OTAGO MEDICAL SCHOOL
Te Kura Hauora o Ōtākou
2020-2021
Dunedin Campus
Advanced Learning in Medicine Sixth Year
Trainee Intern Handbook
ALM
6ti
Disclaimer
While al responsible efforts have been made to ensure that the information contained in this
publication is correct at the time of printing, matters covered in this publication are subject to
change.
The University reserves the right to change courses and course requirement at any time.
23 November 2020
Table of Contents
Welcome from the Dean __________________________________________________________ 5 Welcome from the MB ChB Programme Director _______________________________________ 6 Course Information ______________________________________________________________ 7
Sixth year undergraduate medical course dates 2020 – 2021 ___________________________________ 7
Course Convenors and Administrator Staff for 2020 – 2021 ______________________________ 8 Introduction to al clinical teaching staff and the role of the Trainee Intern on ward attachments
_____________________________________________________________________________ 10 Educational objectives and assessments ____________________________________________ 11
General ____________________________________________________________________________ 11
Overview of attachments ________________________________________________________ 12
Elective quarter ______________________________________________________________________ 12
Speciality Management Quarter _________________________________________________________ 14
Community and Critical Care Quarter _____________________________________________________ 16
Critical Care Module (6 weeks) __________________________________________________________ 16
C-E-O Module: General Practice Attachment (2.5 weeks) _____________________________________ 17
C-E-O Module – Outpatient Clinics (2.5 weeks) _____________________________________________ 18
C-E-O Module: Health Care Evaluation Project (6 weeks)______________________________________ 18
Ward Management Quarter ______________________________________________________ 20
Surgery ____________________________________________________________________________ 22
Professional Development _____________________________________________________________ 23
MB ChB Programme of Assessment Policies and Procedures _______________________ 26
For the most up to date information on assessment in the ALM6 year please refer to page 91 of the MB ChB
Programme of Assessment Policies and Procedures. ____________________________________________ 26
MCNZ ePort _________________________________________________________________________ 26
School Buildings and Facilities _____________________________________________________ 27
Trainee Intern Common Room & Fraser Building ____________________________________________ 27
General computing information _________________________________________________________ 27
Health Science Library _________________________________________________________________ 28
Southland Hospital Invercargil ____________________________________________________ 30
Arrival _____________________________________________________________________________ 30
Travel arrangements _______________________________________________________________ 30
Orientation ________________________________________________________________________ 30
MRSA clearance _____________________________________________________________________ 31
ID / access cards ___________________________________________________________________ 31
Photocopier and Southern District Health Board computer use ___________________________ 31
Car parking ________________________________________________________________________ 31
Library ____________________________________________________________________________ 31
Dunedin Campus computer facility in Invercargill______________________________________ 32
Computer help in Invercargill ________________________________________________________ 32
Doctors' Residence __________________________________________________________________ 32
Bike security _______________________________________________________________________ 33
Videoconferencing Room ____________________________________________________________ 34
Zoom room ________________________________________________________________________ 34
Contacts ___________________________________________________________________________ 34
Paediatrics zoom link ________________________________________________________________ 34
Complaints and/or concerns ____________________________________________________________ 34
Student welfare and services ______________________________________________________ 35
Student Affairs Office – Sayers Building – Otago Medical School Administration ___________________ 35
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Medical Education Unit - Sayers Building – Otago Medical School Administration __________________ 35
Otago University Medical Students’ Association Inc (OUMSA) __________________________________ 36
The New Zealand Medical Association (NZMA) _____________________________________________ 36
Class representatives _________________________________________________________________ 36
Student with impairments _____________________________________________________________ 36
International student support ___________________________________________________________ 37
Māori Centre – Te Huka Mātauraka https://www.otago.ac.nz/maoricentre/index.html _____________ 37
Pacific Island Research & Student Support Unit _____________________________________________ 37
Student Health Services https://www.otago.ac.nz/studenthealth/index.html _____________________ 37
General Information ____________________________________________________________ 38
Administrative details _________________________________________________________________ 38
General Notes _______________________________________________________________________ 38
Notices/updates _____________________________________________________________________ 38
Student Leave _______________________________________________________________________ 38
Application for Leave _________________________________________________________________ 39
Consideration of Leave Application ______________________________________________________ 39
Sick Leave, Bereavement Leave or other Emergency _________________________________________ 39
Dealing with Missed Sessions ___________________________________________________________ 40
Public Holidays ______________________________________________________________________ 40
Attendance at clinical rounds while unwel ________________________________________________ 40
Sixth Year TI Grant ____________________________________________________________________ 40
Trainee Intern Training Grant - Information regarding entitlement to payment ____________________ 40
Information from Study Link ____________________________________________________________ 41
Lump sum payment ___________________________________________________________________ 41
Monthly payment ____________________________________________________________________ 41
Grant eligibility ______________________________________________________________________ 41
Communication ______________________________________________________________________ 41
Checking your student email ____________________________________________________________ 41
Cel phones, iPads or Laptops ___________________________________________________________ 42
Social medial and the medical profession __________________________________________________ 42
Recording of patient interview and clinical presentations ______________________________ 42
Graduation _________________________________________________________________________ 42
Graduation application process _________________________________________________________ 42
Draft Graduation weekend programme (times to be advised) __________________________________ 42
Dunedin Campus Trainee Intern Graduating Dinner & Prize-giving ______________________________ 43
House Officer positions ________________________________________________________________ 43
Probationary medical registration _______________________________________________________ 43
JPs on Campus _______________________________________________________________________ 43
Assessments in TI year ___________________________________________________________ 44
Course Objectives ____________________________________________________________________ 44
Personal Attributes ___________________________________________________________________ 44
Interactive Attributes _________________________________________________________________ 44
Disciplinary Attributes _______________________________________________________________ 45
MB ChB Assessment Policy & Procedures (COVID Edition) _____________________________________ 45
Guide to academic conduct_____________________________________________________________ 45
Introduction ________________________________________________________________________ 45
University of Otago Medical School Prizes and Dunedin Campus Prizes and Awards _________ 46
Otago Medical School _________________________________________________________________ 46
Batchelor Memorial Medal and Prize in Gynaecology and Obstetrics __________________________ 46
