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Contents2 President’s Report - Liz Berryman3 Top10TipsforHouseOfficers4 ACEScheme8 Your Future Employer

DHB Summaries9 Auckland11 Canterbury13 Capital & Coast, Hutt Valley & Wairarapa15 CountiesManukau17 HawkesBay19 Lakes21 Midcentral23 Nelson 25 Northland27 SouthCanterbury29 Southern31 Taraiwhiti33 Taranaki35 Tauranga37 Waikato39 Waitemata41 Whakatane43 Whanganui

46 Finances50 Legal Stuff58 DiTC61 Professional Representation69 Welfare74 AbouttheNZMSAGuidetoGraduation

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A word from the President

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Congratulations, six years of medical school are done and dusted. Your long-awaited career awaits.

What kind of Doctor will you be?Over your years of medical training you would have been exposed to many sit-uations, some positive, some negative. Experiences which have been reward-ing and some which have been challenging. What did you learn from these ex-periences? What will you now take forward with you in your future practice?Your house officer roles will soon begin. You will quite likely be moving across the country to set up your new home, and you will be holding that first DHB pay check. You’ll be signing the plethora of scripts and discharge summaries and respond-ing to the incessant pager bleeps. You will be celebrating new freedom of no as-signments or looming exams and be able to tick your e-portofolio off with ease.

So my question to you is, what kind of Doctor will you be? Will you wait till you’re a reg-istrar, till you’re a consultant before you start to practice the way you would like? Or will you start at day 1? Will you start now? Will you take the time to listen to patients, even when your rushed off your feet and the ward round is taking too long? Will you say a kind word to a receptionist, a cleaner or orderly? Will you value the teaching of the con-sultants and in turn will you take time to help the students wandering aimlessly around your ward? Will you notice the colleague who is unusually quiet and take the time to ask them how they are? Will you have empathy for yourself and realise that although the six years are over, that the learning still goes on and it is impossible to not make mistakes.

Life will be busy. New responsibilities. But you will succeed. You will work through the haze of night shift and never ending ‘long-days’. You will hold the hand of a dying patient and offer words of comfort. You will be a part of the team that solves a difficult diagnosis and see a patient recover to full health. You will emerge as a confident and empowered Doctor and will have had exposure to many different aspects of the medical profession. You will be excited about the future of medicine and decide which direction your career will take.

So my question remains. Will you start your career how you intend to finish? Instead of becoming that doctor ‘some day’, will you make it ‘today’. What kind of Doctor will YOU be? We hope this guide can provide some answers and links to information regarding some of the questions you have about what lies beyond the medical school gates. We wish you all the best with your future careers and are proud of each and everyone of you.

Yours sincerely,

Elizabeth BerrymanNZMSA President 2015

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FOR HOUSE OFFICERS 1. Know your rightsIt is important that you understand the MECA (your work contract) and what it entitles you to - like leave entitlements, restrictions on working hours. If you decide to join the Resident Doctor’s Association (RDA) they play a significant role in helping you with your legal/employment rights, and they are your advocate (so if you have a problem with the RMO office or in the workplace, they can be your first port of call). There are other or-ganisations that can give you advice depending on the context, like Medical Protection Society (again, if you decide to join) and the New Zealand Medical Association (NZMA).

2. Know your responsibilities It is important, and so helpful, to read the run descriptions which your attachment is obliged to give you before you start. Not many of us actually read this, but it can save you from being dumped with responsibilities that aren’t yours and clarify what is ex-pected of you, and what is not.

3. Know where to find outAfter six years of cramming information into your head, once you start working there is very little knowledge that you actually carry around with you. Get familiar with where you can go for more information... and don’t be afraid to go there when you need to! No one will think less of you if you take a minute to double check the dose of a drug you’re not certain of or quickly re-read your hospital’s policy.

4. Know that it’s all worth itThe job can be demanding but it is highly rewarding if you choose to take that per-spective. There is recognition to be had from your patients and from colleagues - and the pay is pretty awesome too! A healthy perspective is one of the best ways of pro-tecting yourself from burn-out.

5. Know that you have to take the smooth with the roughThe major difference between the work of a doctor and other health professionals is that we are paid to get the job done - not work an x-hour shift (with the caveat that we are not abused in doing so).

TOP 10 Tips

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This means that there may be times when you work much harder than everyone else, but there will (hopefully) be equally many times when you can have a few extra coffee breaks. There is a season for everything in life.

6. Know that you are not aloneThere is no reason to freak out about having to make tough calls yourself or being swamped with an unbearable workload. Seniors, colleagues and nursing staff are all there to help if you need. All you need to do is ask.

7. Know that being nice takes you a long wayWork is a lot easier with the goodwill of nursing staff especially, and medical and allied health workers as well. Not to mention patients and their families. It requires patience but it’s well worth it in the long run.

8. Know that you are entitled to a ginormous tax refundBecause you only start work in November, but you get taxed as if you have been working the entire year, you are entitled to a tax refund - depending on which DHB/pay category you are working in - in the couple thousand dollars mark. All you have to do is call the Inland Revenue Department (IRD) and request a personal tax summary. It takes about six weeks to process, but it’s well worth it! Consider it a bonus for getting through your first half year.

9. Know that everyone will make mistakes, including youIt’s part of being human, it’s part of the art of medicine, and most importantly, it’s how we learn. So do just that, learn from it... and be a better doctor as a result.

10. Know that vital signs are vital! It’s not just talk. Never brush off an acute change in vitals.

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ACEScheme

Key Contacts for ACE ACE Consultant Phone 0800 ACE CENTRE (0800 223 236) Email: ace@kiwihealthjobs.comAddress: Level 3, Building 14, Greenlane Clinical Centre Private Bag 92189, Victoria St West, Auckland 1142

How to applyApplicants should visit http://acenz.net.nz which will take applicants to the First Year House Office application site. The page provides you with the instructions you will need as a first time applicant regarding registering with ACE and creating a login, and then completing and submitting your application. Within the download section of the site you will be able to find the Applicant Guide which provides you with all the relevant informa-tion you will need to complete your application. It is strongly advised that your read (and print) this document.

Eligibility to apply through ACE

Who is eligible to participate in the ACE programme?Category 1: Graduates from New Zealand medical schools and are citizens or permanent res-idents of New Zealand/Australia.

Category 2: Graduates from Australian medical schools and are citizens or permanent resi-dents of New Zealand/Australia.

Category 3: Graduates from New Zealand medical schools and are not permanent residents of New Zealand/Australia.

Note that the ACE Match algorithm gives preference to Category 1 applicants, then Category 2 and then 3. Please bear in mind therefore that chances of obtaining a position through the ACE process are greatest for Category 1 applicants.Applicants should be able to commence employment at the start of the relevant training year (November 2015). If an applicant is unable to start on time they must indicate this and the reason in their Cover Letter. Late start applicants will still be sent to the DHBs and will be clearly marked as late starts. This way, DHBs still have the option to rank these applicants if they are happy to accommodate the late start.

Important dates for the ACE process can be found at www.kiwihealthjobs.com/ace/graduate-doctors

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DHB PreferencesACE has changed the minimum number of DHBs that applicants are required to pref-erence from 4 to 6; however, ACE recommends that you preference at least 10 DHBs. Applicants should be aware that they may need to be flexible with their location and DHB preference and should rank as many places as they are prepared to work at.

ACE strongly recommends that an applicant does not preference a location or DHB that they are not prepared to work at as the expectation is that once offered a position it is accepted, and that declining an offer will result in the application being withdrawn from the application process and excluded from the Talent Pool.

ReferencesIt is advised that applicants talk to potential referees as soon as possible to establish whether they are willing to provide a reference and to obtain the correct contact details to provide as part of the ACE application process.

The policy set by the District Health Boards is that each applicant is required to identify, discuss and agree with 3 of the Senior Medical Officers (SMO) who have supervised them clinically in 6th year TI experience, to act as referees.

ACE will allow a few exceptions to this if the applicant is a Trainee intern going on an overseas elective during the first ½ of your TI year: One of these 3 references may be from the second half of your 5th year. OR One reference may be from your elec-tive provided it is from a hospital that is included the MCNZ list of comparable health system countries.

In addition you will still need 2 references from your supervising clinicians from your 6th year.If you have any difficulties (for example you were doing research during your 5th year and will be on elective in the first ½ of the 6th year) you should contact the ACE centre to discuss your options. Your referee must be a Senior Medial Officer who is vocation-ally registered in the specialty they are working, or a General Practitioner.References must be obtained within 2 years of graduation and from placements the applicant has completed in their final year of study.

The preference is for electronic reference submission via the ACE application process where applicants enter the referee’s details and their e-mail address and click “Send”. The ACE system will send a request for a reference to the referee which must have been agreed this with the referee in advance. The referee will then complete an online form which will then be included in your application.

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Quick tips!Students should be aware that there are a large volume of graduates that apply

through ACE and that competition for positions is high. To improve their chance of

being successful they should make sure that:

Whilst applications are open ACE respond to emails within 48 hours and if the

question requires more attention ACE will communicate this to the applicant.

CV is up-to-date and relevant

Include a Cover Letter to the DHBs

you will preference as is provides as

an opportunity to help your applica-

tion stand out from other applicants.

Write individual DHB Cover Letters

Instead of using one Cover Letter to be sent to

all DHBs write individual DHB letters

It is important to address your cover letters to

the correct DHB! Sending one to Lakes DHB

addressed to Auckland is going to look bad

Applicants must ensure that correct information is entered for the referees email ad-dress as any delay in contacting reference may delay an application. A paper down-loadable version of the Referee Report Form is available within the document section of the application site.

This can be completed and sent to the ACE Consultant to be added to an application. It is the applicant’s responsibility to ensure that all references are received and attached to the application. You will not be able to view any of the references received by the ACE Centre.

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Your future employerRMO units at a glance

DHB ProfilesThe following information about each DHB and hospital has been sourced from a previous or current RMO where possible. Each year the RDA put out a thorough review of each DHB - find more information at www.nzrsa.org.nz

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Auckland

District Health BoardWhy choose ADHB?• Largest DHB with the greatest range of sub specialties and national clinic leaders• Strong tradition of clinical education and teaching support with protected training since 1999

Key attractions to the region • CBD and bustling waterfront – restaurants, cafes, pubs and clubs• Community events – free outdoor cinema, music events, farmers market• Wide variety of ethnic food, local wine, beer and culture• Access to harbour islands, e.g. Waiheke and Rangitoto• Museum, art gallery, Sky Tower, theatre

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PGY 1 runs available • General Medicine • General Surgery •Urology • Cardiology • Orthopaedics• ORL/ENT • Neurosurgery •O&G • Vascular • Psychiatry • Renal • Geriatrics PGY 2 runs available • CTSU • Oncology • Ophthalmology• Haematology • Anaesthesia • O&G• Paediatrics • NICU • ED

PGY 1 Average pay • Medical Runs – B or C MECA run category, on average $83 944 per annum• Surgical Runs – most are a B run category, at $88 576 per annum

Vocational training offered o Anaesthesia o Emergency Medicine

Medicine And Sub-Specialties o Cardiology o Dermatology o Endocrinology o Gastroenterology o Geriatricso Haematology o Infectious Diseases o Intensive Care o Neurology o Obstetric Med-icine o Paediatrics o Pathology o Psychiatry o Public Health o Radiology o Sexual Health

Surgery And Sub-Specialties o Orthopaedics o Paediatric Surgery o Urology o Neurosurgery o ORL o Plastic Surgery o Cardiothoracic o Oncology o Renal o Respiratory o Rheumatology o Intensive Care Medicine o Obstetrics And Gynaecology o Ophthalmology Surgery o Vascular Surgery o General Surgery

Indicated number of positions available PGY 1 House Officer – 43 PGY2 House Officers – 100 Registrars and Fellows – 386 SMOs & MOSS – 800 Regular HO teaching available • Weekly teaching session on a Tuesday• ALERT course• Communication, Clinical and Procedural workshops

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Why choose CDHB? There has never been a better time to consider a career with Canterbury District Health Board. With building work well underway for the largest and most complex health care facility redevelopment in the history of New Zealand public health service you could be part of a team of professionals providing world class health care.

