Rural Medicine Graduates Enthusiastic About Kaitaia

Media Release

March 9, 2016

Rural Medicine Graduates Enthusiastic About Kaitaia

A new training programme for medical graduates planning to specialise in rural hospital medicine is receiving an enthusiastic response from some of those taking part through Northland DHB.

The first four registrars approved to train through the Rural Hospital Medicine (RHM) programme across Northland DHB began in December 2015.

Generally in New Zealand, medical students graduate as house surgeons (surgical) or house officers (medical). After two years they usually apply to their specialist training programme (e.g. surgery, medicine, paediatrics, gynaecology, general practice) and start training towards their vocational registration.

RHM is another type of specialty which began in New Zealand in 2008 and allows the specialist to work independently in New Zealand’s many rural hospitals and cover a wide scope of practice, from emergency to inpatient work.

The four-year training programme includes time in general medicine, paediatrics, ICU/anaesthetics, emergency medicine, rural hospital (on two sites) and rural general practice, plus elective time for further training.

Northland DHB’s programme guarantees all of the training requirements over a four-year period, all within Northland and all accredited by the division of rural hospital medicine, Royal NZ College of General Practitioners.

Namibian-born Dr Amanda van Zyl had already worked in centres such as Hamilton, Rotorua and Tauranga when she heard Kaitaia Hospital clinical leader Dr Sarah Clarke speak about the RHM programme at a conference.

“As soon as she finished talking, I was up the front saying: ‘Hello, I am your first participant’,” Dr van Zyl recalls.

Following a couple of visits, she and her husband and their baby daughter relocated to Kaitaia, where they live in a house on the hospital site. “I will always have very fond memories of that house because it’s where my little girl had her first Christmas and took her first steps.”

Dr van Zyl describes Kaitaia as “a glorious place. I really love it here. The hospital’s great – it’s really welcoming – and town is really nice. I feel like I’ve got everything I need to have here.

“Living here, you go fishing and enjoy the beach.”

One of the standout features is the range of work. “I remember on my first week going home to my husband and saying: ‘I cannot believe the stuff these guys are competent to deal with’.

“The hierarchy here in the hospital is quite flat, so everybody’s available to be questioned and happy to be questioned. And in turn, they will find the best person and ring up and ask the experts questions and then act on that.” The benefit is that patients can be treated in their home area, with the accompanying family/whānau support.

“I think it’s a really good training scheme and I’m going to be spreading the word about training in Kaitaia,” says Dr van Zyl. “I intentionally didn’t tell anyone at the beginning to make sure I got a place.”

Fellow resident medical officer at Kaitaia Hospital, Dr Nick Buist, grew up and did his medical training in Auckland but made a conscious decision to do something different and came to Whangarei for his first year of work, where he was a house officer at Whangarei Hospital. He is now doing his community attachment at Kaitaia Hospital as a Post Graduate Year 2 house officer.

“It’s a decision I’m really glad I made,” he says. “I believe in general, it’s important to work in a different place.

“I think people in Auckland are definitely aware that there are different things that happen in other areas, and that includes everything from the way of life to facts like poverty. But until you actually work in it and live in it, you don’t quite appreciate the full gravity of what’s going on.”

Dr Buist says his main reason for applying for the community attachment in Kaitaia was the ‘big learning opportunity.

“I get to see patients in ED, admit them and try to work out their issues myself,” he says. “There’s no real hierarchy – all doctors do their own paperwork and consult together, so it’s quite refreshing as a junior doctor to have that and I think it’s a really good opportunity.

With an interest in teaching, he sees value in the fact that there are students at Kaitaia Hospital and adds: “There are definitely some attitudes and skills that I would like to retain when I’m a senior doctor in terms of educating junior staff.”

Another factor is gaining a first-hand appreciation of the initiatives that are underway to address inequities in health. “It’s something you read about and you have an idea about but until you actually see how it works first-hand, you don’t really know what’s going on.”

Dr Buist sums up. “I’m finding the community attachment very worthwhile and I would encourage other house surgeons and students to apply to come up here. I think there’s a lot to be gained from it.”

-ENDS-

© Scoop Media