Stanley Batchelor Memorial Prize in Surgery _____________________________________________ 46
Colquhoun Memorial Medal in Clinical Medicine ___________________________________________ 46
The Rita Gardner Travel ing Scholarship in Medicine ________________________________________ 46
T W J Johnson Memorial Prize in Clinical Medicine ___________________________________________ 46
Emily Hancock Siedeberg Memorial for the Best Overal Woman Student ______________________ 46
Psychological Medicine Prize ____________________________________________________________ 47
J M Watt Prize in Paediatrics and Child Health _____________________________________________ 47
Dunedin Campus _____________________________________________________________________ 47
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Marjorie McCal um Medal in Medicine __________________________________________________ 47
James Renfrew White Prize in Orthopaedic Surgery ______________________________________ 47
Patricia Buckfield Prize in Paediatrics ___________________________________________________ 47
Sir Gordon Bell Prize in Surgery __________________________________________________________ 48
Paediatric Artistic Expression ___________________________________________________________ 48
Mary Shaw Surgical Prize _______________________________________________________________ 48
Stanley Wilson Prize ___________________________________________________________________ 48
Sir Bernard Dawson Prize in Clinical Obstetrics and Gynaecology _____________________________ 48
Professor Basil James Prize in Psychological Medicine _______________________________________ 49
RNZCGP Otago–Southland/JAD Iverach Prize in General Practice _______________________________ 49
JAD Iverach Prize in Medicine ___________________________________________________________ 49
Inkster-Ross Memorial Prize ____________________________________________________________ 49
Elective Report Award _________________________________________________________________ 49
University Bookshop Prize for Best Student Contribution to Medical Education ______________ 49
John Russell Ritchie Prize (to be confirmed if available in 2021) ______________________________ 50
Kōtahu – Centre for Hauora Māori Excel ence Awards ______________________________________ 50
Working in a Clinical Setting ______________________________________________________ 51
Clinical Education: Chaperoning _________________________________________________________ 51
Adult Patients _______________________________________________________________________ 51
Children ____________________________________________________________________________ 51
Dress and appearance _________________________________________________________________ 51
Cultural y-sensitive issues ______________________________________________________________ 52
Dress requirements in theatre __________________________________________________________ 52
Professional behaviour: General _________________________________________________________ 52
Professional etiquette and practical ethics for clinical education (teaching, learning & assessment) ____ 52
Patient rights in general _______________________________________________________________ 52
Consent for clinical education ___________________________________________________________ 53
Clinical examination of patients _________________________________________________________ 53
Professional behaviour: Supervision ______________________________________________________ 54
Privacy and Confidentiality _____________________________________________________________ 55
Access to notes and handling of written material ___________________________________________ 55
Release of Information ________________________________________________________________ 56
Medical student rights ________________________________________________________________ 56
Code of Conduct and Integrity (District) _____________________________________________ 57
Key policies and regulations related to the MB ChB __________________________________________ 67
4
Welcome from the Dean
Warm welcome (or if you are a TI year, welcome back) to the Advanced Learning in Medicine programme at
the Otago Medical School – Dunedin campus.
You made the right choice and we are delighted to have you at the Otago Medical School – Dunedin campus.
We hope you had a refreshing break and that you are looking forward to an exciting and fulfil ing year learning
how to be a great doctor. During your time here you wil begin to make the patterns of medical life that wil
continue rest of your career – you wil see examples of variety of professional practices from our committed
and outstanding academic and clinical staff. Many wil be inspiring and leaders in their respective field. We
pride ourselves on high standards of care and teaching, and wil try and offer you excel ent opportunities for
learning. Please talk to staff about your experience as we are always learning and want to improve and provide
you the best learning environment in New Zealand. I would be delighted to talk to any of you that want to
bring significant issues to me directly or through the student committee.
An important partner for us in offering the right environment for learning is the Southern DHB. Their staff also
recognise the value of having students within our services. As students, you need to respect and add value to
this relationship, remembering that your influence wil affect many other students behind you. Key to al that
we do is a respectful and empathic attitude to all patients – maintain that under all circumstances, even when
you are stressed.
One issue to note is the DHB policy on taking photos of patients on personal cel phones. This is not al owed
by either DHB staff or by you as students at the OMS-Dunedin campus. Bear this in mind, and if you need a
clinical image, ask a DHB or staff member about how to go about doing this (requires ful written informed
consent, a record in the clinical notes and for the photo to be taken using a dedicated camera for this purpose,
and stored in the clinical record).
Finally, there is abundant research opportunities in each area of clinical medicine. OMS-Dunedin campus
actively encourages you to get involved in clinical research to develop a clinician-scientist career. Care of
individuals or groups with health problems is wonderfully rewarding, often day to day, but there is even
greater long-term satisfaction possible if you find out what works best by conducting research. Research and
clinical practice contributes to each other and elevate both disciplines. If you are interested in immersing
yourself in medical research, BMedSci(Honours) or an intercalated MBChB/PhD degree pathway wil set you
far ahead in a rewarding academic clinician career in Medicine.
We hope that your year wil be exciting, rewarding and successful and we very much looking forward to
teaching and mentoring each and everyone of you.
Kind Regards
Professor Rathan M. Subramaniam
MBBS, BMedSci, PhD, MPH, MClinEd, FRANZCR, FACNM, FSNMMI, FAUR
Dean, University of Otago Medical School
5
Welcome from the MB ChB Programme Director
Welcome to the final year of your medical degree. The Trainee Intern year’s apprenticeship model aims for
you to be ful y integrated with a variety of health care teams, taking responsibility for patient care decisions
while knowing when to ask for help, and while remaining under supervision by both the medical school and
your clinical team.
We encourage you to continue to develop your independent learning and your team work, and to ask for
feedback and reflect on it. These habits wil prove valuable in the years ahead of you.
The Otago Medical School, the MB ChB programme and your base campus provide resources and support for
this last stage of your undergraduate training. We look forward to seeing you graduate at the end of this year,
and to working with you in the future.
Professor Tim Wilkinson
MB ChB Programme Director
6
Course Information
Sixth year undergraduate medical course dates 2020 – 2021
Monday 23 November 2020
First Quarter begins
Monday 21 December -
Monday 4 January 2021
SUMMER VACATION
Tuesday 5 January 2021
First Quarter continues
Sunday 28 February 2021
First Quarter ends
Monday 1 March 2021
Second Quarter begins
Sunday 23 May 2021
Second Quarter ends
Monday 24 May 2021
Third Quarter begins
Sunday 15 August 2021
Third Quarter ends
Monday 16 August -
Sunday 29 August 2021
WINTER VACATION (2wks)
Monday 30 August 2021
Fourth Quarter begins
Monday 15 November -
Wednesday 17 November 2021
Pass/Fail & Distinction exams
Thursday 18 November 2021
TI Prize- giving & Graduation Dinner (DSM&UOC)
Friday 19 November 2021
TI Prize- giving & Graduation Dinner (UOW)
Sunday 21 November 2021
End of Academic Year
Monday 29 November 2021 (TBC)
House Officer Year Commences
Statutory Holidays
If a Trainee Intern is required to work public holidays with their team, they should be al owed one day’s leave
in lieu of this, to be taken at an appropriate time within the same module. This should be discussed with the
senior members of the team to arrange a day that is beneficial for all parties and where there is likely to be
significant loss of learning opportunities. Further information can be found on Moodle.