A career with us means working for an organisation committed to providing the best health care possible to the people of Canterbury. Opportunities exist for fantastic ca-reer development and you will gain extensive experience in a wide variety of settings.Christchurch is an exciting, vibrant, ever changing city, so much so that it has been ranked Number Two on the New York Times Fifty Two Places to go in 2014 and named as one of Lonely Planet’s Top Ten cities to travel to.

You can easily balance your career and live the lifestyle of your dreams as the beautiful Canterbury district offers recreational opportunities and a way of life that is second to none including surfing and skiing, tramping, local wineries, shopping, theatres, rugby and so much more.

Canterbury

District Health Board

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DHB selection criteria • Mandatory Cover Letter and CV • Consideration of ACE scoring (PGY1 applicants) • Like to give those from CHCH opportunity to return • References from supervisors • Preferential and Special Pathways

PGY 1 runs available• General Medicine • Cardiology • Gener-al Surgery • Emergency Medicine • ENT • Gastroenterology • Oncology • Orthopae-dic Surgery • Acute Psychiatry • Respi-ratory Medicine • Older Persons Health • Vascular Surgery • Plastic & Reconstruc-tive Surgery

PGY 2 runs available - As above +• Anaesthesia • Paediatric Medicine • Ob-stetrics and Gynaecology • Orthopaedic Rehabilitation • Spinal Unit • Perioperative Medicine • General Practice • Cardiotho-racic Surgery • Haematology • Orthopae-dic Outpatients • Neurology • Neurosci-ence • Nephrology • Ophthalmology • Psychiatry - Crisis Resolution • Psychiatry –Forensic • Psychiatry - Eating Disorders• Urology • Various Relief Runs

PGY 1 Average pay 2015Medical Runs – C or B MECA run catego-ry, on average $83 944 per annumSurgical Runs – C or B MECA run catego-ry, on average $83 944 per annum

Types of roster: Rosters vary across specialties however to give you an idea: Medical runs – most consist of • 1-2 long days per week (0800- 2300) • 1 in 7 weekends (0800-2300) • 1 in 7 sets of night duties worked (set = 7 consecutive nights)

Surgical runs – most consist of • 2 long days per week (0800-2300) • 1 in 6 weekends (0800-2300) • 1 in 6 sets of night duties worked (set= 7 consecutive nights)

Vocational training offered All specialties of Medicine and Surgery; Psychiatry; Emergency Medicine; Inten-sive Care Medicine; Anaesthesia; Public Health; Pathology including Anatomical Pathology, Microbiology & Biochemistry; Obstetrics & Gynaecology; Paediatrics, Ophthalmology, Radiology.

Indicated number of positions avail-able PGY 1 House Officer – 44 PGY 2+ House Officer – 106 Registrars – 300

Regular HO teaching available • Weekly RMO Teaching on Wednesday afternoons for PGY1s and PGY2s • RMO Grand Round once a month • Skills Sessions • PGY2 Peer Re view Session • Additional PGY2 Teaching Pro gramme • Annual Careers Event

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Capital & Coast, Hutt Valley and Wairarapa District Health BoardsWhy choose the Wellington Region? • Make a fresh career choice and join us in Wellington, New Zealand. • Wellington has repeatedly been voted New Zealand’s top life- style city and is the cultural and creative hub of the country - renowned for its café culture, fantastic restaurants, sparkling har-bour and close proximity to vineyards.• Rotations are available across all 4 of our hospitals means you can meet all of your training requirements within the one region; this includes the possibility of Rural at-tachments. • You’ll love working with us. We have a great team, a culture that values and involves people and a reputation for our relationships with our community and our willingness to take the initiative. Key attractions to the region • More Cafes and Restaurants per capita than New York City • Strong Arts and Cul-tural scene including the World of Wearable Arts, as well as Live theatre, music and festivals, beaches • Wineries in the Wairarapa region• Wairarapa Balloon Festival • Dowse Art Gallery in Lower Hutt• Multitude of outdoor activities and sports including the annual dragon boat festival.

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DHB selection criteria • Cover Letter • CV • References • Applicant interview process: Phone interview along with expres sions of interest letter • Consideration of ACE scoring • Individual DHB selection criteria e.g., studied in the region, family ties, career progression and aspirations.

PGY 1 runs available • General Medicine • Cardiology • Gen-eral Surgery • Orthopaedics • Urology • Plastic Surgery • AT&R • Otolaryngology • Vascular • Rehab

PGY 2 runs available• Plastic Surgery • Orthopaedics • Emer-gency Medicine • Paediatrics • Psychiatry • Gastroenterology• Oncology • Haematology • Respiratory • Renal

PGY 1 Average pay • Medical Runs – on average most of the Medical Runs are Category D, some are C and above.• Surgical Runs – on average most of the Surgical Runs are Category C, some are B.

Types of roster exampleMedical runs – most consist of • 1 long day per week • 3-4 weekends per run • 1 set of Nights per runSurgical runs – most consist of • 1 long day per week • 3-4 weekends per run • 2 sets of Nights per runHutt Hospital runs – most consist of • 8-9 long days per run • 2 weekends per run • 2 sets of Nights per runWairarapa Hospital runs – most consist of • 5 long days per run • 2 weekends per run • 2 sets of nights per run

Vocational training offered • Plastic & Reconstructive Surgery • Anaesthesia • General Surgery • Cardiothoracic Surgery • Clinical Genetics • Rheumatology • Radiology • Emergency medicine • General Surgery • Intensive Care Medi-cine • Internal Medicine • Neurosurgery • O&G • Ophthalmology • Otolaryngology • Paediatric Surgery • Paediatrics • Palliative Medicine • Pathology • Radiation Oncology • Rehabilitation medicine • Urology • Vascular Surgery

Indicated number of positions PGY 1 House Officer – 43 PGY 2 House Officer – 64 Senior House Officers – 22 Registrars – 208

Regular HO teaching available • Weekly teaching session on a Tuesday afternoon 1200 – 1400. • ALERT course

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Counties Manukau District Health BoardWhy choose Counties Manukau? • Supportive friendly environment• Diverse range of patient presentation• Busy attachments but incredibly rewarding clinical work and huge opportunities for learning

Key attractions to the region • Local markets • Polynesian festivals • Botanic gardens • Bushwalks • Theme park • Orchards and local produce

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DHB selection criteria • Optional Cover Letter • CV • References • Consideration of ACE scoring • PVTC Selection and Allocation Policy including preferential pathways and Fit for Purpose Practitioner model

PGY 1 runs available• General Medicine Psychiatry • Geriatrics • Paediatrics • General Surgery • Orthopaedics

PGY 2 runs available • Plastic Surgery • ICU/HDU • Renal • Cardiology GP Placement Rehab • O&G • Rheumatology • Stroke

PGY 1 Average pay Medical Runs – B or C MECA run catego-ry, on average $83 944 per annum Surgical Runs – most are a B run catego-ry, at $88 576 per annum

Types of roster Rosters vary across specialties however to give you an idea;Medical Runs – most consist of• 1-2 long days per week (0800-2230)• 1 in 3 weekends (0800- 2230 and 0800 – 1600)• 1 in 6 night duties worked in sets of 2 and 5 consecutive nights Surgical Runs – most consist of• 1-2 long days per week (0800-2230)• 1 in 3 weekends• 1 in 6 night duties worked either in sets of 4 or 7 consecutive nights

Vocational Training Offered • Anaesthesia • Emergency Medicine

Medicine And Sub-Specialties• Cardiology • Dermatology • Endocri-nology • Gastroenterology • Geriatrics • Haematology • Infectious Diseases • Intensive Care • Neurology • Obstetric Medicine • Oncology • Renal • Paediatrics • Pathology • Psychiatry • Public Health • Radiology • Sexual Health • Respiratory • Rheumatology • Intensive Care Medicine • Obstetrics And Gynaecology • Ophthalmology

Surgery And Sub-Specialties • Orthopae-dics • Paediatric Surgery • Urology • Neurosurgery • ORL • Plastic Surgery• Cardiothoracic Surgery • Vascular Surgery • General Surgery

Indicated number of positions available PGY 1 House Officer – 44 PGY2 House Officers – 62 Registrars and Fellows – 261 SMOs & MOSS – 352

Regular HO teaching available• Weekly teaching session on a Tuesday • Smart shop, Pro shop, Safe Shop work-shops 2 days in duration • ACLS Course

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Hawkes Bay District Health BoardWhy choose Hawkes Bay DHB?About Hawkes Bay Hospital and the District Health Board:Hawkes Bay Hospital is a 400 bed secondary hospital located in Hastings. All special-ties are on site (except Cardiothoracics, Plastics and Neurosurgery). Serving a regional population of approximately 160,000, Hawkes Bay Hospital is one of the country’s largest provincial hospitals and has a key role in providing a high level of care to the wider Hawkes Bay, Wairoa and Central Hawkes Bay.

Our region has a population of close to 160,000 people, most of who reside in or around the twin cities of Hastings and Napier. There is a strong sense of community in Hawkes Bay, and whatever your interest, chances are there will be clubs and com-munity organisations who will offer you a warm welcome. Restaurants, cafés, arts and cultural activities rival those on offer in bigger centres.Hawkes Bay is only four hours drive from Wellington, five hours drive to Auckland, and an hour and half to Taupo with its famous trout fishing lake, rivers, ski fields and re-sorts.

For more information on our lovely part of the work and to find out more about our enviable lifestyle, visit these websites: Tourism Hawkes Bay www.hawkesbaynz.com Hastings District Council www.hastingsdc.govt.nz Napier City Council www.napier.govt.nz

Key attractions to the region We are big enough to offer variety, challenge, quality learning and development oppor-tunities and collegial support.At the same time we are small enough that friendships flourish, commuting can be fun (nearly 200km of cycle trails connect the main centres of Napier, Hastings and Clive) and we take your work/leisure life balance seriously (supporting staff wellness is an organisational KPI).

