Newsletter April 2014 For all Division enquiries and further information, visit our website, or email or phone the Division s administrator Helene Keating on 04 550 2829. Congratulations and a warm welcome to new Fellows of the Division of Rural Hospital Medicine The Rural Hospital Medicine family continues to grow. The following three doctors are new Fellows of the Division of Rural Hospital Medicine (FDRHMNZ): Emma Davey Fellow through the Registrar Training programme Susan Burslem Fellow through the Registrar Training programme Valerie August Fellow via the Experiential Interim Pathway Chris Henry Fellow via the Experiential Interim Pathway DRHM Registrar Training Programme 2015 Applications have closed for the December 2014 intake of the training programme. A record number of applications have been received and the clinical leaders are busy interviewing the many candidates. Thank you to all who encouraged colleagues to apply. New DRHM Council members At the recent Annual General Meeting, three new board members were appointed to the Council of the Division of Rural Hospital Medicine. Dr Scott Wilson, Ashburton Hospital I have spent almost my entire medical career in provincial hospital practice, having worked extensively throughout New Zealand and Australia. For the past seven years I have been based in Ashburton, gaining my Fellowship in Rural Hospital Medicine in 2011. In 2012, in addition to my full-time clinical duties, I acquired the clinical director responsibilities and oversaw the challenging transition from a traditional model of individual specialist care to the implementation of Rural Hospital Generalists. This has been a great challenge for me personally and I have been thrilled to see the hard work of Rural Hospitalists becoming recognised fully at a tertiary level. In my spare time I am a proud father of two and I enjoy adventure sports and travel. I have a number of initiatives to complete locally, and would love to have an opportunity to contribute at a national level. 1
Dr Jennifer Keys, Lakes District Hospital I graduated from the University of Dundee in 1991 and started 20 years of random jobs and studies which included five years of medicine, Membership of the Royal Colleges of Physicians, GP training, lots of rural GP locuming around New Zealand, becoming a Member of the Royal College of General Practitioners, a little bit of intensive care, obstetrics and gynaecology and paediatrics, a year in the Antarctic with an MSc in Remote Healthcare and a few years as an ED Medical Officer of Specialist Scale. I've mostly been in New Zealand since 1994 and since 2009 I've been a full-time Rural Hospital Doctor at Lakes District Hospital in Queenstown. I gained my Fellowship of the DRHMNZ in 2011. I think remote generalist medicine is a huge challenge for us all and I feel strongly about equity of healthcare for rural people. Dr Greg van der Hulst, Dargaville Medical Centre I have worked in Northland for Dargaville Medical Centre as a rural GP for eight years, and I also work as a part time Rural Hospitalist at Dargaville Hospital. I gained by Fellowship of RNZCGP in 2011 and my Fellowship of DRHMNZ in 2013. My special interests include medical education, the use of clinician-performed ultrasound in the rural context, rural emergency medicine, and aeromedical retrieval and transport. I was co-opted onto the DRHM Boar of Studies and Council in 2010 to provide representation for Northland and a Level 2 rural hospital. I am happy to continue on Council and Board of Studies to consolidate the RHM training scheme s excellent reputation among registrars nationally, demonstrated by the number of high quality candidates applying for places every year. Credentialing request for information The DRHM is working at collecting information on credentialing processes around the country. If you and your hospital are happy to share the experiences of your credentialing process, please contact helene.keating@rnzcgp.org.nz You will then be contacted by DRHM Deputy Chair of Council, Nina Stupples, in the next month. PG Diploma in Rural and Provincial Hospital Practice Semester 2-2014 Papers There are still a few places left on GENX726 - Obstetrics and Paediatrics in Rural Hospital Practice. This includes a residential in Wellington (1-4 September) with a strong line-up of specialist teachers. Although trainees who have passed PRIMEX, or have a PGDipCH or PGDipOMG, are currently exempt from taking this paper to meet the academic requirements for Fellowship, they are certainly not excluded. We welcome a mix of experienced and less experienced students for all university papers. Registrars who have a strong background in either obstetrics or paediatrics, or older doctors who may have experience of both over the years, should consider doing this paper, perhaps as a part of the requirement for the PG DipRPHP. GENX 727 Surgical Specialties in Rural Hospitals is also being run in Semester 2, with a residential likely to be in Dunedin from 3-7 November. Please contact the rural PG administrator Bron Hunt as soon as possible if you are interested in one or both of these papers - bron.hunt@otago.ac.nz, phone 03 440 4345). 2