7
Course Convenors and Administrator Staff for 2020 – 2021
Position
Name
Trainee Intern Course Adviser
Professor R J Walker
[email address]
Trainee Intern Course Coordinator
Jil ian Tourel e
jil ian.tourel [email address]
Trainee Intern Electives Administrator
Sheryl Foster
[email address]
Associate Dean for Student Affairs
Dr P Eames
[email address]
Ward Management Quarter
Medicine Module
Administrator
Sheryl Foster
[email address]
Convenor
Professor R Walker
Surgery Module
Administrator
Ruth Mul enger
[email address]
Convenor - Surgery
Associate Professor M Thompson-Fawcett
Trainee Intern Supervisor
Mr J Woodfield
Specialty Management Quarter
O&G Module
Administrator
Donna Robson
[email address]
Convenor
Dr R Crumb
Paediatric Module
Administrator
Mel O’Brien
[email address]
Convenor
Associate Professor B Wheeler
Psychological Medicine Module
Administrator
Sandra Paterson
[email address]
Convenor
Dr C Mentzel
Community – Evaluation – Outpatient / Critical Care & Emergency Medicine Quarter
General Practice Module (including clinics)
Administrator
Liz Dijkstra
[email address]
Co-Convenors
Dr C Atmore & Dr J Ross
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HC Evaluation
Administrator
Kelsey den Boestert
[email address]
Convenor
Associate Professor John Dockerty
Critical Care & Emergency Medicine Module (including advanced resuscitation)
Administrator
Aroha Meikle
[email address]
Convenor
Mr M Hunter & Dr S Beck
Elective Quarter
Administrator
Sheryl Foster
[email address]
Convenor
Professor R J Walker
Professional Development Module
Angela King
Administrator
[email address]
Convenor
Dr Nigel Thompson
Invercargil Campus (Southland Hospital)
Administrator
Madge Storm
dsm.invercargil [email address]
Associate Dean, Southland
Mr K Richter
Timaru Hospital
Administrator
Jehan Cunningham-Beynon
[email address]
Associate Dean, South Canterbury
Ms M Steel
9
Introduction to al clinical teaching staff and the role of the Trainee Intern
on ward attachments
From time to time, there has been some misunderstanding as to the role of the Trainee Intern attached to
Ward Services. The Trainee Interns have voiced some concerns over the variability between attachments and
what is expected. They have also raised some concern over assessment and feedback (or lack thereof) with
regard to performance on the various services. We need to make sure that ongoing feedback regarding
progress and ability is provided. The Trainee Intern year is a unique aspect of our medical training programme
which gives our medical graduates an opportunity to gain skills in patient management, such that when they
commence working as House Officers, they have already developed the necessary skil s to practise as good
clinicians. Our role as supervisors is to make sure that this experience remains an excel ent learning
opportunity and appropriate feedback is given early on in the attachment as wel as at the end of the run. The
Trainee Interns value positive feedback, and therefore I would like to remind you of this and ensure that
ongoing feedback with regard to progress is provided. With the increasing number of problematic patients, it
is very easy to focus on a purely service workload, however as a teaching hospital, we have a responsibility to
make sure that education of our future medical workforce is ongoing.
The Trainee Intern should be given every opportunity to take responsibility for a number of patients within
the clinical service that she / he is working for. This usual y varies between one third to one half of the patients,
depending upon the patients' clinical problems and the confidence and competence of the Trainee Intern. The
main line of responsibility for day-to-day patient care is from the Trainee Intern to the registrar, not via the
house officer. It is essential that the registrar and consultant make sure that the Trainee Intern is encouraged
in this role as an active member of the clinical team. This should include participation in the ward rounds, in
particular, taking responsibility for presenting and updating the status of their patients. The Trainee Intern is
not the house officer’s general slave undertaking menial tasks only, as is unfortunately occurring on some
runs. Clearly there needs to be col egial interaction between the Trainee Intern and the house officer for good
clinical management and this should be encouraged. The consultant for the team, that the Trainee Intern is
attached to, should make sure that the junior medical staffs is aware of the role of the Trainee Intern within
the clinical team.
From time-to-time, it is appropriate to ask the Trainee Intern to take on responsibilities as an acting house
officer, but this does need to be under direct supervision and it is important to make sure that the workload
is not excessive. The Trainee Intern should not be expected to act up, within the first two weeks of an
attachment. Close supervision by the registrar and consultant must be ensured. The Trainee Intern must be
given the option of saying no, if they feel too threatened by the situation. If there are any concerns over the
workload and the role of acting house officer, this must be discussed with me.
I would like to ask you to make sure that your clinical team understands the role of the Trainee Intern and
continue to provide a stimulating learning environment within the framework of an active clinical service. If
there are any issues related to this, please contact me.
Professor Rob Walker
Trainee Intern Course Convener
10
Educational objectives and assessments
General
During the sixth-year course each student should:
1.
Consolidate his/her knowledge and understanding of clinical science by its application in medical
practice and, in particular, gain an understanding of the principles and practice of the therapeutics of
common disorders.
2.
Enhance his/her basic clinical skil s including those of history taking, examining, problem identification
and definition, and decision making.
3.
Develop additional clinical skil s, including those of:
a. Responsibility for continuing management of individual patients
b. Prescribing specific treatments for individual patients
c. Basic medical and surgical ward procedures
d. The ability to recognise a medical emergency and to initiate appropriate action
e. Patient diagnosis and management in environments other than a hospital ward
f. Communication with patients and relatives, including counsel ing
4.
Increase his/her awareness of the role of health education for patients, relatives, health professionals
and teachers in the maintenance of health and prevention of il ness, and of the various strategies
available to achieve better health through education and prevention.
5.
Enhance his/her perspective of medical practice by experience:
a. In a variety of medical disciplines
b. In a variety of practice environments
c. In a variety of geographical locations
d. With a variety of teachers, including a number working outside the
Medical School and Dunedin Hospital
The 48-week year is divided into four 12-week modules, which are:
A. Free Elective
B. Specialty Management
C. Community Management
D. Ward Management
Plus Professional Development Module, which runs throughout the year.