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DHB selection criteria • Mandatory Cover Letter • Consideration of ACE scoring • Individual DHB selection criteria TI placement in HB Family connec tions to HB

PGY 1 runs available • General Medicine • General Surgery • Assessment & Rehab• ENT/Dental/Ophthalmology • Orthopaedics • Psychiatry • Urology • Relief (4th quarter only)

PGY 2 runs available In addition to above • Emergency Medicine • Obstet-rics & Gynaecology • Paediatrics

PGY 1 Average pay • All 1st year runs are paid at Category C - $82,589 Non UrbanScale of the MECA.• Relief runs are paid at Category A - $104,825

Types of rosterHouse Officers will work on average 55 -59.5 hours per week, including:3-4 weekends per quarter 1-2 rostered evenings per week 1-2 weeks of night shift per quarter (1st years do not do nights until the 3rd quarter)Number of weekends rostered on average • 3-4 weekends per quarterVocational training offered Diplomas in Obstetrics & Gynaecology and PaediatricsBasic and Advanced training in: • Anaesthetics (including ICU)• Emergency Medicine• Medicine • Obstetrics & Gynaecology • Paediatrics • Psychiatry • Surgery (Gen Surgery, Orthopaedics and Urology)

Indicated number of positions PGY 1 House Officer – 18 PGY 2 House Officer – 28 Anaesthetic Registrar – 9 Emergency Medicine Registrar – 10 ICU Registrar – 6 Medical Registrar – 16 O&G Registrar – 6 Ophthalmology Registrar – 1 Orthopaedic Registrar – 6 Paediatric Registrar – 6 Psychiatric Registrar – 2 Rural Registrar – 1 Surgical Registrar – 6

Specialties:Hawkes Bay District Health Board offers a wide range of services, including sub-spe-cialties as follows:

General Medical including Respiratory, Neurology, Cardiology, Infectious Disease, Endocrinology, Dermatology, Gastroen-terology, Rheumatology, Gerontology and Renal.

Surgical and Orthopaedic - including runs in Ophthalmology, ENT, Urology, Gynae-cology, Maxillo-facial and Dental, Paediat-ric and neo-natal services, Intensive Care Unit, HDU and Coronary Care, Emergency Department, Radiology, Operating The-atres and Anaesthetics, Dental and Public Health Services, Mental Health and Addic-tion Services.

Regular HO teaching available • Informal teaching• Formal teaching – Grand Rounds, Clini-cal meetings within specialties, Pathology meetings, Clinico-Radiology meetings, weekly teaching sessions.

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Lakes

District Health BoardWhy choose Lakes DHB? Friendly & supportive atmosphere, modern facilities. Gain hands-on experience in a wide range of clinical conditions. Easy access to outdoor activities like kayaking and mountain biking.

Key attractions to the region• Lakes and Mountains Skiing• Mountain Biking • Fishing • Kayaking • Beaches • Tramping • Maori culture

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DHB selection criteria• Prefer a personalised cover letter• Consideration of ACE scoring• Personal or family connection to the Lakes DHB area Keen interest in working at Lakes DHB (ie: visited prior to applying) • Identify as Maori or Pacific Island ethnicity PGY 1 runs available • General Medicine • Rehabilitation• General Surgery • Psychiatry • Orthopaedics

PGY 2 runs available • ICU/Anaesthetics • ED• Orthopaedics/ENT • Paediatrics • Rural • GP • Obstetrics & Gynaecology

PGY 1 Average payCategory C – non urban

Types of rosterRosters vary across specialties however to give you an idea;• Medical attachment– most consist of1 long day per week (0800-2300) Average 1 in 3 weekends (0800-2300 and 0800 – 1600) I set of 7 nights per quarter. Nights not worked in first 6 months as a PGY1. Number of weekends rostered on average Rosters vary across specialties however to give you an idea;• Medical Runt– on average 1 in 3 weekends are rostered Surgical Runs – on average 1 in 2 weekends are rostered

Vocational training offered • General Surgery • Anaesthetics • General Medicine • Radiology • Paediatrics • Ophthalmology • Obstetrics & Gynaecology • Psychiatry

Indicated number of positions available PGY 1 House Officer – 12 PGY 2 House Officer – 7 Radiology Registrar - 1 Ophthalmology Registrar - 1 Medical Registrar – 9 Paediatric Registrar - 2 Surgical Registrar –5 O&G Registrar - 2 Anaesthesia Registrar – 2 Orthopaedic Registrar - 5

Regular HO teaching available • Weekly teaching session on a Wednesday & Thursday• Department teaching Grand Round PLS. NLS. ACLS, PROMPT

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Midcentral

District Health BoardWhy choose MDHB? • We are a modern 356 bed hospital• We provide a supportive learning environment• Plenty of “hands on” experience• All first year runs have registrars and consultants• 5 relief positions to cover leave absences• Excellent library facilities• 5 minutes from city centre – no traffic hassles!• Affordable living expenses

Key attractions to the region• Tramping • Mountain biking • Fishing/hunting • Kayaking• World class car, truck, motor bike racing and equestrian events at Feilding’s Manfield Park• 2 hour drive to Ruapehu and Turoa ski fields• 2 hour drive to Wellington• 3 hour drive to Taupo• 30 minutes to Himatangi Beach

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Midcentral

District Health BoardWhy choose MDHB? • We are a modern 356 bed hospital• We provide a supportive learning environment• Plenty of “hands on” experience• All first year runs have registrars and consultants• 5 relief positions to cover leave absences• Excellent library facilities• 5 minutes from city centre – no traffic hassles!• Affordable living expenses

Key attractions to the region• Tramping • Mountain biking • Fishing/hunting • Kayaking• World class car, truck, motor bike racing and equestrian events at Feilding’s Manfield Park• 2 hour drive to Ruapehu and Turoa ski fields• 2 hour drive to Wellington• 3 hour drive to Taupo• 30 minutes to Himatangi Beach

DHB selection criteria for applicant selection • Academic Achievement Record• References• Consideration of ACE scoring• Personal interests/hobbies• Cover letter giving reason for choosing Palmerston North eg studied here, family ties

PGY 1 runs available • General Medicine • Respiratory • Elder Health • General Surgery • Orthopaedics • ENT • Obstetrics & GynaecologyPGY 2+ runs available • ICU • Cardiology • Emergency • General Practice • Haematology • Mental Health • O&G • Oncology • Orthopaedics • Paediatrics • Psychogeriatrics • Rehab/Neuro • Renal • Relief • Urology

PGY 1 Average pay • Medical Runs – C MECA run category $82,589 per annum• Surgical Runs – C MECA run category $82,589 per annum• O&G Runs – B MECA run category $92,911 per annum

Types of roster:• General Medical runs – most consist of• 1-2 long days per week (0800-2230)• 1 in 3 weekends (0800-2230 and 0800 – 1600)• 1 in 13 night duties worked in sets of 7 consecutive nights• General Surgical, Specialty Medical & Surgical runs – most consist of• 1-2 long days per week (0800-2230)• 1 in 3 weekends (0800-2300 Sat and Sun)

• 1 in 13 night duties worked in sets of 7 consecutive nightsNumber of weekends rostered on average:Medical Runs – on average 1 in 3 weekends are rosteredSurgical Runs – on average 1 in 3weekends are rostered

Vocational training offered • General Surgery • Orthopaedics • ENT • Urology • General Medicine and Subspecialties • Anaesthetics • Obstetrics & Gynaecology• Paediatrics • Radiology • Radiation Oncology • Medical Oncology • Haematology• Emergency Medicine • Palliative Care • Mental Health

Indicated number of positions available PGY 1 House Officers – 18 PGY 2+ House Officers – 47 Registrars – 83

Regular HO teaching available • Weekly HO teaching sessions on Wednesday and Friday • Grand rounds for Medicine and Surgery • ACLS

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Nelson

District Health BoardWhy choose NMDHB? • As advised by our present 1st Years –• Nelson is a neat close knit hospital that offers a greater level of clinical experience and just happens to be located in the sunshine capital of NZ with good weather throughout the year• Nice city/beaches/national parks• Great kayaking, mountain biking, rockclimbing, tramping• Friendly hospital• Supportive Consultants and Registrars who are keen to teach.• Lots of 1:1 learning• Lots of hands on learning/procedures e.g. ascetic drains, chest drains, intubation, time in theatre• Lots of opportunities to be involved in frontline patient care• Good opportunities to continue post grad training• Very satisfying workplace.• 3 National Parks and a Forest Park within about an hours drive containing approx 90 backcountry huts• Supportive and helpful RMO Unit

Key attractions to the region • Lifestyle• Beaches/Rivers• Wineries/Breweries• Mountain Biking, Kayaking, Tramping, Rock Climbing, Sea Swims, Cycle Races, Beach Volleyball etc etc• Stable Consultant Staffing.

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DHB selection criteria • Mandatory Cover Letter – no.• Applicant interview process- conducted throughout the year and leading up to selection.• Consideration of ACE scoring.• Individual DHB selection criteria (e.g., studied in the region etc, can work effectively/collegially in a small group)

PGY 1 runs available • General Medicine • General Surgery • Orthopaedics/Dental• Orthopaedics/Ophthalmology • Geriatrics • Psychiatry • Urology • Gynae/ENT• Relief (variety of above)

PGY 2 runs available• Anaesthetics • Emergency • Cardiology • GP Rural • O&G Diploma • Paediatric Diploma • Community Psychiatry

PGY 1 Average pay • All runs are Category C $82,589 except General Surgery whichis a Category B $92,119 (run review being carried out this year to determine Cate-gory going forward). PGY1’s can do relief in the 3rd of 4th Quarters on Category A $104,825.

Types of roster • Generally 1 long day per week (0800 to 2300)• 1 in 4 weekends (one day long, one day short)• 7 straight nights. At present no nights in PGY1 year.

One set per quarter in PGY2 and up years. PGY1’s cover week long 1600-2300 shifts instead of nights.

Number of weekends rostered on average Rosters vary across specialties however to give you an idea;• Ward Roster – on average 3 weekends per quarter• ED Roster (PGY2 and up) 4-5 weekends per quarter

Vocational training offered • General Medicine • Cardiology • General Surgery • Orthopaedics • Psychiatry• Urology • Paediatrics • Anaesthetics • O&G • Ophthalmology• Emergency• Paediatric Diploma • O&G Diploma

Indicated number of positions available PGY 1 House Officer – 10 PGY 2 House Officer – 23 Registrars (various) – 25

Regular HO teaching available • Weekly teaching sessions 12.30pm to 1.30pm Tuesday, Wednesday, Thursday and Friday. • 2 days Airway Training in Theatre. • Advanced Cardiac Life Support Courses.• Other miscellaneous course e.g. PROMPT, Paed Life Support, Family Violence, Simulations.

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Northland

District Health BoardWhy Choose Northland DHB Step up - Up north.Choose Whangarei for the first step of your medical career. Be close to the action with small teams, a wide variety of services and plenty of opportunities to learn and im-prove. Make Whangarei your home for two years or more and spend time in the highly regarded Emergency department, Paediatrics or as an O&G house officer working side by side with consultants. Work in an environment that is about supporting your devel-opment. Get to work alongside specialists, be able to access support for further study and take advantage of a workplace that rewards those who want to go above and beyond. Whangarei can take 12 applicants each year, make sure that you are one of them!https://www.facebook.com/NorthlandDHB http://www.northlanddhb.org.nz/

Hunting, fishing, diving, canoeing, tramping and surfing, as well as all the usual leisure and sporting activities. Other activities include, walking/hiking, horse riding, a whole variety of sports and tourist-based activities from tandem skydiving through to dune surfing and quad biking and some of the best golf courses in New Zealand.

http://www.northlandnz.com/ Information correct as of February 2015 however is subject to change.

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DHB Selection Criteria• Cover Letter Essential• Applicant Interview at applicant request• Consideration of ACE scoring• NDHB scoring including have you worked in the region, do you have personal connections to the region, career intentions.

PGY1 Runs Available • General Medicine • Renal Medicine • General Surgery • Orthopaedics • Urology PGY2+ Runs Available • Assessment & Rehabilitation • Emergency Medicine • Eyes/ENT • O&G • Paediatrics • Psychiatry • Relief

PGY1 Average Pay Medical and Surgical Based runs are C or D category, on average$73,058-$82,589 NDHB is currently a hard to staff community under the Voluntary Bonding Scheme.

