Jeff Garrett
Dr Jeff Garrett is currently the head of the vocational training committee for medicine in the Auckland Region. He talks about what it is like to train as a physician and explains why it is an exciting and stimulating career choice...
Medicine at Middlemore...
Working as a Physician at Middlemore Hospital provides a diverse
working environment with many clinical challenges that
ensures our doctors are always stimulated. Whether attempting to
diagnose a rare condition or to disentangle a complex presentation,
or even something straightforward, there is the potential to
enhance a variety of skills.
Our emphasis is on continuity of care and integrated care.
Therefore, whether you are working within the acute care team, on
the ward or in the ambulatory setting it remains important to
remember you are part of a multidisciplinary team.
We place a strong emphasis on clinical research (there are 7
clinical research fellows) and quality improvement initiatives. The
desire to question the way we do things and to improve upon
existing models of care is important. In acknowledgement, we
host an annual Science Festival and encourage junior staff to
present research studies or audits.
One of the main reasons I enjoy practising medicine at
Middlemore Hospital is the humility shared by so many of our senior
clinicians and nurses. I think this reflects in part, the community
we care for, but also reflects the culture that has existed at
Middlemore over many years. There is also very capable clinical
leadership within this organisation. We have good decision makers
and good infrastructure which is allowing us to develop into one of
New Zealand's leading healthcare providers.
Training in Medicine...
Training in medicine allows junior doctors to acquire many
skills essential in developing a successful career. There is a
strong team focus in medicine and contribution at all levels is
vital. Senior physicians are expected to lead or become a major
contributor to the provision of infrastructure that supports good
care (eg clinical pathway development, audit, IT development,
e-learning modules). Internal medicine remains the important hub of
any successful hospital so the wide-ranging role of the physician
is essential.
Basic Trainees at Registrar level can sit their part 1 exams
once they are comfortable with their knowledge base. This usually
occurs 2 to 3 years into their Registrar training. The part 1 exam
consists of a written exam, then around 3 months later (assuming
the trainee passes their written exam) they are eligible to sit
their clinical exam which (if they pass) will allow them to become
an Advanced Trainee. Around 70% of our Advanced Trainees are dual
trainees (which usually consists of between 3 to 4 years of
training in internal medicine and their chosen subspecialty).
Around 30% train purely within a single subspecialty. We recommend
for them to complete one of these years abroad. Our training
programme offers strong international affiliations with
internationally renowned centres overseas (predominantly Australia,
UK and North America)which strengthens the training scheme.
Training in medicine can allow a work life balance as long as
you manage and maintain your workload effectively. After hours work
can at times be onerous however there are more opportunities now to
protect your responsibilities and develop a variety of interests
outside of medicine. We have ensured no Senior Physician performs
more than 11 weekends of call a year and we have more oncall teams
than most other hospitals so that workload is more evenly shared
afterhours. We encourage medicine trainees to have a life out of
work to maintain a rounded personality which is beneficial for our
patients.
Why Medicine?
If you want a career that will remain challenging, exciting and
intellectually stimulating then medicine is a good career choice.
You will be surrounded by pleasant people with a strong team focus.
Medicine is an area which allows people not only with intellect but
also practical skills to excel therefore it is a very accommodating
area to practice and offers a diverse experience.