driver🚆
Emeritus Staff
I have had quite a number of experiences now in internships, research studentships or other casual jobs where I am sitting or lab work most of the day, and I have come to really dislike it.
Oh bard, I can see it now - you'll be one of those people that go on a massive run on their lunch break! 🤣

I wanna explore this being physically active thing a bit more... Would you accept standing up and (for lack of a better word) shuffling around one set area? (Like a community pharmacist in the dispensing area - or is that too close to lab work?) How about around the few rooms of one particular hospital ward? Or is going around multiple wards across the whole hospital the only desirable outcome?

I share your aversion to being "stuck" in an office (for example, on the GP rotation back in my 4th year, I realized I couldn't see myself just sitting there in the same office day in, day out with patients coming and going), but not really the physical activity part - I'm happy enough sitting at a desk where the scenery moves and I have various levers and wheels and pedals and buttons/dials/switches to interact with said motion. (i.e. bus driving and now train driving)

I mean, there's like, a tonne of railway jobs (no pun intended) that are physically active - some of which even involve traveling on trains or ferries. But that's not really what you're after here.


I personally would love to work at a rural hospital or in a rural setting. I was wondering if the vast majority of those you listed have shortages in rural settings?
On the assumption that this is about NZ (the following wall of text won't apply if you're looking to skip country), I'd have to ask how rural you're looking. (It's a perpetual joke that your local uni, Auckland Uni, has a Regional/Rural Admission Scheme whereby people from Palmerston North, 8th largest city in NZ, are considered "regional/rural". Heck, if I went to school in the satellite town of Rolleston or Lincoln, 20min from central Christchurch, I'd technically be "regional/rural" too, even though I'm from Christchurch!)

I'm not sure if it's because of NZ's compact size compared to Australia, but with very few places more than 2-3 hours drive from the nearest centre, and fairly small populations in the small places, my personal impression is that for the most part, even community stuff (that will stick you in an office) would only be in the bigger towns (like, places you've definitely heard of as a NZer), let alone hospital stuff.

In 3rd year at Otago med, we did a Community Contact Week - spent a week in a rural district as a group, had a bunch of scheduled sessions where we were first introduced to the district by the mayor, then visited most of their healthcare facilities, had an excellent time, and had to write up a report about the district, their health needs, how these needs are currently met, any unmet needs and how these could be addressed. I was part of a group that visited the Hurunui District in North Canterbury. Their community health services are concentrated in Amberley (the district centre and one of the more populous towns), with a 10-bed hospital in Waikari providing maternity and medical (convalescence) services, and a nurse-led community clinic in Hanmer Springs. The hospital in Waikari (not to be confused with Wakari Hospital where Dunedin's mental health unit is based) had less than a dozen staff, not all of whom were full-time; many were nurses, with a couple of other roles (cook, porter); and most were women from farming families in the area. The convalescence medical services there was sort of an intermediary between "inpatient care at Christchurch Hospital" and "discharge to home"; patients there were medically stable but needing some nursing cares as they recover from illness. The few doctors based in the district were all rural GPs, with occasional visits and clinics by Christchurch-based hospital docs, as well as visits from the Mobile Surgical Bus. There was no ED attached - indeed Christchurch was only a 45min drive away.

Taking a look on the NZ Ministry of Health Public Hospitals listing (link here), and focusing on the South Island (familiar for me, less hospitals to scroll through, and more sparsely populated than the North Island), for all 29 hospitals listed, if we exclude all the "5-21 bed, maternal + medical +/- geriatric" facilities that appear (at least by description) to be on the same model as Waikari (i.e. not a massive source for hospital-based allied health employment), then we end up with the following localities in ascending size order - all of which you would normally consider to be "towns/cities" as opposed to "rural, rural":
Ashburton (54+37 beds in two facilities),
Blenheim (100 beds),
Greymouth (114 beds),
Timaru (132 beds),
Invercargill (168 beds),
Nelson (191 beds),
Dunedin (361+90 beds in two facilities), and
Christchurch (833+229+195+53 beds across 4 facilities).
(Oamaru has a hospital, but is public/private integrated and not on the MoH listing.)