Types of Roster Medical or Surgical based attachments will work on a 10/4 roster. On average you will work:• 1 Long day per week• 1-2 Short day Weekends with the preced-ing Monday and Tuesday rostered off per attachment• 1-2 Long Day weekends with the follow-ing Thursday and Friday rostered off per attachment• 7-11 night shifts per attachment worked in blocks of 4 and 3 nights Number of weekends rostered on average

Rosters vary across the specialties howev-er, PGY1s allocated on Medical or Surgical based attachments will work on a 10/4 roster. On average you will work:• 1-2 Short day Weekends with the preced-ing Monday and Tuesday rostered off per attachment• 1-2 Long Day weekends with the

following Thursday and Friday rostered off per attachment

• 1-2 Long Day weekends with the following Thursday and Friday rostered off per attachment.

Vocational Training Offered NDHB is committed to training with support for courses, diplomas and study.• Anaesthesia • Emergency Medicine • ENT/ORL • General Medicine • General Surgery • Geriatrics • Intensive Care • Orthopaedics • Paediatrics • Psychiatry• Renal • Urology

Training in a regional centre provides excel-lent “hands on”, well supervised training. Whangarei has close links with Auckland hospital. They provide tertiary care and many sub-specialists do outreach clinics in Whan-garei. There are also close links with tertiary centres for educational purposes. There are positions available for basic and advanced trainees with college accredited Registrar training jobs in most specialties.

Indicated Number of Positions Available PGY1 – 12 PGY2 – 32 SHO – 2 Registrar – 49

Regular HO Teaching AvailablePGY1 teaching is scheduled twice weekly on a Tuesday and Thursday for 1.5 hours.

Whangarei Hospital • RMO lounge• On-site clinical library• Free on-site 24/7 staff gym• Free on-site outdoor swimming pool• Two on-site cafeterias• Social Club

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South Canterbury District Health BoardKey attractions of the region • Large picturesque coastal town• Central Location – approx 2 hours from Christchurch and Dunedin• Many outdoor recreation opportunities, such as boating, surfing, camping, tramping, climbing and skiing• Within easy reach of sea, lakes, rivers and mountains• SCDHB Tekapo Holiday Home• Good range of pubs/bars, cafes and restaurants• Multiplex Movie Cinema • 1-2 Long Day weekends with the following Thursday and Friday rostered off per at-tachment

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PGY 1 runs available • General Surgical/ Ophthalmology / Dental / ENT / Pain Clinic• General Medical/Age Care • Orthopaedics PGY 2 runs available • Gynaecology • Emergency Department • Paediatrics• Anaesthetics • Age Care/Psychiatry • Medical Relief • Surgical Relief • Night Relief

PGY 1 Average pay • Medical Runs – C MECA run category, on average $82,589 per annum• Surgical Runs – most are a C MECA run category, at $82,589 per annum, one B at $92,199 per annum Types of roster • Most runs consist of on average• 1 long days per week (0800-2300)• 1 in 3 weekends (0800-2300 and 0800 – 1600)• 1 in 7 night duties worked in sets of 7 consecutive nightsNumber of weekends rostered on average• Medical/Surgical Runs – on average 1 in 3 weekends are rostered

Indicated number of positions available PGY 1 House Officer – 7 PGY2/ SHO – 14

RMO Run Feedback ‘Lifestyle-work balance is good here’ ‘No registrars + only a few medical students = way more experience’ ‘You feel like a valued member of the team, not just a paper pusher’ ‘Where else will you go straight from manipulating a femur in orthopaedic theatre to holding the camera in a laparoscopic appendectomy’ ‘Whatever run you do, there are always opportunities to branch out and see a wide range of clinical scenarios’ Ranking and selection criteria/ process’

With no registrars and a relatively small team of RMO’s, candidates need to have a reasonably high level of academic achievement and clinical competence. Most impor-tantly candidates must be able to demonstrate the following characteristics: • Supportive team member • Flexible attitude • Resilience • Self-confident but aware of limitations • Excellent communication skills • Understanding of the Timaru hospital environment • Strong desire to work here

Referee reports carry considerable weight and the RMO Coordinator is keen to talk to anyone interested in working here.

Contact Details: Andrea McAlister, RMO Coordinator, 03 687 2389 amcalister@scdhb.health.nz

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Southern

District Health BoardWhy choose SDHB, Dunedin?Dunedin is a 300 bed tertiary hospital offering experiences in a wide range of special-ities, both Surgical and Medical. The Hospital enjoys close ties with the University of Otago and prides itself on creating excellent learning opportunities for junior staff.

Key attractions to the region Wide and varied including:• Excellent beaches for surfing and exploring• Close to Central Otago• Great wildlife attractions• University of Otago (research options for many Registrars)

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DHB selection criteria • Cover Letter required • Consideration of ACE scoring • Consideration given to ACE referee reports • Contact with Prevocational Educational Supervisor and RMO Unit indicating a desire to work in Dunedin Hospital

PGY 1 runs available • General Medicine • Cardiology • General Surgery • Orthopaedics • Psychiatry • Older Person’s HealthPGY 2 runs available • Obstetrics and Gynaecology • Paediatrics • Emergency Medicine • Gastroenterology, • Haematology • Oncology • Renal • Respiratory • Neurosurgery • Neurology • Ophthalmology • Cardiothoracic

PGY 1 Average pay • All of the runs are Band C on the urban scale, except for one run which is Band D.Types of roster Rosters vary across specialties however to give you an idea;Most runs consist of:• 1 long days per week (M – F 0800-2230)• 1 weekend day every 2 – 3 weeks (0800-2230)• Split nights (4/3)

Vocational training offered For PGY2+ Dunedin offers a wide range of vocational training options.

Indicated number of positions available PGY 1 House Officer – approximately 15 -17

Regular HO teaching available • Weekly teaching session, the University of Otago’s Grand Round. • Thursday protected teaching times are sessions arranged by the RMO Unit utilsing staff’s areas of interest.

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Taraiwhiti

District Health BoardWhy Taraiwhiti?Learn and experience what real doctors do from your first year here as we have no registrars so that means lots of hands-on experience under the guidance of our fan-tastic supportive SMO team. Flat at a reasonable cost with your work colleagues in a beach-side mansion, enjoying your early morning surf and sunny bike to start work. Fire up that BBQ!

Key attractions to the region• Beaches / Surfing• Wineries• Outdoor Lifestyle• Sunny Weather• Eligibility for MOH Voluntary Bonding Scheme

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DHB selection criteria • Good Mandatory Cover Letter - required• Preferred either did university attachment/medical elective or have local connections to the area (either through family or friends/current H.O’s)• Personally came and visited TDH and met RMO co-ordinator and/or Pre-Vocational Educational Supervisor and kept regular email contact since

PGY 1 attachments available: • General Medicine • Orthopaedic • General SurgeryPGY 2 attachments available:In any given quarter • Emergency (2) • Paediatrics (2) • Anaesthetics/ED (1)• Reliever (2) • Repeat either Gen Surg/Gen Med or Orthopaedic (2)

PGY 1 Average pay • Category C (ave wkly hrs 55-59.9) • Non-Urban• Year 1 • $82,589 p.a (under MECA now expired 30.11.13)

Types of roster• PGY1 Roster – 2.5 Weekends per H.O quarter (when working weekend you work 10 Rostered days on then 4 Rostered Days Off ) and 10 Evening Shifts (long days) per H.O quarter. – NO NIGHTS AT ALL FOR PGY1 ROSTER

• PGY2 Roster – 14 Roster overnight shifts per H.O quarter (split x2 sets of 3 consec-utive nights and x2 sets of 4 consecutive nights – with the following 2 full calendar ros-tered days off) and 6 Evening Shifts (long days) per H.O Quarter

Number of weekends rostered on average • PGY1 Roster 2.5 weekends per House Officer Quarter • PGY2 Roster 2 weekends per House Officer Quarter

Vocational training offered • G.P Training from PGY3 + • Rural Hospital Medicine Training from PGY3 + • Diploma of Child Health – PGY2 • APLS – PGY2

Indicated number of positions available PGY 1 House Officer – 9 PGY 2 House Officer – 9

Regular HO teaching available• Weekly teaching session on a Tuesday lunchtime (protected)• Ground Rounds every Wednesday• Departmental teaching sessions including formal (journal clubs, grand rounds etc.) and informal one-on-one teaching during daily ward rounds

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Taranaki District Health BoardWhy choose Taranaki DHB? Taranaki Base is a great place to work and learn. Junior staff find that the hospital pro-vides a very supportive and friendly working environment. We have a stable Consultant and experienced nursing base to help through those tricky times.

You really get to know everyone and you get enough time off to enjoy the lifestyle. New Plymouth itself is a vibrant and progressive town and Taranaki is a province with virtual-ly unlimited opportunities for recreation. People love living here.

Key attractions to the region • Beaches • Mountain Biking • Surfing • Kite Surfing• Hiking • Watersports • Fishing • Entertainment and arts • Endless outdoor opportu-nities • Easy relaxed lifestyle

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DHB selection criteria• Although not mandatory a cover letter is useful and is your opportunity to stand out.• Formal interviews are not conducted.• ACE scoring is taken into account with different selection panel members placing their own weighting to each criteria.• Taranaki DHB are looking for applicants with good communication skills who work well in a team and are motivated with a genuine interest in working at Ta-ranaki DHB.

PGY 1 runs available • General Medicine • Orthopaedics • General Surgery

PGY 2 runs available In addition to the PGY1 runs above, PGY2 HOs also have the following runs available to them:• Emergency • Medical Admitting/Relief • O&G • Paediatrics• GP (dependent on recruitment)

Types of roster • 1 long day per week (0730/0800-2300hrs)• 2 weekends per quarter (0730/0800-2300hrs)• 1 set of night duties per quarterNumber of weekends rostered on aver-age • Generally 2 weekends per quarter

Vocational training offered• General Surgery• Orthopaedics• Psychiatry• General Medicine• O&G• Paediatrics• Rural Hospital Medicine• Anaesthetics

Indicated number of positions available PGY 1 House Officer – 10-12 PGY 2 House Officer – 25 Medical Registrar – 9 Surgical Registrar – 6 Anaesthetic Registrar – 6 Orthopaedic Registrar – 5 O&G Registrar – 2 Paediatric Registrar – 2 Psychiatry Registrar – 1

Regular HO teaching available • Weekly protected teaching session on a Tuesday and/or Wednesday• Grand Round every Thursday• Departmental teaching one day per week

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TaurangaDistrict Health BoardWhy choose BOP DHB – Tauranga Hospital? • 285 bed hospital• Good supervision and well supported• Small enough to be inclusive and big enough to see a wide variety of patients• Good location (no traffic jams!)