2015 Papers Next year, four papers are being offered: Semester 1 GENX 729 (Medical Specialists in Rural Hospitals) and GENX 730 (Trauma and Emergencies in Rural Hospitals) Semester 2 GENX 724 (The Context of Rural Hospital Medicine) and GENX 728 (Cardiorespiratory Medicine in Rural Hospitals) Please contact Bron if you have any queries about the 2015 papers. GENX 725 - Residential Thirteen University of Otago students (including nine RHM registrars) were hosted on Waiwhatawhata marae over the first weekend of April as part of the Communication in Rural Hospital Medicine paper. The weekend was an excellent insight into the Māori and Pacifica approach to personal relationships and their effect on healthcare interactions, with great teaching from local kaumātua, and an impressive range of resource people. Clinical medicine was discussed, and everybody made the most of the opportunity to strengthen and renew friendships with fellow registrars. A huge thanks to our hosts for their overwhelming hospitality, and to Dr s Blattner and Clarke for co-ordinating the program and maximising the benefit for all involved. Andrew Laurenson. Cook Islands project update March 2014 New Zealand Doctors to the Cooks The NZAid funded health specialist visits (HSV) primary care/frontline services project, which commenced March 2012, finishes up in April with a final visit to the Cook Islands for review of the programme with the Cooks Ministry of Health. The next aim is to put a further proposal to NZAid. In the meantime, those who have expressed interest in spending time working in the Cook Islands may be able to tap into alternate funds e.g. sabbaticals, as several have done during the past two years. Cook Island doctors to New Zealand The RNZCGP is working with the Cook Islands Ministry of Health on setting up a programme for Cook Island generalist doctors to train in generalist practice/rural hospital medicine in New Zealand. 3
Three senior Cook Islands doctors are enrolled on distance learning papers of the Rural Hospital Medicine diploma, University of Otago this semester. This links them in with some of the academic component of the DRHMNZ training programme. DRHMNZ registrar post in Cook Islands The Division is progressing this initiative and looking at various funding options. If there are registrars interested in an attachment in the Cook Islands towards the end of their training, please get in touch with Helene, Pragati or Patrick. General news for 2014 Two Cook Islands doctors attended the World Summit for Rural Generalist Medicine hosted by ACRRM in Cairns in late 2013. It was great to have a Pacific presence and to hear their perspectives. For the Cook Islands doctors it was a great opportunity to hear wider rural generalist perspective. Cook Islands Annual health Conference July 2-4 in Rarotonga and 7-8 in Aitutaki. Please contact Kati Blattner if you are able to attend so we can co-ordinate contributions. University of Otago CME Workshop for Rural Hospital Doctors Nov 26-28 in Rarotonga. In collaboration with the Cook Islands Ministry of Health, this workshop, which was first run in 2012, returns to Rarotonga in November. Three days of CME with a Rural Hospital focus. For more details please contact helene.keating@rnzcgp.org.nz in the first instance. Financial Support available for maternity training The Government is continuing to provide support for general practitioners to become more involved in, or return to, providing primary maternity services. Financial support, which in some circumstances includes funding for locum cover, is available to GPs to assist with the costs of training or up skilling in maternity care. Funding is available for enrolment in the following courses: Postgraduate Diploma of Obstetrics and Medical Gynaecology (PGDipOMG) ( or Otago) Postgraduate Certificate in Women s Health (PGCertWHlth) (Otago) Postgraduate Certificate in Health Science (PGCertHSc) () Paper in Pregnancy Care in the Community (OBGX713 Otago or OBSTGYN 713 ). Full information below: https://www.rnzcgp.org.nz/financial-support-available-for-maternity-training-2/ GODZone 2014 race report Sometimes it's better not to know what you're getting yourself in for! With this as an underlying theme, team Pat Farry Trust embarked on a gruelling seven day test of character, strength, and humour to complete the 2014 GODZone adventure race. Team captain Rachel Lynskey, navigators Garry Nixon and Mark Smith and packhorse Jeremy Webber came together to join 40 other teams in Kaikoura last month for the 11 stage race across some of the most remote and diverse terrain in the area. The course, only revealed to competitors on race morning, started with a scenic taster of sea kayaking and coasteering around the Kaikoura peninsula before heading inland on mountain bikes. As night fell, and the tracks became unrideable, we soon came to appreciate the challenges we were in for over the coming days where accurate navigation, particularly in dense bush at night, was critical. Twelve hours later we commenced the trekking highlight, an ascent of Mt Tapuae-o-unuku, New Zealand s highest peak outside the Southern Alps, a bitter night tenting on the snow, and a trudge into transition 41 hours later on blistered, tired feet. The only break to the self-supported event was a welcome meal of soup and lasagne before heading onto the Molesworth Station for 160km of mountain biking. First light does wonders for fading spirits and the dawn fog along this spectacular high country station was stunning. We can also recommend the burgers in Hanmer when you're next passing through. 4