NGO-type locations would appeal to me too :)
Look out for the possible trap that the NGO (especially a local one) is just some outfit that'll put you in an office. 🤣 Through med school we were introduced to a range of local non-profits and NGOs that work on various aspects of health, but there seemed to be a lot of offices! (I must admit upon seeing " NGO", even I had a vision of roaming around Africa doing good deeds, maybe that's just ingrained from too much Hollywood?)
 

Registered members with 100+ posts do not see Ads

acbard9

BBiomedSc(Hons) 2020
Cathay thank you for your response, mate :) . Guess I'm just really enjoying the fitness buzz from the Fitness Goals thread ;)🤣

I would definitely accept being able to move around the few rooms of one particular hospital ward. Not too big a fan of just standing and shuffling! I, for one, share your sentiment on being "stuck" in an office.

As for rural/regional, I just sort of want to be in areas where there's a large unmet need for medical care. I have personal stories of my extended family living in such areas (but not in NZ), and I have spent the last year or so thinking about the kind of work I would find fulfilling. In that regard, I would relish the opportunity to be there for people like my family and others in that position.

That's a very interesting find for sure. I did imagine further afield, considering I would say those hospitals you found are towns and cities. In truth, if they are the regions that have the large unmet medical needs then that is where I would like to be. You have piqued my interest and will look at the North Island counterparts, and read a bit more into the hospitals you've listed. I do notice that these tend to be nurse-strong, which is great to hear as I have considered nursing in the past, and have it as a potential career choice. Given there are MNurs courses, I wouldn't have to wait too long to get stuck into it.

Thanks again Cathay and to LMG! and chinaski for your thoughtful replies :)
 

chinaski

Regular Member
As for rural/regional, I just sort of want to be in areas where there's a large unmet need for medical care.
That being the case, I would recommend gravitating towards broad bread-and-butter allied health professions that are in high demand and commonly required across general medicine and/or surgery, rather than focussing on fringey/niche services. In areas of workforce shortage, the first need they start filling in are the bread-and-butter services, rather than establishing a presence for the more obscure/"nice to have but not essential" services.
 

Cathay

🚂Train Driver🚆
Emeritus Staff
As for rural/regional, I just sort of want to be in areas where there's a large unmet need for medical care.
I know we've addressed this in ChatBox earlier but I'll put this here for others to see: "unmet need" does not equal "employment opportunity". In many cases "unmet need" refers to "things they need but haven't got funding for" rather than "staff vacancies". (i.e. A service shortage rather than a workforce shortage.)

The largest unmet *staff* need in NZ is in the realm of rural GPs - that has been an area of chronic unfilled staff vacancies since before I was at med school, it was also what we found during our community contact week, and a quick Google shows that it still dominates the headlines today. It's actually quite hard to find information about what other health workers are needed in rural NZ, with this rural GP shortage dominating the public discourse. I understand the government is developing a funding package to boost the number of rural doctors, nurses, and midwives; but struggle to find information about rural nurse shortages (assuming there is one), for example.

From memory, the inability to attract rural GPs was despite what we were told was "competitive salary". I recall some issues listed like lack of locum relief for holidays, lack of support, being in high demand for after hours callouts (particularly in a small town with only one doctor!), and lifestyle issues particularly around professional boundaries in a small town of a few hundred - or less. I recall on community contact week that the district we visited was addressing the "owning/operating/maintaining the practice" side of things by having the council purchase the practices under a holding entity, so that any rural GPs they recruit would simply be working there on salary, as opposed to having to buy, own, and run the practice.