Key attractions to the region• Location, location, location• Beaches• Proximity to other regions

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DHB selection criteria • Cover letter essential • Interview process for shortlisted candidates

PGY 1 runs available • General Medicine • Health in Aging • Psychiatry • General Surgery • Orthopaedics (2nd qtr on) PGY 2 runs available As above, plus: • Emergency • O & G • Paediatrics• ENT/Urology

PGY 1 Average pay • All PGY 1 & 2 dedicated runs are remunerated at Category C• Reliever Category A

Types of roster• 1- 2 long days per week• Split nights (4:3)• PGY1’s do not work night duties in the first 6 months

Number of weekends rostered on average1:4 to 1:5 average (inclusive of night duty allocation)

Vocational training offered• All runs at Tauranga Hospital are accredited towardsvocational training

Indicated number of positions available PGY 1 House Officer – 18 PGY 2 House Officer /SHOs – 35 Medical Registrar – 22 Surgical/Orthopaedic Registrar – 17 Anaesthesia Registrar – 8 Radiology – 5 O & G Registrar – 6 Paediatric Registrars – 5 Emergency Registrars – 7 Psychiatric Registrars – 8

Regular HO teaching available• Dedicated Teaching Wed & Thurs; Grand Round Tues; Weekly Service based teaching

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WaikatoDistrict Health BoardWhy choose Waikato DHB? • A few years ago we surveyed our house officers and asked them why they had cho-sen Waikato DHB. These were some of their top reasons for wanting to further their careers here:• Excellent senior and junior teaching staff• Supportive atmosphere with friendly and flexible working environments• Wide range of specialties on one campus – loads of opportunities to learn proce-dures• Friendly & helpful RMO unit dedicated to working with and for you• No traffic or parking problems• Availability of good, affordable accommodation close to the hospital• Fantastic lifestyle• On average, less demand on your time after-hours and at weekends than other hos-pitals

Key attractions to the region• Beaches • Skiing • River - rowing • Cycling • University • Fieldays • Hamilton Gar-dens • Balloons over Waikato • A super rugby team that wins

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DHB selection criteria • Waikato DHB uses both the scoring cri-teria established by ACE, as well as a set of DHB specific criteria (eg, Waikato listed as an applicant’s first choice, whanau / fami-ly connections, TI or medical attachments completed here)• Applicant interview process • Interestingly enough – we are getting increasing numbers of TIs from Otago Med-ical School being ‘matched’ to Waikato DHB

PGY 1 runs available • General Medicine • Orthopaedics• Cardiology • Plastics • General Surgery • Paediatric Surgery • Haematology • Rehabilitation • Mental Health • Respira-tory • Neurology

PGY 2 runs available • As above + • ICU/HDU/ED • Surgical Reliever • Cardiothoracic • Medical Reliever • Vascular • ENT • Anaesthetics • Renal • GP training • Paediatric Medicine • Thames Rural hospital • O & G • Community Practice (new) • Gastorenterology • Neurology

PGY 1 Average pay • During the first 6 months, we do not roster PGY1s on tonights, so their run cate-gories reflect this• Paediatric surgery = ‘E’ category [$61,085]• Mental Health and Rehabilitation = ‘D’ [$70,247]• Medical and surgery runs range from ‘C’s in the first 6 months to ‘B’s in the second 6 months [$79,412 - $88,576] when they may be rostered to night duties.

Types of roster Paediatric Surgery• 4 x weekends per quarter (0800-2230)

• No long days or nights• Medical and surgical runs – mostly con-sist of :• @10 - 13 long days per quarter (0800-2230) • Up to 3 weekends per quarter (0800-2230 and 0800 – 1600)• 1 x set of 7 night duties (7 consecutive nights) in second 6 months only may be rostered Mental Health• Cover the medicine after hours roster, so 10 x long days and 3 x weekends per quar-ter • No nights Haematology• 4 x long days per quarter (0800-2230)• 4 x weekends per quarter (0800-1200 ‘on duty’ then ‘on call’ from 1200-2230)• 1 x set of 7 night duties (7 consecutive nights) in second 6 months only may be rosteredNumber of weekends rostered on average Rosters vary across specialties but in gen-eral terms: Medical Runs – up to 3 x weekends per quarter (Mental Health PGY1s cover on the medicine & respiratory after hours ros-ter) Surgical Runs – up to 2 x weekends per quarter Paediatric Surgery – up to 4 x weekends per quarter but no long days Vo-cational training offered • Vocational training is offered in all specialty services exceptneurosurgery

Indicated number of positions available House officers - 110The house officers configuration at present is: PGY1s = 42FTE (30 NZ graduates + 7 x NZREX + 5 x Internal graduates) PGY2s = 26 and SHOs = 42

Regular HO teaching available• Weekly teaching session on a Tuesday (this is protected teaching time with pagers being held for the duration of the teaching)

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WaitemataDistrict Health BoardWhy choose WDHB?WDHB is a particularly good run for PGY1s because it has so many general runs avail-able. From this general platform you can launch into your chosen specialty with confi-dence.

Key attractions to the region • Sparkling East Coast swimming beaches• Rugged West Coast surf beaches• Vineyards• Orchards and local produce• Hot pools• Bushwalks• Suburban shopping areas and markets• Access to island ferries

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DHB selection criteria• Optional Cover Letter• CV• References• Consideration of ACE scoring• PVTC Selection and Allocation Policy including preferential pathways and Fit for Purpose Practitioner model

PGY 1 runs available • General Medicine Psychiatry• Cardiology Orthopaedics• General Surgery Geriatrics

PGY 2 runs available • O&G • ECC• ED • Haematology• Urology • Forensic Psychiatry

PGY 1 Average pay • Medical Runs – B or C MECA run cate-gory, on average $83 944 per annum• Surgical Runs – most are a B run cate-gory, at $88 576 per annum

Types of roster Rosters vary across specialties however to give you an idea;• Medical runs – most consist of• 1-2 long days per week (0800-2230)• 1 in 3 weekends (0800-2230 and 0800 –1600)• 1 in 6 night duties worked in sets of 2 and 5 consecutive nights• Surgical Runs – most consist of• 1-2 long days per week (0800-2230)• 1 in 3 weekends• 1 in 6 night duties worked either in sets of 4 or 7 consecutive nights

Vocational Training Offered • Anaesthesia• Emergency Medicine• Medicine And Sub-Specialtieso Cardiology o Dermatology o Endocri-nology o Gastroenterology o Geriatrics o Haematology o Infectious Diseases o Intensive Care o Neurology o Obstetric Medicine o Oncology o Renal o Respira-toryo Paediatrics o Pathology o Psychiatry o Public Health o Radiology o Sexual Health

Surgery And Sub-Specialties • Orthopaedics • Paediatric Surgery • Urology • Neurosurgery • ORL • Plastic Surgery • Cardiothoracic Surgery • Vascular Surgery • General Surgery • Rheumatology • Intensive Care • O&G • Ophthalmology

Indicated number of positions available PGY 1 House Officer – 43 PGY2 House Officers – 100 Registrars and Fellows – 386 SMOs & MOSS – 800

Regular HO teaching available • Weekly teaching session on a Tuesday and Thursday• ACLS course• Procedural skill workshops• Case presentations and case based learning

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WhakataneDistrict Health BoardWhy choose BOP DHB – Whakatane Hospital?• 110 bed hospital• Good supervision and well supported• Opportunities to learn directly from Consultants• Good location and the best beach in NZ!

Key attractions to the region• Over the hill to Ohope• Beaches• Lifestyle

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DHB selection criteria• Cover letter essential

PGY 1 runs available • General Medicine• Psychiatry• General Surgery• Orthopaedics (2nd qtr on) PGY 2 runs available As above, plus:• Emergency *”Accredited for Rural Medicine Trainees”• O & G *”Accredited for Rural Medicine Trainees”• Paediatrics *”Accredited for Rural Medicine Trainees”

PGY 1 Average pay • All PGY 1 & 2 dedicated runs are remunerated at Category C• Reliever Category A

Types of roster• 1- 2 long days per week• PGY1’s do not work night duties in the first 6 monthsNumber of weekends rostered on average 1:4 average(inclusive of night duty allocation)

Vocational training offered • Accredited for ED/ O& G & Paeds for Rural Medicine Trainees

Indicated number of positions available Total number of RMO Runs: PGY 1 House Officer – 6 PGY 2 House Officer/SHOs – 13Regular HO teaching available• RMO Teaching occurs daily 12-3:00pm

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WhanganuiDistrict Health BoardWhy choose WDHB?• Close working relationship with the Consultants/Supervisors• Optimal time in theatre during surgical runs• Good RMO/Consultant ratio• Great place to start your medical career• More responsibility and opportunity at a junior level, making treatment decisions rath-er than just clerking patients• Whanganui Hospital has a wide range of services with general medicine, general surgery, orthopaedics, O&G, ENT, ophthalmology, dental and psychiatry included. Our Critical Care Unit caters for the majority of our intubated patients, with further support and other specialties provided by Palmerston North Hospital and tertiary care at Wel-lington Hospital.

Key attractions to the region • With everything ‘at the backdoor’, your move to Whanganuiwill allow you to experience our special connection to the outdoors. It’s easy getting to the mountain to ski or tramp, to the lake or sea to fish or boat, or getting to the beach for a surf or quiet walk. Whanganui boasts an exciting arts community and facilities, a mix of local and travelling music talent, educational and sporting facilities for all ages, historical buildings and culture and all only a two-and-half hour drive (45 minute scenic flight) to our capital city, Wellington. See our link on moving to Whanganui http://www.wdhb.org.nz/content/page/move-to- whanganui/m/2722/

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DHB selection criteria:• Mandatory Cover Letter- required• Consideration of ACE scoring• Individual DHB selection criteria: Lived/family & studied in the region NZ permanent resident/citizen

PGY 1 runs available • General Medicine • General Surgery• Orthopaedics • Paediatrics• Emergency Department • Psychiatry• Geriatrics/rehab PGY 2 runs available • General Medicine • General Surgery• Orthopaedics • Paediatrics• Emergency Department • Psychiatry• Geriatrics/rehab • O&G

PGY 1 Average pay • Medical Runs – C run category, on aver-age $82,289 p/a• Surgical Runs – C run category, on aver-age $82,589 p/a

Types of rosterRosters vary across specialties however to give you an idea;• General Medical & General Surgical runs – most consist of• 1-2 long days per week (0800-2230)• 1 in 3 weekends (0800-2230 and 0800 – 1600)• 1 in 4 night duties worked in sets of 3 and 4 consecutive nights

• Emergency Department- most consist of• 1 in 2 weekends, including nights (2130 – 0830)• 1 in 3 night duties worked in sets of 3 and 4 consecutive nights

• Psychiatry- most consist of• 1 in 3 weekends (0800 – 1600)• 1-2 long days per week (0800-2230) & on call to 0800• No night shift

Number of weekends rostered on averageRosters vary across specialties however to give you an idea;• Medical Runs – on average 1 in 3 week-ends are rostered• Surgical Runs – on average 1 in 3 week-ends are rostered• Emergency Runs – on average 1 in 2 weekends

Vocational training offered • Orthopaedics• Psychiatry

Indicated number of positions available PGY 1 House Officer – 4 to 6 PGY 2 House Officer – 0

Regular HO teaching available• Weekly ED teaching session on Tues• Weekly teaching by other specialities• NLS• ACLS• Prompt• Airway Study Day• Trauma Study Day

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FinancesOne of the best things about starting work is the freedom you gain from earning your own money. What many people aren’t prepared for, are the financial decisions you need to make when you start making money, so here are our top tips for new grads.

A LITTLE TIME NOW MEANS A BIG PAY OFF IN THE FUTUREThe earlier you set up a plan, the quicker your debt will shrink, your savings grow, and your financial goals become a reality.

Step 1. “Where do I want to be?”Before you start living pay-to-pay, how do you see your life in one year? Five years? 10 years? Ideally they’ll be specific -“I want to buy a house for $500,000 in six years” – but it is ok if it is simply, “I want to enjoy and maintain my lifestyle for the next couple of years”.

Step 2. “Where am I now?”You need a starting point. What is your income going to be? What will the DHB give towards your KiwiSaver account? What are your regular expenses? How much debt have you got?

The more you know the better.

