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Medical students challenged to make a difference - Northland DHB

Fuseworks Media
Fuseworks Media

An extraordinary year of unique challenges laid before this years' intake of Pūkawakawa students did nothing to darken the experience for the 24 students and 19 Trainee Interns (final year) farewelled at a pōwhiri at Te Puna o Te Mātauranga Marae earlier this month.

If anything, the students spoke of feeling fully supported by the University of Auckland, Northland DHB and academic coordinator Dr Win Bennet and site team leader Caroline Strydom throughout their nine months in the North.

The Pūkawakawa programme was set up by the University of Auckland's Faculty of Medicine and Health Sciences and the Northland DHB in 2007 to offer year five medical students the opportunity to gain valuable experience in regional and rural health. During their year, the 24 students would have usually spent most of their time at Whangarei Hospital and then seven weeks in integrated care and General Practice (GP) attachments at Dargaville, Bay of Islands, Kaitaia or Rawene. However, this year, most of the student's schedules were disrupted because of the COVID-19 pandemic. Many face to face clinical experiences were replaced by online learning, and timetables had to be rewritten as access to hospitals and teaching increased with reducing COVID-10 Alert Levels.

The trainee interns who spent their final year at medical school in Northland also had a disrupted programme to cope with the added stress of knowing that next year they will be practising in hospitals as new doctors. Ten are returning to work at Northland in 2021 and resident medical officer (RMO) Unit manager, Tina Harrop said this demonstrates how much they enjoyed their time in the North.

While most speakers avoided the dreaded 'C-word' (COVID-19), University of Auckland Tumuaki and Head of Department of Māori Health at the Faculty of Medical and Health Sciences, Professor Papaarangi Reid stressed to the students how valuable this experience would be to them in time. She talked about how COVID-19 has changed the world, us as humans and how we think about each other and the importance of reflecting on that.

"When you're old and look back, you will be able to say, 'I was finishing my training in the time of COVID-19'. You ought to look back and ask, what were the big issues? How did it change you, and what did you do about it? That is our challenge for years to come."

Dr Reid thanked Northland DHB for supporting Pūkawakawa and talked about how it is helping to change the rural medical and GP workforce. She asked the DHB to also support both Otago and Auckland University's endeavour to encourage more Māori and Pacific students to study medicine to help increase the Māori and Pacific health workforce in our communities.

"Having doctors who are the same as you play a role in getting a better outcome. It's not the whole answer, but it's part of the answer."

Dr Nick Chamberlain, Northland DHB chief executive, recalled being a medical student 35 to 36 years ago and told them what a privilege it is to work in health. He asked them not to let that privilege blind them, and always remember the inequities in health care are our greatest population health challenge.

"Get righteous about it. It's unfair, unjust and all of us have the power to change it. Speak out and speak up when you see something you believe is wrong - whether it's about inequity, institutional racism or a clinical decision. Address issues with courage and gentleness but don't just let them happen."

After spending time at Te Hiku Hauora, trainee intern, Benjamin Leeston said he was inspired by their GPs' commitment to resolving the inequity. He now feels the most valuable thing he can do is learn to practice equitably. Benjamin wants to make sure that Māori and others who are victims of institutional racism get equal access to healthcare and health outcomes, adding, "If we're not in it for equity, why are you here?"

Benjamin will be returning to do his postgraduate year (PGY) one, and two with Northland DHB. He said it was his first choice, as it is for many graduate doctors because of the opportunities they get to do rural hospital and GP medicine here.

Year five students, Ethan Wells and Laura Anderson, both spoke about how special it was for them to see Māori doctors working in the Northland hospitals.

Ethan spent a year at Auckland Hospital last year and didn't meet a single Māori consultant. However, during his seven-week placement in Kaitaia, he met several as well as non-Māori who were all incredible.

One of Ethan's supervisors, South African, Dr John Bradley, pointed out some key differences between being a GP in a rural setting compared to an urban environment. Specifically, because Kaitaia is a small hospital that serves a substantial geographical area, their patients often live a long way away. Ethan said he learnt to trust his gut instinct and keep patients overnight, rather than send them home if they could be still at risk.

"You need to put yourself in the shoes of your patients. Do they have the means to do what you want them to do or should you better support them by keeping them in to be safe?", he also said Dr Bradley proved that you don't have to be Māori to be culturally competent.

Dr Bennett said that it had been a very different and challenging year for students, teachers and University staff. He wanted to thank the students for bearing it all with good humour and for their resilience, clinical teachers for responding so positively to the change and thank the administration staff for hours of additional work pulling things together.

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