OQA Sponsors Felicity

Friday, 1st January 2010

As part of the medical degree at King’s College London, students must organise their own 8 week placement at the start of the 5th year, known as the elective. This is an opportunity to explore career options and experience medicine in a different culture or country and therefore lots of us use it as an excuse to go abroad!

For my elective I spent 8 weeks at Wellington hospital in the capital city of New Zealand. I chose New Zealand as I have always wanted to revisit since travelling there during my gap year. The healthcare system is similar to the UK which I thought would be relevant and useful for my junior years as a doctor. I was lucky enough to receive a generous sponsorship from Queen’s College to help me, as the elective is unfunded by the medical school and all costs must be met by the student.

My aims were to gain hands-on experience on the wards; to increase my knowledge of specialties that I’d had little exposure to; and to consolidate the areas that I have been excited by so far in my medical career and also to experience medicine and medical training in a different country. My first 4 weeks were spent in cardiology, based on the coronary care unit where I was able to perform ward-specific tasks such as clerking in patients, taking blood as well as spending time in clinic seeing patients. I had the opportunity to follow patients through their admission, witnessing and assisting with intervention, and helping plan their aftercare and discharge home.

One thing I found particularly interesting during my time in cardiology was the Maori culture and their view of medical care. The Maori are the indigenous people of New Zealand, comprising about 14% of the country’s population. They have a rich cultural heritage with history and the men are traditionally seen as warriors.

It is well reported that cardiovascular risk factors and disease have a high prevalence in the Maori people but they are reluctant to present to hospital –
it is not very ‘warrior-like’ to complain, or succumb to weakness! Unfortunately, this means that often the first time they present is due to something serious such as a myocardial infarction or ‘heart attack’. Many studies have highlighted the need to target cardiovascular risk management among this group. I’ve always been keen to promote primary risk prevention and public health awareness and this made me realise how difficult it is!

My second 4 weeks were spent in the ophthalmology department which I chose as we have little exposure to it during our training. My time was spent in clinic seeing patients and also in surgery. I was able to witness and assist with cataract operations, squint operations as well as enucleation (removal of the eye)! This is a fascinating area of medicine as eye disease is related to many systemic diseases and is important to screen for.

Another issue highlighted during my time in New Zealand was the country’s population density in comparison to the UK. There are 4 million people in NZ, which is the same number of people that commute into and out of London each day! This means that the population is concentrated around the main cities and therefore so are the big specialist centres. Wellington Hospital is the only place for miles around that can provide percutaneous coronary intervention, the definitive treatment for blocked coronary arteries. This means that patients from the bottom of the north island and the top of the south island are referred there, some of them travelling hundreds of miles. Wellington Hospital has a catchment area of 1,000,000 and a geographic radius of 300kms. I thoroughly enjoyed my time in New Zealand – both in and out of the hospital. The general atmosphere in the hospital was incredibly friendly and upbeat and the doctors were very willing to teach and share their expertise. They also encouraged me to explore the country. I was able to travel around and experience the fantastic landscape and culture and take part in some of the outdoor activities that New Zealand is famous for including kayaking, skiing and also sampling some of the local wines!

Sports and leisure are a predominant feature of the New Zealand cultural identity. It made me think about my future career in terms of picking a specialty, and it also made me realise how important my life outside the hospital is and will be – I found it appealing how New Zealanders put a lot more emphasis on quality of life as opposed to the amount they earn. My elective has been invaluable in terms of making me realise what the important things in life are.

I was very lucky to be able to visit New Zealand again and this is, in part, due to the support I have received from others, including my old school!

Felicity Herbert

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