Student samples NZ medicine
Jo spent time with New Zealand medical students during her exchange.
Jo Borgelt, based this year with SRH East & South Gippsland, spent two weeks in New Zealand on exchange.
I have just returned from New Zealand having been lucky enough to be one of two students from the School of Rural Health East & South Gippsland to be given the opportunity to undertake a two-week exchange with the University of Otago. I was based in Masterton, a town on the north island with a population of around 20,000. It is about 1.5 hours’ drive north from Wellington across ‘the hill’, a section of the highway that is regularly closed due to snow in winter.
Masterton mainly services the surrounding agricultural industries, including sheep, beef, dairy and forestry. I spent a day on a 10,000 acre, 1000-odd head cattle station on the south coast of the island and was in awe of the landscape. The stock roam free within the boundary fences and cattle grids through steep hills, freezing creeks and deep valleys. Escaped sheep from neighbouring stations also roam free growing excessively long wool, until the farmers round them up and return them (or eat them!). Closer to town the countryside is flatter and looks very similar to Heyfield where I am based here in Gippsland. Masterton is also home to the Golden Shears, the national shearing competition. This is a huge event for the town with spectator tickets sold out almost a year in advance. This also worked in my favour as I gained a lot of street-cred having a shearer as a boyfriend!
I spent the majority of my placement with the Masterton Medical Centre, the only GP service in the town. Masterton Medical employ 16 GPs and 20 nurses across a number of sites providing standard GP consultations, ED-style acute treatment bays, over the phone prescriptions and nurse triage, diabetic and respiratory nurse consultations, as well as a youth and Maori specific clinics.
I was surprised to learn of the costs involved for New Zealand patients to see their GP. While Australians are up in arms about a possible $7 co-payment, New Zealanders are paying around $40 each time they visit their doctor. The GPs are funded similarly to the British NHS in that each GP is given a lump sum of government funding each year for each patient that signs up to their “list”, regardless of the number of visits the patient has. Thus if a patient chooses to see a GP that isn’t theirs there are further fees charged by the clinic.
I spent a couple of mornings in the Maori clinic, an initiative of Masterton Medical to provide individuals that identify as Maori to see a nurse or GP for free (although donations are encouraged). This was a walk in service run by one of the GPs who had great rapport with the patients and was well trusted within the Maori community. It was here that I saw my first case of chicken pox, something I had not encountered since I had it myself as a child, due to the introduction of the vaccine to the Australian immunisation schedule (it is currently optional on the NZ immunisation schedule).
I also spent a day with the domiciliary nurse practitioner and the nursing home doctor. We visited a number of small private nursing homes in the town and I was able to participate in the management of a number of patients including palliative patients. I have gained a better understanding of chronic organ failure and the impact that this has on the patient, the family and carers from speaking to people on these visits. I also have a better understanding of the role the GP has in the care of nursing home patients and the importance of having experience and empowered nursing staff at the home who are about to make decisions, especially in end of life care.
I spent two days in the local ED department at the Wairarapa Hospital. Unfortunately these happened to be the two coldest days of my trip (it snowed!) which must have deterred patients because both days were exceptionally quiet. However following a wet week, with icy conditions and rugby season in full swing I was able to employ my Ottawa ankle rules for a number of rolled ankles requiring assessment. I was also fortunate enough to be rostered with other international students (one from the UK, another from Germany) and some doctors who were very enthusiastic about teaching, leading to a few impromptu tutorials. We became very close friends after visualising each other’s internal organs with the ultrasound machine when the department was empty!
Wednesdays were spent with the 3 other University of Otago students and their coordinator, David, discussing cases. Their model of study is VERY self-directed and I’ve grown a whole new appreciation for our ‘matrix’ of conditions that gives us at least a little direction for our learning at Monash. The other students were very welcoming of me, even taking me out for my birthday to their ‘secret pizza place’ (which was closed but it’s the thought that counts!). I was invited to people’s houses a number of times for tea and people were always offering to drive me places.
While in New Zealand I couldn’t let the opportunity to pass for some sight-seeing, even with the wet weather. I visited a light house, gorges, an alpaca farm, the Cobblestone Museum, cute little touristy towns, a wildlife park with a white kiwi and the National Shearing and Sheep museum. In the last couple of days the sun even came out and I discovered we were in fact surrounded by snow-capped mountains, previously concealed by low lying cloud.
The whole experience was fantastic. I learnt so much being exposed to a whole range of different medical professionals, each with their own ways of practice. I was also able to reflect on the systems used within the GP practice as well as the differences between government funding priorities. Thank you to everyone at Masterton Medical, Wiararapa ED, David and the other students, Alice, Nat and Erin for a wonderful time! I am an aspiring GP but I was given the freedom to spend time with any/all of the wards or health services in the town and I’d highly recommend the exchange for anyone doing 4C in East Gippsland in the future.
– Jo Borgelt