The document ‘Apprenticeship Expectations for Trainee Interns in the Clinical Environment (approved by MCC April 2019)
can be found at: https://www.otago.ac.nz/medicine/current-students/resources/policies-guides/index.html
11
Overview of attachments
Elective quarter
The sixth (Trainee Intern - TI) year of the medical degree is a year during which students prepare to take on
roles as a junior doctor in an apprenticeship model. The aims of the year are broad and normal y include
students being ful y integrated within a variety of health care teams and taking increasing responsibility for
patient care decisions while remaining under supervision. Although in their final year of medical training, TIs
are not yet qualified doctors and therefore need adequate supervision and unambiguous, ready access to
appropriately qualified col eagues, especially with respect clinical management decisions including prescribing
of medications.
The TI Elective Module accounts for one quarter of the final year. Traditional y students have determined an
area they wish to pursue to enhance their learning and career choices and arrange a suitable placement in
agreement with the module convenor. The majority have arranged electives placements overseas. With COVID
19 disruption, overseas placements are no longer an option for the foreseeable future. Hence the university
is having to take a greater role in identifying potential placements and matching students to them, although
students are stil encouraged to identify potential placements themselves in close discussion with the module
convenor.
Placements can be clinical, research based or with supervisors/organisations which expose them to a wider
view of medical experiences including policy development.
The TI Elective Module Objectives
The objective of the Elective Programme in the Trainee Intern year is to complement an individual student’s
education needs through at least one of the fol owing:
Gaining medical experience in different types of health care delivery to that practised in New Zealand
(although currently overseas electives are not possible)
Further developing knowledge in a particular branch of medicine (particularly those not taught in the Trainee
Intern year curriculum (e.g. Sports Medicine))
Gaining medical experience of a particular branch of medicine that may influence subsequent career
orientation
Gaining medical experience in a particular community that may influence subsequent career orientation
Obtaining in-depth experience in medical research methods
Gaining medical knowledge and experience via project work related to health issues
Obtaining in-depth experience in the delivery of medical services including policy development, working with
allied health workers, community health providers and others.
Students on their elective are required to complete 12 weeks of placement. This can be broken into shorter
periods. The minimum placement being 4 weeks. Many students prefer two six-week blocks. Research and
other project work are usual y for the ful 12 weeks.
As a guide to those supervising TIs the guidelines fol owing have been developed.
With appropriate supervision they can continue learning in all their usual roles including:
• Learning to work as part of an inter-professional health care team
• Taking histories, assessing and admission of patients in hospitals
• Undertaking consultations with patients, their family/whanau in primary care, hospital and outpatient
settings
• Maintaining medical records
12
• Initiation of management and continuing fol ow up under supervision
• Presentation of cases
• Being involved in public health work, including contact tracing
In addition, they may take on wider clinical and non-clinical roles
• Supporting general practice e.g. telephone fol ow up of vulnerable patients and their families/whanau,
giving influenza vaccines
• Supporting rural medical communities
• Undertaking research projects
• Working with those involved in service delivery including health policy development
Orientation
When students arrive at the location, someone should be designated to orientate them to the hospital,
community, research or organisation setting. For clinical placements this should include the clinical workplace
and the clinical team members. This is often best to be an experienced administrator or practice manager who
can also ensure they have also completed any remaining form fil ing, health screening, issuing of swipe cards.
The supervisor – as below – should discuss the proposed work and placement learning outcomes with the
student, check with the student directly as to their confidence and comfort in the particular clinical
environment, gauge the level of supervision likely to be needed initial y, and introduce the l team members.
Pastoral support: please ensure students know from the outset who to go to and how to access support and
health care should they need it.
If at any point in time the supervisor has any concerns regarding the student or their placement, please do not
hesitate to contact the TI Elective Module convenor.
Supervision and assessment
Students should each have one lead supervisor, usual y a senior member of the team, who is responsible for
overseeing the student’s learning and the overal tasks al ocation.
The lead supervisor does not however have to be directly supervising on a day to day basis; this can be
delegated to a greater or lesser extent within teams as considered appropriate to the tasks in hand, and we
actively encourage this.
The lead supervisor is required to complete a brief global assessment form in appropriate consultation with
other team members. This is an electronic form, the supervisor wil be emailed a link in the final week of the
placement. The supervisor is free to discuss the assessment with the student.
The student is required to submit an Elective Report to the module convenor on completion of the placement.
Nil further assessment is required.
We thank you for considering supervising a student during their elective, an important component of the final
medical school year.
OMS TI Elective Module convenors
Prof Rob Walker (Dunedin) [email address]
Assoc. Prof John El iott (Christchurch) john.el [email address] (finishes Dec 2020)
Dr Jenny Visser (Wel ington) [email address]
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Speciality Management Quarter
In this quarter, Trainee Interns wil have the opportunity to enhance specialty skil s which wil be used in a
relatively large proportion of clinical encounters. Experience in this module should include management of
hospital inpatients and outpatients and some experience of care in the community. The quarter wil normal y
comprise three 4-week attachments. Attachments in Obstetrics and Gynaecology, Paediatrics, and in
Psychological Medicine may be taken at Southland Hospital, Invercargil . Arrangements for these attachments
are made during the fifth year of the medical course. Changes in attachments should be
made only after consultation with the convener of the Specialty Management Quarter and the Trainee Intern
Course Coordinator.
Students will normally select attachments in Obstetrics and Gynaecology, Paediatrics, and Psychological
Medicine in order to meet examination requirements, but those who have had approved experience in one or
more of these disciplines in their electives may select an attachment in another specialty. Approval for this
must be obtained from the Department Heads (or Trainee Intern Course Conveners) in this quarter before the
year commences.
Objectives
The student in this quarter shal , under appropriate supervision:
1.
Extend his / her skil s in obtaining an adequate psychiatric, obstetric, gynaecological and paediatric
history and be competent to carry out the appropriate examination including specific techniques
important in each of these disciplines.
2.
Consolidate his / her knowledge of the common psychiatric, obstetric, gynaecological and paediatric
disorders, their natural history, investigation and management.
3.
Be able to recognise emergency situations in each of these disciplines and initiate appropriate
interventions.
4.
Gain an understanding of the importance of the family and the community in the presentation and
management of his / her patient il ness and be able to utilise appropriate community resources.
5.
Recognise the importance of encouraging positive health attitudes in his/her patients and the value of
screening methods for those diseases in which early diagnosis is essential. Detailed objectives for
disciplines of Obstetrics and Gynaecology, Paediatrics and Child Health, and Psychological Medicine wil
be available to students one week before the commencement of each attachment.
Assessment
1.