Rachel and Mark (DRHM registrars), Jeremy and Garry (Fellows of DRHMNZ) Back onto our feet again and into another night for a further 24-hours of trekking where the course enabled multiple route choices. Garry and Mark took us down what turned out to be one of the faster routes which became critical to us getting through the cut-off the following day. Another highlight was the paddle down the Hurunui River, the odd involuntary swim, and a few pruning diversions of some overgrown willow trees. Teams not through the half-way point on the river were redirected to a shortened course. We were the last team allowed through, with less than an hour to spare, which cemented our title of best 'value for money' team. Out of the boats and back onto our bikes, feet, bikes and feet again as we made our way back towards Kaikoura. The final leg had us back around the peninsula in sea kayaks in the company of a pod of dolphins and the hum of the coastguard boat piloting us to wash up at 5am back where we started almost seven days previously. The team was placed 22 nd overall. An average of 2-3 hours of sleep a night, excluding a welcome compulsory 10 hours in the gorse on the riverbank, and innumerable calorie gels and bars gave us all a new respect for what the body can achieve under pressure. 5
Most importantly, this race has been an opportunity to share a remarkable journey with three wonderful friends whose character and humour kept the legs moving when the mind had switched off and was tucked into bed many miles away. We are extremely grateful to the enthusiastic team of the Pat Farry Trust, our wonderful hosts Tim and Charmaine, and all family and friends who followed our adventure. We hope to have helped raise the profile of rural medicine and show the resilience and resourcefulness that epitomises New Zealand rural doctors. Jeremy Webber Courses Advanced Paediatric Life Support (APLS) courses 2014 Wellington Dunedin Waikato 14-16 May 20-22 May 14-16 August 27-29 August 22-24 October (tbc) 5-7 November (tbc) 26-28 November (tbc) To get programme details, or to register online, please visit the APLS website http://www.apls.org.nz/ Early registration is advised as places fill up quickly. You need to allow plenty of time to read the 416 page manual. It's not the sort of course that you can slot into with only a week to prepare! To get the most from the course, the manual does need to be read thoroughly and a multiple choice questions (MCQ) completed (open book test). Please be aware that attendance at all sessions is mandatory. The course requires your full commitment and it is not possible to take mobile phone calls during the course or undertake clinical duties. Jo Jones Executive Officer APLS NZ Phone: (07) 312 9574 E-mail: jo@apls.org.nz Website: www.apls.org.nz Advanced Life Support in Obstetrics (ALSO) ALSO has been running in New Zealand for more than 10 years, and is based on international ALSO teaching. It covers emergency care aspects of obstetrics from first trimester to medical and birth emergencies to neonatal resuscitation. The course is available twice per year. It has been endorsed by the College for 16 hours of CME/MOPS for GPs. Please note: there is an ALSO course in in May that still has places available for GP s and Rural Hospital Doctors. For more information please contact: Suzanne Page, Director Tel/fax: (09) 459 6665 Email: enquiries@also.co.nz Website: www.also.co.nz 6
Vacancies Rural Hospital Medicine Senior Medical Officer Position at Dunstan Hospital Applications should be forwarded in confidence to the Clinical Director, Dunstan Hospital, PO Box 30, Clyde 9341 or emailed to: rob.visser@cohealth.co.nz Dunstan Hospital is a 32 bed acute care rural hospital located in Clyde, Central Otago. We have a part-time position available within the senior clinical team that provides acute care and rural hospital inpatient care at Dunstan. Applicants should have, or be working towards, a Fellowship with the Division of Rural Hospital Medicine of New Zealand. Applicants with other relevant specialist qualifications should also consider applying as there may be the opportunity to expand the role into some selected specialist outpatient services. The position is currently 0.5 FTE, but additional duties may allow this to be expanded. Clinical services at Dunstan Hospital include: acute 24 hour inpatient care and emergency services; a three bed high dependency unit; on-site radiology (including CT scanning); on-site lab; and outpatient specialist clinics. Outpatient treatment services include chemotherapy, day surgery (Mobile Surgical Bus), endoscopy, extensive allied health, and district nursing services. If you wish to advertise runs for Rural Hospital Medicine registrars, please contact Division administrator Helene Keating at helene.keating@rnzcgp.org.nz 7