Step 3. “How do I get there?”This is your plan. You can build it yourself, with the help of some useful websites, or an MAS adviser can go through one with you.A good plan will cover three main areas: Debt Management, Savings & Investments, and Risk Management.

DEBT MANAGEMENT

Student LoanDon’t be scared of your student loan debt. Choose the right tax code, and you’ll be making minimum repayments of 12 cents of every dollar you earn (over $19,084) di-rectly from your pay.

How long will that take to pay it off? What if you want to go overseas for a bit? Does that fit with your plan?

Currently, student loan debt is interest-free while you’re in New Zealand, but if you are overseas for 184 days or more in the year, interest can be charged.If your goal is to go overseas for more than six months, contact the IRD, consider how it may impact you, and plan for it.

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Other DebtIf you have other debt, and your goal is to clear debt, focus on paying off the high-in-terest debt first.This may mean repaying more towards this, or consolidating it with a lower interest rate loan. Come up with a plan, and stick to it.

SAVINGS & INVESTMENTSGet into a good savings habit early, and make sure your money is working as hard as possible towards your goals.

KiwiSaver/SuperannuationAs a DHB-employed doctor, you’re entitled to matching contributions, towards DHB-approved superannuation accounts, of up to 6% of your salary (less tax).Provided you’re contributing 6% of your salary towards one (or more) of these, with the DHB contributions, you’ve almost doubled the money you put in, before it has even been invested!

The first step is to decide whether these superannuation accounts are suited to you and your goals. The next is to make sure that the superannuation account is being invested in a way that you’re comfortable with and understand.Talk to a MAS adviser about the benefits and restrictions of these types of products, and how to choose the investment best for you.

Getting onto the property ladderRetirement can seem a long way off when you’re starting your first day as a doctor, so many young doctors are using KiwiSaver accounts to save towards a first home. With your own contributions, DHB contributions, and some Government contributions working towards that goal, getting a good deposit can be quicker than you think.It pays to make sure your KiwiSaver is being invested with a shorter investment time-frame in mind.

Other savings goalsRather than leaving any spare cash in an everyday cheque account, put it into a high-interest earning account.

For young grads, there may be options for tax-saving investment accounts. For ex-ample, a Portfolio Investment Entity (PIE) is a great option, because the investment is taxed differently to a standard savings account. Under this structure, it looks at what you’ve been earning in the previous two financial years, as opposed to what you’re currently earning – for many young grads who haven’t earned any taxable income in their 5th and 6th year of med school, this may mean a tax rate of 10.5% as opposed to 33%.

RISK MANAGEMENTWhile optimism isn’t a bad thing, it won’t pay the bills when things go wrong. By all means, maintain a positive outlook, but have a “Plan B” just in case.

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Some risks are easily avoided – if I don’t own a car there is no risk of it being sto-len, some you can manage yourself – if my iPhone is stolen I can afford to replace it, while others could be so expensive that they are better managed by someone else – whoops, I accidentally burnt down the flat! MAS – help!

What risks are worth someone else managing?In short, it is the ‘worst-case-scenario’ risks. While the likelihood of some these hap-pening is small, if the risk isn’t zero, it is still a risk, and you should have a plan.• If you’re too sick to work• How long will the DHB provide you with sick leave?• What happens after they’re all gone?• How much does it cost to pay the bills, and who will pay them?• What about all my goals?!• Do I have to move home?!

An income security policy will have someone else manage the risk, by giving you an alternative income if you’re too sick/injured to work and earn your own. This alternative income can allow you to pay the bills, maintain your independence, and maybe even continue saving, until you’re able to get back to working and earning.• If you accidentally damaged your flat• How much would it cost to repair a burned down/flooded house?

You could be charged tens, or hundreds of thousands of dollars for the repair. It is unlikely you’ll have that sort of money lying around, but it can be easily managed with legal liability insurance. This can be found within many contents insurance policies, effectively managing the risk of you damaging/losing your own stuff or someone else’s.• If you make a mistake at work?• What if a patient lodges a complaint against me?• Who do I talk to?Do not forget professional indemnity cover.

IN SUMMARY• Set aside some time, before you start work, to come up with a plan• Address your debt• Get into a savings habit• Prevent risks where possible, but have a cure ready just in case

Useful websites include www.sorted.org.nz , www.ird.govt.nz and www.kiwisaver.govt.nz/already/get-money/early/firsthomeIf you need help or have any questions, contact a MAS adviser today by phoning 0800 800 627 or email info@mas.co.nz

This article is of a general nature and is not a substitute for professional and individually tailored advice. MAS is a Qualifying Financial Entity (QFE) under the Financial Advisers Act 2008. Our QFE disclosure statement is available at mas.co.nz or by calling 0800 800 627.

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Legal Stuff Medical Liability All doctors require medical practice indemnity which can be obtained through the Medical Protection Society, the New Zealand Medical Professionals’ Medical Indemnity Insurance, the New Zealand Resident Doctors’ Association’s professional liability insur-ance programme, or Medicus. The costs of practice indemnity for hospital doctors will be met by the employing DHB.

The MECA Contract All District Health Boards use the Resident Doctors’ Association and District Health Boards Multi Employer Collective Agreement (RDA MECA). This agreement contains the terms and conditions of employment for house surgeons employed at DHBs in New Zealand. Under New Zealand employment law, if a workplace uses a MECA, all new employees must be employed under that MECA for the first thirty days of their employment. All new house surgeons must be employed under the RDA MECA for their first 30 days of employment. Therefore, when you are offered a position at a DHB, the contract you will be presented with will be a copy of the RDA MECA. You will be automatically signed up to this MECA and your employment will be covered by the terms and conditions outlined in the document.

The purpose of this 30 day ‘window’ is to give new employees time to make the deci-sion whether or not to join the RDA (the union). If you choose to join the RDA within the first 30 days, your employment will continue under the MECA. If you have not joined the RDA within the 30 days, you will be required to sign an individual employment agreement (IEA). The DHB will supply you with a copy of this IEA. The IEA is based on the MECA, so the same terms and conditions will apply. You can also choose to join the RDA at any time outside the 30 days, even if you have signed an IEA. In this situa-tion, as soon as you join the RDA, you will automatically be covered by the MECA and your IEA will no longer be in place. One of the roles of any union is employee repre-sentation. If you become a union member, the union will represent you if you have any employment issues or need employment advice. The New Zealand Medical Associa-tion will also provide their members with employment advice, but they do not offer a representation service for employment issues.

Medico-Legal Matters Dr Samantha King of the Medical Protection Society explains why medicolegal matters are so important, and how to avoid common traps for young players. Medicolegal prin-ciples underpin clinical practice. It is often cases where there are ethical or legal dilem-mas which are the most challenging and interesting.

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However, in all cases it is important that doctors apply clinical knowledge in a way that is legally and ethically appropriate; to consult senior colleagues and avoid working in a vacuum. Simple things like writing concise and accurate records, getting valid consent from patients and knowing when to seek advice can help you practise safely.

All health providers need to be familiar with the Code of Health and Disability Consum-ers Rights. The Code sets the standards of service that a consumer has the legal right to receive, and a doctor has a duty to provide. When something goes wrong with the care of a patient it is these rights and duties which will be referred to if there is a review by an authority such as the Health and Disability Commissioner.

The Medical Council of New Zealand is responsible for ensuring that doctors are fit to practice and sets standards of conduct and competence which must be adhered to. If a doctor does not meet the standards set by the Medical Council then there is a risk of restrictions being placed on the doctor’s scope of practice, or even losing registra-tion completely. This is a very high price to pay given the many years of dedication and work required to gain registration as a doctor in the first place.

Avoiding traps for young players Doctors at the start of their career face some particular medico-legal hazards and so you may find some tips to avoid the five most common ones helpful.

Consent You should not feel pressured to do anything beyond your knowledge, experience and competence, this includes obtaining consent for a procedure that you are not familiar with. Always get a senior to explain or demonstrate it as part of training. Failure to take consent properly can lead to medico-legal problems including com-plaints and disciplinary proceedings. If your actions are scrutinized you’ll need more than a signature on a consent form to fight your corner. Consent is a process, rather than a form-filling exercise.

Survival tips #11. Always act in your patient’s best interests.

Record in the notes what a patient has been told.

2. Use your common sense – consent is patient specific and depends on

the individual’s circumstances, including age, lifestyle, occupation,

sporting interests, expectations etc.

3. It may well be that you are not in a position to advise fully, for example

with professional sports people.

4. Ensure that information given to patients is in a form which they can

understand.

5. Patients are presumed competent to consent unless proved otherwise.

6. A competent adult can refuse treatment.

7. The law concerning incompetent adults, who are unable to give valid

consent, is more complicated. If you are in doubt consult senior

colleagues.

8. Remember there are circumstances where a child can give consent

without reference to a parent – if in doubt consult a senior colleague.

Prescribing If you are unsure about a prescription, or mishear on a ward round, always seek clarifi-cation, never guess.

When prescribing, the hazard warning lights in your brain should be flashing per-sistently. This is one of the most dangerous areas for all clinicians. From over-pre-scribing, transferring incorrectly to new charts and prescribing for the wrong patient, toforged prescriptions and overdoses, incorrect dosages, interactions, and allergies, prescribing is fraught with complications. It is imperative that you have a good knowl-edge of the pharmacology and the legislation surrounding drugs, and the hospital protocols and controlled drug routines – if unsure, ask. Always document allergies and double check names, doses, frequency and, in some cases, (like anticonvulsants), brand names. You should not feel pressured to do any-thing beyond your competence always ask a senior for advice. If a patient is admitted and there is any doubt regarding their current medication then consult the ward phar-macists or the GP. Handovers are another tricky area. Teams must work together in the allotted time to ensure that the clinically unstable patients are identified, plans for further care are put in place and tasks not yet completed are clearly understood by seniors and juniors. Make sure that the patient information is written clearly for the handover team. 52

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Confidentiality Doctors who break a patient’s confidence undermine trust in the medical profession. As well as the common law duty of confidentiality, doctors need to abide by the privacy legislation and the Health Information Privacy Code (HIPC). Privacy issues often cause difficulties for doctors who can easily be caught in the middle between their patient, families and third parties such as employers, insurance companies or the Police. The Privacy Commissioner has helpfully summarised the HIPC Code for health providers as follows:

1. Only collect health information if you really need it. 2. Get it straight from the people concerned where possible. 3. Tell them what you’re going to do with it. 4. Be considerate when you’re getting it. 5. Take care of it once you’ve got it. 6. People can see their health information if they want to. 7. They can correct it if it’s wrong. 8. Make sure health information is correct before you use it. 9. Get rid of it when you’re done with it. 10. Use it for the purpose you got it. 11. Only disclose it if you have a good reason. 12. Only assign unique identifiers where permitted.

Survival tips #21. Prescriptions should clearly identify the patient, the drug, the dose,

frequency and start/finish dates, be written or typed, and be signed by

the prescriber.

2. Be aware of a patient’s drug allergies. 3. Good handovers require good leadership and communication.4. If you seek and receive advice from a senior about a prescription, write

that advice in the notes. Refer to the New Zealand Formulary or similar

reference manual.5. Verbal prescriptions are only acceptable in emergency situations and

should be written up at the first available opportunity. Particular care

should be taken that the correct drug is used.

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The starting point should be that information you receive about a patient’s health should not be disclosed to anyone not directly involved with that person’s health care without the patient’s consent. If you disclose information without the patient’s consent you must have a clear justification for this.

Survival tips #31. Before breaching confidentiality, always consider obtaining consent.