I did imagine further afield, considering I would say those hospitals you found are towns and cities. In truth, if they are the regions that have the large unmet medical needs then that is where I would like to be.
I've had a look at the North Island in the same way - excluding the very small 5-30 bed facilities - and we get a very predictable result (i.e. limited to the cities and big towns that even a South Islander like me have heard of), proceeding from South to North we have:
Greater Wellington (Wellington, Hutt Valley, Porirua)
Masterton
Palmerston North
Whanganui/Wanganui
Hawke's Bay (Napier/Hastings)
New Plymouth
Gisborne
Rotorua
Whakatane
Tauranga
Hamilton
Thames
Greater Auckland
Whangarei

I think the problem with going further afield is that, since we're talking about allied health professions (using LMG's list: physio, OT, SLT, social work, psychology, pharmacy, radiography, dietetics, podiatry etc) in the context of facilities that range from "small" (30ish beds) to "tiny" (5-10 beds), it becomes quite uncertain as to whether those facilities have those professions - indeed like chinaski said, the bread and butter stuff are needed everywhere. Since many of them are "convalescence" units (i.e. discharge from bigger hospital into a local small/tiny hospital for further recovery before discharge to home), it's often possible for all the allied health needs of the patient to be addressed at the bigger centres before they are transferred to the small hospitals.

The flip side of that story is that you may not need to be based in those small/tiny rural hospitals to work in those settings - many DHBs that cover rural areas have doctors and allied health professionals alike commuting to the smaller facilities to provide services there, something like a half-day clinic once a fortnight or once a month.


On another topic: there are some issues around living/working in a rural community (should you go for the "further afield" options) that occurred to me, knowing that you're from Auckland and (to be vague for the purpose of the forum) may not be of European descent. There are some questions to be asked, like:
1) Will there be full-time employment, and will it be sufficient to live on? (During community contact week there appeared to be quite a number of part-time nursing roles being used by locals from local farming families as supplementary income, rather than their primary income to live on.)
2) Will there be a possibility of racist/anti-city-folk sentiments and incidents, both personally and professionally? (I realize NZers on the whole are pretty wholesome, but my understanding is that, particularly in rural places further down south, things can be a bit... "traditional" and "conservative".)
3) What about the cultural shift from a city to a small town of a few hundred, where everyone knows everyone, all the gossip goes around and around, and everyone knows what you did last Saturday night and are judging you. (Hypothetically of course 🤣 )
4a) (for young single folk) What of the reduced socializing opportunities, and reduced scope of potential partners available?
4b) (for family folk) What of the reduced opportunities for partners' employment, and reduced opportunities for children's education, compared to a "big town" or a city?

I don't want to come across as discouraging, because your aspirations are admirable (what the young ones now might call "legit goals"), but since you're in the contemplation stage, we may as well get any potential downsides into the mix to be thought of now, rather than later.
 

chinaski

Regular Member
Since many of them are "convalescence" units (i.e. discharge from bigger hospital into a local small/tiny hospital for further recovery before discharge to home), it's often possible for all the allied health needs of the patient to be addressed at the bigger centres before they are transferred to the small hospitals.
Can't comment specifically about workforce distribution in NZ, but be aware that small sub-acute centres will often paradoxically have MORE allied health services (in terms of patient-to-professional ratio) than the large tertiary centres. Convalescence units are underpinned by allied health far moreso than medical services - often the main reason for these units existing is so that patients can be transferred out of an acute medical bed once their medical issues become subacute enough for them to move into an allied-health driven unit instead. They transfer for allied health recovery and rehab, not medical recovery.
 

Registered members with 100+ posts do not see Ads

Cathay

🚂Train Driver🚆
Emeritus Staff
Can't comment specifically about workforce distribution in NZ, but be aware that small sub-acute centres will often paradoxically have MORE allied health services (in terms of patient-to-professional ratio) than the large tertiary centres. Convalescence units are underpinned by allied health far moreso than medical services - often the main reason for these units existing is so that patients can be transferred out of an acute medical bed once their medical issues become subacute enough for them to move into an allied-health driven unit instead. They transfer for allied health recovery and rehab, not medical recovery.
This is a very good point, although I do still wonder how the allied health staffing is done at a lot of these facilities - there's a recurring theme of "12-16 bed facilities that do a mix of maternity, medical/recovery, surgical rehab, respite care etc, located about 1hr drive from the nearest main centre". The proximity to the nearest main centre in particular brings up the question of whether some of the allied health professions would have staff permanently based there, as opposed to sending someone out as needed. Either way, though, sounds like there should be opportunities to work in those rural/regional settings!