The method of assessment wil be essential y the same in each of the three specialties making up the
Specialty Management Quarter: Obstetrics and Gynaecology, Paediatrics and Child Health, and
Psychological Medicine. The assessment wil be ongoing and depend on your performance in the clinical
areas and at any formal or informal seminars which are held and during your case presentations or
Trainee Intern seminars. Al members of senior medical staff, senior nursing staff and the registrars
participate in the assessment using a standard mark sheet (PASAF Form). We wil be assessing not only
your clinical skil s and knowledge, but also your attitudes towards your patients, their relatives and other
staff members. At the end of Obstetrics and Gynaecology and Psychological Medicine Specialty modules
a short viva wil be held to assess your knowledge base and ability to apply that knowledge to clinical
situations. The Paediatrics and Child Health module wil be assessed via seminars, mini-CEX
assessments, and PASAF evaluations.
14
(1a) The method of assessment for Obstetrics and Gynaecology will require all Trainee Interns to
complete case presentation sheets, one for obstetrics and one for gynaecology, carry out a topic
presentation and submit three observation of professional practice assessment forms.
At the end of the Obstetrics and Gynaecology and Psychological Medicine Specialty modules a short
viva wil be held to assess your knowledge base and ability to apply that knowledge to clinical situations.
2.
If your clinical performance is felt to be unsatisfactory you wil be warned approximately half-way
through the attachment by a member of the senior medical staff who is responsible for the Trainee
Intern programme within each department.
3.
At the completion of each specialty within the Specialty Management Quarter your overal performance
will be considered. All three specialties provide formal end-of-run feedback on your performance. In
this feedback you wil be informed whether or not your performance has met the assessment
requirements. If your performance is unsatisfactory you wil be asked to an interview with the Head of
Department concerned or Coordinator of the Trainee Intern programme, who may either offer a further
assessment after a period of personal study, directed elective, or indicate that you wil be required to
present for an oral examination in that subject at the end of the Trainee Intern year. The oral
examination wil be conducted with senior staff from either of the two clinical Schools. Students should
note that they may be invited to present for an examination at the end of the year to meet the
requirements for Distinction and prizes in Obstetrics and Gynaecology, Paediatrics and Child Health, and
Psychological Medicine.
(3a) At the completion of each specialty within the Specialty Management Quarter your overal
performance wil be considered. Al three specialties provide formal end-of run feedback on your
performance. In this feedback you wil be informed whether or not your performance has met the
assessment requirements. If your performance is unsatisfactory in O&G you wil be asked to an
interview with the Head of Department concerned or Coordinator of the Trainee Intern programme,
who may either offer a further assessment after a period of personal study, or directed elective.
15
Community and Critical Care Quarter
The Community and Critical Care Quarter has been in place since the 2015/16 Trainee Intern year began.
Contributing departments include General Practice and Rural Health, Preventive and Social Medicine,
Emergency Medicine, Intensive Care, Anaesthesia, and ENT and Ophthalmology outpatient clinics. It provides
Trainee Interns with a variety of experiences, integrating community services with clinical audit, as wel as
presenting the opportunity to revisit and hone essential clinical skil s to manage the acutely il , undifferentiated
patient. Al students wil attain Level 7 of the Resuscitation Council training as a Medical Council
prerequisite.
The Quarter is divided into two equal sections of six weeks each. These sections are:
A.
Critical Care Module
B.
Community-Evaluation-Outpatients (C-E-O) Module:
1. Introduction to project, GP, hospice – first 2–3 days
2. Alternating attachments:
a. General Practice placements – 2.5 weeks
b. ENT and Ophthalmology Clinics, Urgent Doctors placements, and Hospice visit – 2.5 weeks
3. Healthcare evaluation project – concurrent with other components throughout the 6 weeks
4. Presentations, tutorials and assessments – final 2–3 days Trainee Interns based in Invercargil for the
year wil undertake a similar programme, travel ing to Dunedin for the introductory and final days of the
module.
Critical Care Module (6 weeks)
This six-week attachment will reinforce prior knowledge and enhance clinical skills relevant to critical care. It
will assist in bridging the inevitable overlap between the management of the acute, undifferentiated patient
presenting to an Emergency Department and the care rendered to a patient in an Intensive Care Unit.
Techniques of acute assessment and management wil be reinforced through the combined specialties of
Emergency Medicine, Anaesthesia and Intensive Care Medicine. Learning wil be assessed through a
combination of formative and summative evaluation. By the end of the Module al students wil be expected
to achieve Level 7 of the Resuscitation Council qualification prescribed as a prerequisite for graduation, by the
Medical Council of New Zealand. Each TI wil spend three weeks in the Emergency Department, one week each
in Anaesthesia and the ICU, and the final week working on simulated cases and completing the Level 7 course.
The module wil also offer e-learning opportunities.
Learning objectives
Upon completion of the Critical Care module you wil be expected to
demonstrate:
a.
Proficiency in the immediate assessment and management of undifferentiated acutely il and injured
patients.
b.
An understanding of the role of the Emergency Department as the interface between Primary and
Secondary Health Care provision.
c.
Proficiency in advanced cardiac life support to Level 7 of the Resuscitation Council Standard.
d.
A knowledge of diagnostic and management skil s required to support patients in need of organ support
and invasive monitoring in the ICU setting.
e.
An understanding of the perioperative preparation and subsequent anaesthetic care of the surgical
patient including relief of post-operative pain.
f.
A knowledge of the provision of sedation and anaesthesia for patients undergoing various procedures
outside the operating theatre including endoscopic procedures and interventional radiology. In the
Emergency Department, students wil be rostered to attend ful ED shifts in the company of an ED
16
Consultant or Registrar. You wil be expected to examine patients and formulate treatment plans under
supervision and to demonstrate autonomy and self-direction by integrating yourself into the ED Team.
Likewise on your anaesthetic attachment you wil accompany a Consultant Anaesthetist and participate
actively in all areas of clinical responsibility. During your time in the ICU you wil also be rostered to
specified shifts that wil give you a feel for the real face of Intensive Care. These may be night or weekend
shifts where there are many opportunities for your ful participation as a team member to a level that
acknowledges your level of experience and competence. On each of these specialty attachments you
will be expected to attend all sessions set aside for House Officer (Intern) teaching and as opportunities
arise you may gain valuable experience by presenting your own cases. You may also have some shifts at
Dunedin Urgent Doctors.
Certification in resuscitation for Trainee Interns
The Medical Council of New Zealand requires that every graduating medical student has successful y met the
standards of Level 7 certification prescribed by the New Zealand Resuscitation Council. This is also a non-
negotiable employment obligation to the DHB in which you wil be working as a first year Intern (PGY1). At
the Dunedin Campus this course wil be provided and assessed during the final week of your Critical Care
Module. It wil be held in the Skil s Lab (Fraser Building).