2. Take advice from senior colleagues.

3. If considering passing a patient’s health information to another party

without the patient’s consent, have a clear understanding of your justification

for doing so first with reference to the Health Information Privacy Code.

4. Doctors are required to report to various authorities a range of issues,

including notifiable diseases (e.g. TB).

5. The courts can require doctors to disclose information, although it

would be a good idea to contact MPS if you find yourself presented with a

court order or a police request for patient information.

6. High-risk areas where inadvertent breaches of confidentiality can occur

are lifts, canteens, computers, printers, wards, clinic reception areas, patient

waiting areas, A&E departments, pubs, and restaurants.

7. Be careful not to leave memory sticks or handover sheets lying around.

8. Be sure not to disclose any patient identifiable health information on

social media, Facebook, Twitter etc...

Record Keeping Keeping good notes provides you with the best backup should your care be called into question at some point in the future, though legible notes must be kept primarily to assist the patient when receiving treatment. Notes are a reflection of the quality of care given so get into the habit of writing comprehensive and contemporaneous notes.

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Probity The public expects doctors to have the highest standards of honesty, integrity and ethical behaviour, and the Medical Council requires this. Remember also that there can be professional accountability for behaviour in your private life, such as any criminal conviction. Doctors must be honest and trustworthy when signing forms, reports and other documents and any documents they write or sign must not be false or mislead-ing. This means that doctors must take reasonable steps to verify the information in the documents, and must not deliberately leave out anything relevant. You may encounter families who don’t want certain information visible on the death certificate, but doctors have a legal and professional obligation to complete the certificate truthfully.

Survival tips #41. Always date and sign your notes, whether written or on computer. Don’t change them. If you realise later that they are factually inaccurate, add a cor-rection, but do not delete the original entry.

2. Any correction must be clearly shown as an alteration, complete with the date the amendment was made, and your name. 3. Making good notes should become habitual.

4. Document any decisions made, any discussions, information given, rel-evant history, clinical findings, patient progress, investigations, results, con-sent and referrals. Do not write anything in the notes that you would not be comfortable saying directly to the patient.

5. Remember that email communications between colleagues about a pa-tient may be made available to the patient if an information request is made by them or their family.

6. Only include things that are relevant to the health record. 7. Be wary of including ‘third party’ information in the health record (for example, information about a relative of the patient). 8. Patients have a right to access their own medical records, and many exercise this right.

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Things to remember:• If you are uncertain double check your work with a senior. • Take steps to verify what you are saying. Never sign a form unless you have read it and you are absolutely sure that what you are saying is true. • Probity means being honest and trustworthy and acting with integrity. • Be honest about your experiences, qualifications and position. • Be honest in all your written and spoken statements, whether you are giving evidence or acting as a witness in some legal process. • You must be open and honest with any financial arrangements with patients and em-ployers, insurers, and other organisations or individuals. • Assume that all records will be seen by the patient and/or others, e.g. coroner, Health and Disability Commissioner.

There are medico-legal aspects to all cases, and these should be viewed as interesting and challenging, though very important to get right. If uncertain consult with a senior colleague or get expert advice from one of the medico-legal advisers at MPS(0800 22 55 677).

Useful Links• Medical Council of New Zealand (www.mcnz.org.nz). The “Resources” tab

leads to a number of standards and guidelines published by the Council.

• Health and Disability Commissioner (www.hdc.org.nz). The Code of Health

and Disability Consumers Rights can be found here as well as a range of informa-

tion about the Commissioner’s office and copies of investigations carried out.

• The Medical Council’s statement on Information and Consent:

(www.mcnz.org.nz/portals/0/publications/20 11BInformation and Consent.pdf).

• The Privacy Commissioner has published a “toolkit” for health providers:

(www.privacy.org.nz/health-privacy-toolkit).

• The Medical Council’s foundation document on standards for doctors is at:

(www.mcnz.org.nz/portals/guidance/goodmedpractice.pdf)

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Doctors in Training CouncilWhy belong to the NZMA?New Zealand’s health system is undergoing change and constantly evolving.As a newly fledged doctor and member of a vocation dedicated to the service of oth-ers, you will soon develop an opinion on the system you will find yourself working in, and ideas on how things could be done better for your patients and their communities.Who is representing your interests and advocating on your behalf?The New Zealand Medical Association (NZMA) is the largest medical professional or-ganisation in New Zealand with approximately 5,000 members. It is pan-professional in that it represents member doctors from all disciplines within medicine, at every stage of their careers, including medical students.

As the only medical professional organisation that draws its membership from all areas of medicine, the NZMA is one of the strongest and most important voices we have as doctors. A strong membership base enables the NZMA to be an influential advocate for the profession and to help advance the medical profession and the health of all New Zealanders.

The NZMA proactively advocates, and develops submissions and position statements in response to crucial issues affecting health as well as Government policy proposals and other health sector initiatives.

The NZMA Doctors-in-Training CouncilThe NZMA Doctors-in-Training-Council (DiTC) is made up of elected representatives that work on behalf of Trainee Intern, Resident Medical Officer (RMO) and medical student members. Our key aims are to ensure that all doctors-in-training are valued by the health system, and that service delivery does not compromise the quality of train-ing or the number of training positions available in New Zealand.

The DiTC has a busy time ahead as it seeks to influence and advocate on your behalf for the following issues:• Using our position on the Health Workforce New Zealand Workforce • Taskforce to ensure there are adequate jobs and training opportunities nationally• Getting transparent data on these jobs and training positions for the use of RMOs• Changes to the prevocational training years, including the compulsory community-based attachments• Workplace bullying and wellbeing of RMOs• Supporting the NZMSA on the 7EFTS cap• Wider issues affecting the health system, including the Trans Pacific Partnership Agreement (TPPA), the Korean Free Trade Agreement, and obesity

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We recognise that a high quality training environment is critical in the recruitment and re-tention of doctors to ensure that our country has a sustainable, high performing health-care system. The quality of the training experience must remain the number one priority with adequate training time, mentoring, support and supervision in order for this to be the case.

Find out moreWe encourage you to have influence in shaping your future and our health system by keeping up to date with what the DiTC is doing.

• Read more about the DiTC’s activities and meet your representatives at http://www.nzma.org.nz/about-nzma/nzma-structure-and-representatives/councils/dit-council.We are also keen to hear your views and to know what issues concern you most. The DiTC recognises that to be effective, ongoing dialogue with its members is essential.

• We are always interested in hearing about your experiences and point of view to better represent your interests, so contact us at ditc@nzma.org.nz.

• Connect with your peers on our Facebook page (search for NZMA Doctors-in-Training Council).

The online NZMJ Digest also contains regular updates from DiTC members on the work that we are doing, you’ll be sent the link via email (10 issues per year) or access current and past issues through the NZMA website.

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Professional RepresentationThe NZMSA Doctors-in-Training Council (DiTC) is made up of elected representatives that work on behalf of trainee intern, RMO and medical student members. The council has a busy time ahead as it seems to influence and provide input into issues such as: The proposed revamp of prevocational years. The Careers Intention Plan for PGY1s. College Specific issues that may affect those looking to apply to training programmes. The move towards generalist type training. Potential impact of physician assistants on doctors’ work environments.

The underlying goal behind these issues is the need to improve the recruitment and retention of doctors to ensure our country has a sustainable high performing health-care system. To retain doctors in New Zealand, they need to feel valued by our health system and for doctors-in-training it is particularly important that service provision does not compromise training. The qualitiy of the training experience must remain the num-ber one priority with adequate training time, mentoring, support and supervision.

The DiTC’s members (which include the President of the NZMSA and a PGY1 repre-sentative) contribute towards developing submissions and position statements in re-sponse to policy proposals and other health sector initiatives.

Why belong to the NZMA? Surveys have shown that the majority of NZMA members join to demonstrate their commitment to the profession. A strong membership base enables the Association to be an influential advocate for the profession and to help advance the medical pro-fession and the health of all New Zealanders. We encourage you to have influence in shaping your future and our health system by keepingup to date with what the DiTC is doing. We are also keen to hear your views and to know what issues concern you the most. The DiTC recognises that to be effective, ongoing dialogue with its members is essential. We understake online surveys to improve our understanding of the issues that affect you and to ensure out advocacy is representative of your views. Last year we ran a survey on prevocational training which proved very valuable, as it provided a clearer idea of what our members think of Health Workforce New Zealand’s (HWNZ’s) proposed changes in this area.

Moving from medical school to vocational training brings with it new opportunities and challenges. The DiTC hosts a national Trainee Forum, attended by representatives of the medical colleges, which enables trainee reps to share information and have input into shaping their training experience. Dialogue is crucial - the trainee’s voice is often hidden because of clinical commitments and lack of access. At the Forum reps have the oppurtunity to discuss the issues with HWNZ and the Medical Council of New Zea-land and to hear from senior colleagues. It all adds up to meaningul input into issues that will affect careers into the future.

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Political representation mattersDr Anna Choi, a former PGY1 representative on the DiTC, articulated very well why political representation matters: “Caring for the patient sitting across for us isn’t limit-ed to those 15 minutes of interaction; it is linked to much broader issues of training, workforce capacity and public policy. As individual clinicals we have a responsibility to partake in these issues, whether by awareness, voting for represenation and/or being a voice in the debate.”

Find out moreRead more about the DiTC’s activities and meet your representatives at www.nzma.org.nz/Doctors-in-training We also encourage you to connect with your peers on our Facebook page (search for NZMA Doctors-in-Training Council). DiTC representatives are always interested in hearing about your experiences and point of view to better represent your interests, so contact us at ditc@nzma.org.nz. Also, don’t forget to read Tinnitus - a succinct and informative newsletter that we email to all our DiTC members throughout the year.

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A message from the Residents Doctor’s AssociationWelcome to the profession!The New Zealand Resident Doctor’s Association (NZRDA or the RDA) is the represen-tative organisation that was set up by the Resident Doctors (also known as Resident Medical Officers - i.e. House Surgeons and Registrars) over 25 years ago to provide support, advocacy and industrial power to our group of doctors. It is governed by a National Executive made up of resident doctors from around the country assisted by a network of delegates from the range of hospitals and other work envionments (e.g. GP) and training speciailities within which we work.

The RA negotiates our terms and conditions of employment which are contained with-in the MECA (Multi Employer Collective Agreement). Everything above the minimum wage and statutory obligations are held in here. This includes a meal provided for lunch (breakfast on nights and dinner on a long day), limits on the hours worked; e.g. a max-imum 16 hours a day and 72 in the week, guaranteed every other weekend free from duty.

When you first start working you will automatically be covered by the RDA MECA for the first month and within that time you have to choose if you want to continue to be covered or not. By joining the RDA you will ensure continuation under our MECA and you will get the advice, back up and protection afforded by our organisation. With any problems that may be encountered we have levels of support starting with a friendly chat from one of our local hospital delegates or delegate support officers in the office ranging up to our in house solicitors or even our barrister. You will also be supporting your colleagues, past, present and future, in improving and maintaining our lot in life.

Protection from working night duty for the first three - six months as a doctor (improved from the Medical Council’s rule of six weeks). Cost of the Annual Practicing Certificate and indemnity insurance being reimbursed, along with the costs of training (which can certainly mount up, especially in registrar training programs) as well as salary and other provisions such as leave entitlements etc.

When you move from your place of residence as a TI to your first job, up to 50% of the cost of moving is reimbursed. Our provisions are some of the best in the world for resident doctors, however they do demand on-going work (and sometimes a battle) to maintain what those doctors who have gone before us have fought hard to achieve.