Back to acbard9, just a thought that popped into my head this morning: admissions-wise, would physio still be an option for you? (Otago grad entry physio perhaps?) From previous discussions (both here and on ChatBox) you seem to have an affinity for physical activity, and physio is a bread-and-butter clinical service where, even if you end up working in a clinic in the community all the time, there can still be some physical element to it (e.g. musculoskeletal work, teaching exercises etc) and you're not "just stuck at a desk".

(I was about to say "consider also: Occupational Therapy", but the Careers NZ articles on Physio and OT, updated December 2019, seemed a lot more optimistic on job opportunities for physios than for OT?)
 

acbard9

BBiomedSc(Hons) 2020
It's honestly very awesome that you're all taking my case thoughtfully :). I haven't put much more thought into my situation since last time I was here, but will think out loud from what you guys have said.

I, too, had difficulty finding what other non-GP medical services in particular were lacking out in the regions. Med student friends tell me that they're told that "everyone" (i.e. many non-GP medical professionals) is sought after in those areas. Another friend is consulting her Coromandel-based Doctor sister for me too.

Perhaps it is the convalescence units that I might find fulfilling work. I will definitely consider both Physio and OT given that they meet the physical aspect and bread-and-butter services criteria, but I am also a bit apprehensive with the potential lack of job opportunities as an OT. I do imagine I'd be able to move overseas as a Physio or OT for better job prospects, opening up another can of worms. How about emergency medical services in the regions? I have yet to read about any potential shortages in that respect, but I can imagine such shortages would be present and a serious problem.

I do hope that the salary is enough to live on, and that would be my biggest worry. While perhaps the racism in a non-professional context wouldn't be too significant a bother for me, perhaps the inherent distrust in how well I do my job based on my race may serve a problem. However, I have been to regional NZ for short periods of time and was fortunate enough to be met with kindness. City to rural cultural shift and reduced socialising I don't currently perceive as large problems for me.

Thanks again to the both of you :)
 

chinaski

Regular Member
This is a very good point, although I do still wonder how the allied health staffing is done at a lot of these facilities - there's a recurring theme of "12-16 bed facilities that do a mix of maternity, medical/recovery, surgical rehab, respite care etc, located about 1hr drive from the nearest main centre". The proximity to the nearest main centre in particular brings up the question of whether some of the allied health professions would have staff permanently based there, as opposed to sending someone out as needed. Either way, though, sounds like there should be opportunities to work in those rural/regional settings!
I'd gently remind you that I'm speaking from experience of having worked in/with such places (so I'm not speculating). Obviously I can't speak with any authority as to how things are staffed in NZ, but suffice to say, across the ditch, subacute facilities are often staffed with an embarrassment of allied health workers, compared to ratios seen in large tertiary centres, wherein acute patients can wait days to weeks to see allied health. The same can't be said about medical staff, who actually *do* commonly drop in and out of subacute facilities on an "as needed" basis, as per the scenario you describe above.

How about emergency medical services in the regions? I have yet to read about any potential shortages in that respect, but I can imagine such shortages would be present and a serious problem.
Not really sure why you're asking about emergency medical services in the context of this discussion? What kind of specialist allied health do you think are involved in emergency medicine (as opposed to all other areas)?
 

Cathay

🚂Train Driver🚆
Emeritus Staff
How about emergency medical services in the regions? I have yet to read about any potential shortages in that respect, but I can imagine such shortages would be present and a serious problem.
Like chinaski, I was a little confused by this sharp turn in the discussion. Do correct me if I'm being too cynical, but from the sizeable jumps in exploring different ideas, and the (forgive me for being direct) more general aspirations, I'm sensing that you may be in the brainstorming stage, with a lot of competing ideas floating around?