C-E-O Module: General Practice Attachment (2.5 weeks)
GP placements are arranged by the TI Administrator in the Department of General Practice and Rural Health
rather than by Trainee Interns themselves. This process has been implemented because of reductions in
placement options due to agreements between the Schools of Medicine. It is important that you do not make
your own arrangements with practices. Even if there is wil ingness by both parties, such arrangements are
general y not al owed in most areas.
Prior to the commencement of the module, you wil be contacted and invited to indicate your placement
preferences from the available options. Please note that while your preferences will be taken into
consideration, there are a limited number of placement options, and you may be al ocated to go somewhere
that was not one of your choices.
You should be aware that costs of travel and accommodation for placements outside Dunedin are your
responsibility and that only a smal number of TIs are able to stay in Dunedin, so you should budget for this (it
is an expectation that your TI Grant be used for any expenses incurred for this part of the module). Other
possible sites include Invercargil , Alexandra, Wanaka, Timaru and some rural localities in Otago and Southland.
The Otago Community Hospice and Hospice Southland are also used for placements when the need arises,
and Blenheim and Nelson have also hosted TIs from time to time. The TI Administrator in the department has
information about more affordable accommodation options for most of the areas to which TIs are sent. Please
email [email address] well in advance of your GP attachment if you wish to ask about other possibilities.
During the placement Trainee Interns wil work with clinical tutors in a rural or urban practice. You wil help
the GP with patients and families under their care. After a period of observing you wil have the opportunity
to work up new cases by yourself for presentation. There is no defined clinical curriculum and you are
encouraged to maintain a log of patients and conditions seen and skil s learned, as the basis for self-directed
learning. Take opportunities as they arise in this undifferentiated clinical environment. However you must not
make any medical decisions about patients without supervision from the clinical tutor. You should discuss
aspects of General Practice with local pharmacists and other members of the primary care team. Ask to attend,
with your Clinical Tutor, local medical meetings, seminars or postgraduate activities.
There wil be General Practice tutorials during the first and final weeks. Academic requirements for this
module consist of satisfactory participation in tutorials, two mini-CEX assessments, a medication review, and
17
an overall evaluation of your performance by your primary supervising clinician. Information about these
requirements is available on Moodle.
Objectives: Primary and Community Care
1)
To enable students to consolidate their prior learning in primary care/general practice with a focus on
achieving safe and effective clinical outcomes (SECO) in primary care and community settings.
2)
To enable students to work towards achieving SECO for patients in secondary care outpatient settings
that are at the interface with general practice.
3)
To encourage students to recognise and respond appropriately to growing diversity in the New Zealand
population as experienced in the primary care and community settings.
4)
To encourage students in their final year of medical training to maximise their learning from their clinical
placements.
5)
To enable students to continue to explore and develop their identity as a doctor.
C-E-O Module – Outpatient Clinics (2.5 weeks)
During this attachment you wil attend rostered clinics in ENT and Ophthalmology. You wil also each spend
one day with staff of the Otago Community Hospice, and work two sessions at the Dunedin Urgent Doctors
and After Hours Centre.
Learning objectives
During these attachments you wil be expected to:
a)
Acquire knowledge of the reasons for referral to clinics and the information required by the Consultant.
b)
Develop an understanding of difficulties that may arise as a result of hospital admission/discharge and
strategies to minimise these.
c)
Develop diagnostic and management skil s applicable to General Practice, for patients with disorders of
the eyes, ears, nose and throat.
d)
Observe, diagnose and treat common problems presenting in primary care.
C-E-O Module: Health Care Evaluation Project (6 weeks)
During this attachment, you wil work as a group to undertake a practical audit or evaluation of a specific area
of health care delivery for a client. The project is intended to be a useful assessment of a real problem or issue
in health or health care for which you will work (under supervision) to find a solution. The overall purpose of
the project is to help you learn some of the skil s you wil need to evaluate your own medical practice in the
future – this is also known as practice audit. Audit contributes to ensuring high quality health care services, by
monitoring the quality of care, identifying problems and potential solutions, and evaluating again when
changes have been made. As a medical practitioner, in any specialty, there wil be some requirement for you
to ensure and maintain the quality of your practice by conducting audits of your work. It wil be important for
you to be able to decide on the question you are asking in any planned audit activity, identify the data you
need to col ect to answer that question, and analyse it appropriately (often quite simple analyses wil suffice).
The attachment is run concurrently with General Practice and Clinics and is overseen by the Department of
Preventive and Social Medicine. Administrative support and a Trainee Intern room are provided by the
Department, and we encourage you to attend seminars and events during your attachment with us.
Learning objectives
During these attachments, you wil be expected to:
a)
Gain an understanding of methods used to assess the quality of care in hospital or community practice.
18
b)
Demonstrate the ability to work with others as a team to formulate and carry out a study, and assess
the results.
c)
Show an understanding of the lessons learned from the experience and of ways in which problems in
health care delivery might be avoided or ameliorated.
d)
Present the findings at a departmental seminar to the client and other relevant parties, as wel as
produce a written report for the client
Assessment of the Community and Critical Care Quarter
This quarter has been designed to provide a range of opportunities for every TI to build on prior learning and
to develop appropriate procedural skills to the level required for the step up to Internship (PGY1). Consider
your TI year as a "rehearsal" for PGY1, by becoming self-motivated, assuming an appropriate level of
responsibility and taking every opportunity to become part of your clinical team.
Assessment in sixth-year is primarily formative. Feedback from your clinical tutors informs us of your
progression. We take this feedback very seriously and every component of your work is assessed in some way.
The Committee monitoring student progress is particularly interested in such things as punctuality,
attendance, communication skil s, active clinical participation, demonstration of clinical acumen, competence
in basic procedural skills and your ability to work as part of a team.
An unsatisfactory report in any of these areas may require further summative
assessment and could delay your progress to PGY1.
To meet the requirements of the Community and Critical Care Quarter, you wil need to demonstrate
satisfactory attendance and effective participation in:
· General Practice
· Dunedin Urgent Doctors Clinic and Otago Community Hospice
· ENT and Ophthalmology clinics
· Emergency Department
· Anaesthetic Department
· ICU
· Health Care Evaluation Project
In addition you must gain a satisfactory level of attainment in the Resuscitation Council course and GP
assessments and complete all group and individual requirements for the Health Care Evaluation Project.