Obviously we don’t just negotiate a MECA. NZRDA is involved in working with the wide range of health and government organisations to improve the world within which we live and worl. Our presence reminds “the system” that resident doctors exist and are important not only to the current delivery of quality medical care, but the future as SMOs and GPs.

Other services offered by NZRDA include superannuation through Tower, indemnity insurance and income protection insurance. We strongly recommend joining up with superannuation as this is effectively an automatic 6% pay rise! Talk to a financial advi-sor for specifics but you will be better off with the extra money, however you arrange the details. According to law you will automatically be enrolled in Kiwisaver when you start work, and every time you change DHBs. If you don’t want to be in Kiwisaver, you need to opt out early on. You can split your contributions, e.g. 2% Kiwisaver, 4% su-perannuation, and the DHBs will match you.

Once you become an RMO if you are interested in becoming involved as a delegate or finding out more about the union, a delegate training four-day weekend takes place every March. Leave for the four days is provided for under MECA as employment rela-tions education leave (EREL) and must in all but exceptional circumstances be granted by your DHB. Your accomodation, flights etc are fully funded from our Education Trust for this. To find out more email us and come along!

You can join the RDA by visitiing www.nzrda.org.nz and filling in the forms online, for students it will cost $10 per year. You also need to choose one of the payment options. We recommend the easiest option of a monthly automatic payment with internet bank-ing.

Any problems, either talk to a local delegate, call 0800 803 993 or email membership@nzrda.org.nz.

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In many aspects, doctors enjoy better health compared to the general population. However, medics are often poor at seeking appropriate help when health problems develop1. Some take the saying “physician heal thyself” too literally and do not partic-ipate in health screening; do not have their own general practitioner, self-prescribe or self-refer to specialists. As well as being contrary to the Medical Council of New Zea-land’s “Statement on providing care to yourself or those close to you”2 there is a signif-icant risk that a doctor’s health care is sub-standard by not having their own GP and accessing services appropriately. A doctor with an unrecognised or untreated health problem may unknowingly be impaired and be providing less than ideal care to his or her patients as a result. It is very important that every doctor has their own GP and they consult appropriately and in a timely fashion.

An area where doctors appear to have worse health than the general population is in mental health and substance abuse. The step from being a student to becoming a junior doctor brings significantly increased stress and is a time when it is important to be aware of your health and how to keep well. Occupational health statistics from the UK suggest that the highest rates of work-related mental ill health occur in medical practitioners and members of the armed forces3 . These findings apply to doctors early in their career as well as those towards the end. It is not clear whether this higher rate of mental angst and ill-health is attributable to the dominant personality characteristics of individuals who become doctors, the nature of working in the health business or a combination of these factors. Identified sources of stress which may lead to mental health problems are: - work pressure – workload, inadequacy of resources and poor support - nature of work - high demand and low control, in conjunction with the inherent trauma of dealing with suffering - poor relationships with colleagues - particularly poor team working - service pressures - investigations, complaints and court cases, including in quests. Easy access to prescription and non-prescription drugs, and the ubiquitous presence of alcohol in New Zealand culture, adds to the challenges of mental well-being of doc-tors.

Throughout medical school, you’ve no doubt been inundated with messages about the importance of your own wellbeing. Hopefully, by the time you graduate, you’ll have your own coping mechanisms in place for times of stress.

The transition from student to doctor is a time when you will no doubt need these strategies to help kee you a functioning human being, but it is also a period where it can seem like there is no time for anything other than work.

Welfare

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1 Kay MP, Mitchell GK, Del Mar CB. Doctors do not adequately look after their own physical health. Med J Aust 20042 Medical Council of New Zealand “Statement on providing care to yourself or those close to you” http://www.mcnz.org.nz/portals/0/Guidance/Statement%20on%20providing%20care%20to%20yourself%20and%20those%20close%20to%20you.pdf3 Mental health and ill health in doctors, UK department of Health, February 2008http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset-dh_083090.pdf

Here we look at some hopefully familiar techniques for looking after your-self, along with some practical ways to integrate them into hospital life. The following also include insights from NZMSA’s ‘the first year’ blog which can be found in full at http://www.nzmsa.org.nz/category/the- first- year/.

Don’t forget your relationshipsYour family friends and partners are so important and all too easy to take for granded. Although they no doubt understand how time consuming med-icine is, that’s not a free pass to let your non-medical relationships wither. These people know you; even though you may spend what feels like 23 and a half hours every day with your medical team, and they know exactly how you like your cof-fee, they may not know that the day you put two sugars in that coffee is not shap-ing up to be a good day. Your family and friends do know these things about you, so they are well placed to recognise when your stress has turned into distress.

Not to mention, even though it may be wonderful to have someone enthuse with you over how fantastic the actual medicine is, you also need conversations with people who don’t know the difference between a CABG and a cabbage. So make time for them, it doesn’t need to be a huge chunk of your day or a late night out; meet at a cafe near the hospital, go around to their place with a movie, or even chat over Skype!

Have your own GP(After finally making use of a GP, Anna Choi writes) “It wasn’t just because of what he (the GP) offered for my problem in that moment, but, rather a sense that I was now no longer alone in my holding responsibility for my health, and that there was some sort of accountability, documentation, and safety net I could rely on over time. A fresh, objective set of eyes. working in conjunction with an experienced medical brain. If Joe Bloggs down the street is entitled to this (also known as healthcare), are we not also?”

A GP is an objective set of eyes, with their main agenda being your health. A good GP is worth their weight in gold and deserves some scouting out. Don’t lose touch with the family GP or, if you’ve moved cities, scout out the lo-cal practice at the same time you’re finding the nearest supermarket and cafe.

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“An important part of growing into this new role of being a “doctor” is knowing when we need to relinquish it to some degree. This is easier said than done because like I menioned earlier, being a doctor is not like a coat we can take on and off, but rather, a new skin we grow into. With that, we’ll never be able to fully separate ourselves from our identity as a doctor. But in those moments when it comes to our own health and well-be-ing, and of those we love, it’s important that we recognise that we are only human.”

Be active If the thought of 5:30am gym sessions makes you shudder,

try getting your daily quota of exercise by walking/cycling to work, joining

a social sports team, or investing in a console like Wii or Kinect. Remem-

ber that you’re getting plenty of exercise running around the hospital, so

whatever form of activity you choose, it should be fun and relaxing.

Don’t forget to sleep There’s nothing you can do about your long

days, but you can optimise the time you have to sleep. If you need a peri-

od of time for your brain to switch off before you can fall asleep, put away

your computer (Facebook and Twitter updates are not more important

than your pillow) and try reading a non-medical book, listening to music

or even trying some meditation exercises. And, of course, cut out the late

night caffeine and alcohol.

You only get out what you put inNutri-Grain has got a point here, and the food you put into your body has conse-quences on your ability to do work and provide the best care for your patients. Howev-er, when you’ve got patients to see, and you’re run off your feet, it can be hard to find the time to eat a banana, let alone sit down for lunch!

However, if you want to be at the top of your game, hypoglycaemia and dehydration are not your friends! If you don’t have time for lunch, carry arround some trail mix or muesli bars, and try to sit down and enjoy your snack, even if its only for two minutes.

There’s nothing better than a home cooked meal at the end of a day, so try making use of a slow cooker; everything can go in the pot in the morning, ready for you to en-joy later. Or cook en masse when you have an empty afternoon, and freeze the meals for the coming week. And if all this is just too much work and you’re craving the fast fix of takeaways, search for a sushi or salad bar, there are more healthy takeaway stores emerging, it’s just a matter of finding your favourite.

Be self aware Everyone has different warning signs, and it’s import-ant to take heed of yours. Whether it’s withdrawl from those around you, an increase in your alcohol intake, a shorter temper, or stopping those activites you normally enjoy, be aware of your body and mind’s needs to take a breather.

You have spiritual needs too Finding a higher meaning in life can make dealing with hardships, such as the inevitability of a dying pa-tients, easier to bear. Take comfort in your religion or if you are not reli-gious, spirituality can mean finding beauty in nature, faith in humanity, or a myriad of other simple pleasures.

Take the time to focus on the positive, because even though you are sur-rounding by death and dying in a hospital, you are also surrounded by hope, and love, and small miracles every day.

Have faith in yourselfBeing responsible for someone’s health is a big deal. There will be times that you feel out of your depth and down right scared, but don’t lose faith in yourself and your abil-ities. You survived six years of medical school; those around you clearly believe that you’re capable and worthy of the responsibility of the Dr preface to your name, so don’t let your self doubt hamper you.

“With time and experience, you start to notice yourself becoming more confident in your clinical judgement and skills. That wonder you once had as a fourth year medical student watching the house offer get a patient’s consent or take that ABG oh so slickly is replaced by - unconscious competence. Clinical acumen develops only with experi-ence; experience is only possible by logging in the hours, by spending all day everyday seeing patients. You learn by watching, by doing, by asking, and, most of all, by learn-ing from your mistakes all day everyday.”

Take care of each otherEven though it can look like everyone around you is impossibly confident and accom-plished, in truth, everyone struggles at some point. Noticing someone who is strug-gling, and just stopping to ask “How are you coping?” can be one of the most im-portant things you can ever do for that person. When Anna Choi struggled, someone recognised it, and helped.

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“All I wanted was a breather. A moment to myself to collect my thoughts. And as my thoughts were collected it dawned on me that I was completely shattered. At that mo-ment one of the medical registrars happened to walk by. I’ve never been good at hid-ing my emotions and he must have noticed something was wrong because he asked me how I was doing. With that, I couldn’t stop myself from crying right there and then. [Yes, again with the tears!] This lovely registrar forced me to leave the ward for twenty minutes, but not before taking my pager and half of the on-call house surgeon job list. He was still helping me with jobs at six in the evening (despite his shift technically fin-ishing at four). No amount of baked goods could ever convey my gratitude. All my life, I will never forget his kindness.”

We lavish compassion, kindness and care onto our patients, so don’t forget that every once and awhile, a fellow doctor may need it too.

What to do if you’re fast approaching rock bottom“More often than not, rock bottom sneaks up on us. It is a gradual build-up of seem-ingly insignificant ‘little lows’ which we keep hidden to ourselves. Your ‘little lows’ may be different from mine, they may build up faster or slower; maybe your week six will be pretty darn sweet. But one message I want to leave you with as you head into your first year as a doctor is this: we all struggle. It is not just you. Those second years around you, those registrars, your consultants, each of them have gone through what you are going through now, no matter how on-to-it they seem. Each of us have had those lows. We’re just not good at talking about it. Us Kiwis are so good at being nice, but we’re not very good at asking the tough questions. “ARE YOU OK?” “ARE YOU COPING?” YOUR ANSWER DOES NOT HAVE TO BE A NOD AND A SMILE.”

Rock bottom is a place none of us want to head, but envitably, some of us will find ourselves there. If you do find yourself there, it’s important to get help. Ask for leave from the RMO office, tell someone you trust, at work and at home and that you’re not coping so well, and remember that there is a light at the end of the tunnel and things will start looking up.

Professional help is availble, both privately and through your GP, is who is able to refer you for four sessions of psychotherapy and counselling. Similarly, MPS has a counsel-ling service: 0800 225 5677 via the option medico-legal advice.

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About the NZMSA

Guide to GraduationContributors

Deborah Lambie, Natalie Ron, Elizabeth Berryman, Ben Drinkwater Format and Design: Michelle Bai

Editor: Alistair Lock

The team at the NZMSA wishes you all the best for you PGY1 year!