If you are talking in terms of ambulances, paramedics etc, I feel obliged to mention that all the media references to rural emergency services shortages I've found were regarding funding shortages, and subsequent shortages in equipment and (in particular) paid positions, over-reliance on local volunteers with subsequent staff burnout and shortage. This is consistent with what I remember of our Community Contact Week visit to the St John Ambulance facility in Amberley, where staff expressed to us that their challenges lie in under-resourcing and not enough paid positions, relying on local volunteers.

Assuming this is correct, this would be a "service shortage" rather than a "workforce shortage" - i.e. the problem is more "they don't have enough paid jobs for paramedics and ambulance officers", rather than "they need people to go work there and fill those jobs". This is in contrast to the rural GP shortage, where the positions and funding exist, but the positions go unfilled due to lack of doctors willing to work there.

Edit: To clarify, I’m not saying “don’t become a paramedic” if that’s ultimately what takes your fancy, I’m just saying I’m not getting the impression that “becoming a paramedic” would immediately lead to “full-time paid employment in rural NZ”.


I, too, had difficulty finding what other non-GP medical services in particular were lacking out in the regions. Med student friends tell me that they're told that "everyone" (i.e. many non-GP medical professionals) is sought after in those areas.
Pardon my cynicism again, but if med students were being told this, I'm wondering if the meaning was "all types of doctors are sought after in those areas" (and indeed I would be tempted to interpret it this way.) If we are talking "medical services" and "medical professionals", that makes me think "doctor".

Also an issue is the distinction between "regional" and "rural". Places like Greymouth, Timaru, or Rotorua are "regional", but not "rural"; these regional hospitals have medical teams of many specialties based there, in contrast to a "rural hospital" where doctors tend not to be based but drop in as needed. (All three of the ones I've listed are currently on the hard-to-staff list for the NZ New Graduate Doctors Voluntary Bonding Scheme, which supports the notion that "all types of doctors are sought after out in 'the regions'".)
 
Last edited:

Registered members with 100+ posts do not see Ads

acbard9

BBiomedSc(Hons) 2020
Apologies for the jump.

I was under the impression that paramedics would potentially be considered a bread-and-butter service, and that large distances from emergency services was a common problem for the regions.
 

chinaski

Regular Member
I would imagine that in a small country like New Zealand, you'd probably rely more on transferring critical patients directly out of regional areas and into your tertiary centres via air, rather than having specialist paramedic services dotted throughout the boondocks. Bear in mind that in rural/regional areas, the daily need for a dedicated local full time paramedic service would be reasonably limited.
 

Cathay

🚂Train Driver🚆
Emeritus Staff
I was under the impression that paramedics would potentially be considered a bread-and-butter service, and that large distances from emergency services was a common problem for the regions.
I think it depends on what you mean by "emergency services". In rural NZ, distance to the nearest ambulance station is usually within 20-30min drive basically everywhere - St John has 207 ambulance stations across the country as of 2017, and even when one station isn't staffed (due to unavailability of volunteers for a particular shift - e.g. Saturday night) they do cross-coverage with the nearest other station.

As chinaski said, though, this does not mean paramedics in every little town - see St John Practice Levels. Even in the cities, I remember hearing at my first aid course, that the paramedics tend to be in those St John cars with lights and sirens, rather than in ambulances, so they can respond as needed *in addition* to the base ambulance crew who would be at FR and EMT level.

Distance to hospital, though, can be a different story (although as chinaski said, critical patients will tend to be transferred by air to a tertiary centre).
 

chinaski

Regular Member
Probably best to clarify the difference between a paramedic and an ambulance officer. If you're looking for the specialised, high-level hands-on, critical pointy bit of the job, then you're not likely to get much paramedic opportunities based in rural settings.
 

Registered members with 100+ posts do not see Ads

I'm currently in my first year of biomedical science and I've been tossing between optometry and medical imaging. Please drop all info you have on both, their pros and cons, wages, all that stuff. Some backg info about me, I enjoy biology and anatomy more than chem and physics.
 

dotwingz

Irregular Member
Valued Member
Given that you have been tossing up between the two, why dont you start the thread off and tell us what info you have found to separate the two professions?
 

Registered members with 100+ posts do not see Ads

Top