19
Ward Management Quarter
The Ward Management Quarter comprises two six-week attachments in which the student has
individual responsibility for the continuing care of a limited number of hospital in-patients under the
direct supervision of a Registrar or Consultant. The student wil also have an opportunity to be
involved in the management of outpatients attending clinics and to gain experience of patient
management in anaesthesia under the direction of specialists in this discipline. Normal y students
should select two six-week attachments in medicine and surgery from a list of currently approved
options. Proposals to work on a service not listed would be considered by the Departmental Heads
in this quarter and would take into account patient management experience acquired in other
quarters including the elective.
Objectives
The student in this quarter shal , under appropriate supervision:
1
Become accurate and efficient in interviewing and examining patients and in identifying their
significant health problems.
2
Continue to develop and improve development of the skil s in diagnosis, problem list
differential diagnosis for each major problem and to propose and, as appropriate, implement
plans for the clinical, social, laboratory and radiological investigation of patients.
3
Develop skil s in treatment, particularly the ability to propose and, as appropriate, to
implement plans for the management of patients. This shal include the prescription of drugs,
diets and fluids, the performance of minor medical and surgical procedures and the
involvement of nursing, physiotherapy, occupational therapy and social work services.
4
Develop the ability to recognise a medical emergency and to initiate appropriate action.
This shall include the ability to recognise priorities when faced with a multiplicity of tasks.
5
Enhance personal knowledge and understanding of il nesses and develop the skil s of in-
service learning, which wil be continued throughout the graduate's practising life. In
particular the student shal learn to use the resources available from a medical library
including electronic databases such as OVID and PubMed, e-journals and electronic
references such as UpToDate with respect to investigation and management of patients
under his/her care.
6
Develop managerial skil s in the conduct of duties in the ward and clinic and to enhance the
efficiency and effectiveness of patient care. This shal include the ability to maintain an
accurate, clear and concise ongoing record of the illness and management of patients under
his/her care.
7
Develop skills and sensitivity in communication, interpersonal relationships and teamwork as
these affect patient care.
8
Develop an awareness of his / her personal role in the management of individual patients, an
understanding of his / her own limitations in this role, and an appreciation of when it is
appropriate to consult.
Trainee Intern participation in on cal commitments during ward based attachments
A trainee intern is expected to participate in on cal session as a valued member of the team.
This is an essential part of the learning experience and participation is required for terms to be
awarded.
To avoid a disparity between runs and to maximize the exposure of all TI's to acute cal , a minimum
requirement should be met. Attending on call sessions enhances the role of a TI as a team member.
20
It also maintains continuity as the TI takes responsibility for a sub group of patients on the ward, and
engages in their management plan.
An appropriate involvement would be one day per week and one weekend in five. The majority of
teams participate in 24-hour call, so a reasonable attendance would be until about 10pm in the
evening, but should relevant clinical events occur after this, then the Trainee Intern is strongly
encouraged to use his / her initiative to make full use of the learning opportunity. Seeking greater
involvement in 'out-of-hour' clinical experience is left to the Trainee Interns own choice.
Some runs where the team has acute cover for 24/7 (eg Neurosurgery, Urology and Vascular
Surgery) the TI must discuss the expectation and how acute experience is achieved with the
academic staff member on that team.
Assessment
As a TI on Medicine there is an opportunity to acquire skil s in management of patients in a ward setting
such as wil be required of a house-surgeon.
The aim is to make the transition from being an undergraduate student to functioning as a junior
house-surgeon. It is therefore expected that the TI is a productive member of the ward medical
team, shouldering some of the work of the team. This would usual y involve supervising some
patients. This wil require close interaction with other members of the team, especial y the house-
surgeon and registrar, under the supervision of the team consultant. It is expected that students wil
already be proficient in taking a history, conducting an appropriate examination and constructing a
good problem list. In this attachment emphasis should be placed on acquiring further ability to plan
investigation and management of patients. The TI is expected to be on cal at least three times during
the six week rotation. Progress in the area of team interactions will be assessed on the PASAF, and
overal ward grading. A long case will also be used in assessment of the ability to assess and present
patient problems. Emphasis wil be placed on definition of the patient's problems and plan for
investigation and management. The student must gain a Pass or higher in both ward assessment and
long case to pass their Medicine attachment.
To pass the PASAF the Trainee Intern must adhere to the fol owing:
· Punctuality
· Professional attitudes and behaviour in al aspects of patient contact and ward management
· Become a good team member and work closely with all members of the team
· Attend all tutorials
Selected students will be invited to sit the JAD Iverach Prize Examination, which consists of a
presentation gift. This is a prerequisite for being invited to sit the distinction examination. The
Iverach Prize is held on the Friday of the fifth week of the last quarter, with the distinction the
fol owing Wednesday. Students who are on a fourth quarter elective should check with Sheryl
Foster prior to going on elective to confirm if they will be invited to sit the JAD Iverach Prize in
Medicine.
A booklet will be issued at the beginning of each attachment with more detailed information on the
requirements of the Medicine run. It wil include the tutorial information, and names and tracers
of the registrars attached to the appropriate teams.
21
Surgery
The emphasis for Trainee Interns on the surgical attachment is to develop the interpersonal,
practical, and technical skil set which wil enable them to become part of a surgical team and to
function as much as possible as an 'apprentice house officer.
Throughout their training the interns have completed runs in a number of surgical specialities, and
the pathophysiology and clinical presentations covered in these rotations is the ‘core knowledge’
that they bring to the Trainee Intern attachment in surgery. To facilitate the practical and
apprenticeship aspects of this rotation, interns are attached to a surgical team. They wil become ful y
integrated into the medical work of that team, and wil be given increasing opportunities to develop
their clinical skil s as they help care for patients. A wide range of choices of teams are available,
including in general and vascular surgery, ENT, urology, neurosurgery, cardiothoracic surgery, and
plastic surgery. The programme of the team is the first priority of the intern.
Additional leaning opportunities are also provided throughout the rotation. During the first week a
practical suture workshop wil be held. Throughout the rotation a weekly clinical tutorial held 11am–
12noon Wednesdays (seminar room 431, 4th floor) with Mr Audeau. Attendance to this is
compulsory. There are also radiology tutorials and opportunities to attend tutorials linked to the
general medical attachment (which cover the period of time you are attached to Surgery and
Medicine). Making the most of learning opportunities wil have a beneficial impact on the rotation.
It is your responsibility to assess and admit a good number of patients, to attend acute cases (which
may involve staying in hospital when the team is on cal ), and presenting as often as possible to your
Consultants. Ongoing involvement and a good grasp of the daily progress of your patient wil also be
noted. You must complete the surgical skil s card during the course of the run. Note that this
represents a minimum attainment and you should certainly not restrict yourself to that. It must be
signed by a consultant or your registrar.
In terms of assessment any deficiencies in performance wil be brought to your notice during the
run, and/or at the final assessment. During the last week of the run, you must give your assessment
form (PASAF) to one of your consultants and make a firm appointment to discuss the assessment and
receive feedback before the run ends. You must sign the completed form and return it and your skil s
card to Ruth Mul enger (PA to the Head of Department).
While your clinical assessment abilities are formal y tested in the Medicine component of this quarter
by the presentation of a Long Case, this is not repeated in the surgical attachment. However, your
ability to frame a significant question, research and critically assess the literature, and write a
coherent argument in the manner of a scientific paper or review, is. This is the essential purpose of
the Surgical Essay, and you wil receive further instruction on how to go about this. The best surgical
essay wil win the Stanley Wilson Prize at the end of the year. Please note the deadlines for
completion and submission of the essay, as this is a requirement for terms.
If there is a genuine reason for possible delay in submission, you must contact Mr Woodfield and/or
Ruth Mul enger in advance of the deadline and seek permission for an extension, which wil only be
granted for extenuating circumstances. Students who perform well in both their surgical attachment
and essay wil be invited to a distinction viva at the end of the year.
22
Professional Development
Introduction
Professional Development (PD) in the Trainee Intern year wil reflect your increasing duties and
responsibilities as a senior medical student.
You are now an integral part of each clinical team, and your role in patient care becomes increasingly
important. In 4th and 5th year, the Professional Development lectures and mentoring were
designed to give you additional skil s and to help you form healthy attitudes in your clinical practice.
You wil now be required to demonstrate that learning. In a year, you wil become a house officer and
you wil need a wide range of professional tools to enjoy what wil be a chal enging period of personal
and professional growth. The PD activities listed below are designed to support your year as a
Trainee Intern and to help you develop and learn from your clinical experiences.
Professional development objectives
These are drawn from the Otago Medical Graduate Kaupapa Profile and the Core Professional Activities
1
Be able to describe the implications of professionalism including the responsibilities,
obligations and privileges in being a doctor.
2
Demonstrate the ability and wil ingness to learn and appreciate that learning continues
throughout life and that the maintenance of professional standards is a lifelong commitment.
3
Display insight and awareness into your own needs as a person and the occupational chal enges
of medical practice, and in response to this, establish and use appropriate support methods.
4
Display an awareness of the doctor-patient relationship and what factors may positively or
negatively impact upon it.
5
Be able to explain and demonstrate skil s in teamwork and group work with peers and other
health care professionals.
6
Be able to describe and demonstrate the establishment and maintenance of appropriate
professional boundaries in medical practice.
7
Know how to recognise and manage uncertainty, error and adverse outcomes in medical
practice and have awareness of the causes especial y preventable ones.
8
Be able to explain the impact on the student and doctor of witnessing suffering, loss, death
and dying.
9
Display an awareness of the environment of medical practice including the medico-legal
structure.
10 Be able to describe the impact of cultural background and beliefs on health and health
care. Develop insight into your own culture and beliefs and how these may differ from
that of others.
Self Care
We now know that patient safety is inextricably linked with physician wel -being and we encourage you to
continue to develop good habits of self-care which are most useful for you and are likely to include but are
not limited to:
·
Stress management and emotional intel igence tools
·
Having your own GP
·
Having a healthy diet
·
Exercising
·
Meditation or some other mindful practice
·
Being aware of and avoiding occupational hazards such as a mental and emotional fatigue, and
unhelpful strategies such as alcohol/drug abuse
23
·
Being aware of and managing boundaries
Mentoring Groups
Trainee Interns are expected to continue attending their mentor / peer review group. The
expectation is that you wil manage 3 to 4 meetings during your TI year. If you are unable to attend,
it is a professional courtesy to let your mentor know beforehand. Your role as a senior member of
an established peer group gives you the opportunity to offer support to the 4th and 5th year
students. They appreciate this and we hope you wil enjoy this role. It is a professional expectation
that we al offer support and assist in the education of our junior col eagues. As you know, you have
now had two years of working in smal groups and mentoring with the opportunity of discussion
with more senior doctors. Do take some time before your meetings to be clear about the issues you
wish to discuss with the mentor and your TI col eagues to facilitate their assistance. The meeting
after you come back from your Elective is an excellent opportunity to review your experiences and
learning, after having been in a different learning context. We expect you go to mentoring prepared
to discuss something that is important related to your clinical training. The reason why good
contact with your mentor and your peer group is helpful is that the Trainee Intern year wil be quite
different to your experiences in 4th and 5th year. Previous TIs have reported how they felt more
included in clinical teams, and their responsibilities were increased as the year went on. There are
closer interactions with patients and with other staff; these interactions can be both rewarding as
wel as challenging. The common topics in the first two years of peer group or mentoring were:
"difficult" patients; death, dying and suffering; colleague relationships, and styles of feedback.
These main topics came as no surprise, as they are generic issues for medical students around the
world. While some of these topics were addressed in your Integrative days in PD in 4th and 5th year,
you wil need to grapple with these issues again this year as you encounter them in the clinical
context. Other topics were; boundary issues, occupational hazards, respecting difference,
uncertainty, teamwork, and complaints. We appreciate that the TI year is busy, often runs are away
from Dunedin and the elective time is often taken away from New Zealand. Peer group work forms
a vital part of every doctor's support system. The issues that make attendance difficult for a TI are
the same ones that make it difficult for established doctors. Finding ways of surmounting these
obstacles is a part of becoming a professional y safe medical practitioner.
It is most important that if you are having trouble in arranging your sessions, then you need to be in
touch with the PD convenor - Dr Nigel Thompson. [email address] or 021 550 950
Tutorial work
Surgical Run
There is a Professional Development tutorial in the final week of your surgical run. This is facilitated by
Dr Lynley Anderson and Associate Professor Mark Thomson- Fawcett.
Community Practice
There is a Professional Development tutorial in the first week of your GP attachment facilitated by
Dr Nigel Thompson. There is a further review session in the first week with the opportunity to
formally reflect on your recent attachment experiences with your col eagues and teachers.
Reflective Practice
Some of the activities expected of you in this PD course come under the concept of 'reflective
practice'.
24
This is the term general y used to describe a structured time which practitioners use structured time
to review their clinical experiences, including their own ideas on the nature of practice. Just as
study of the doctor- patient relationship is relatively uncommon in medicine, practitioners who
take reflective practice seriously are few and far between. More than simply 'mul ing over' the
day's events or chatting about them with someone else at the end of the day, structured
activities of reflection include journaling, critical incident analysis, formal peer group
discussion, mentoring and supervision. However, any ‘thinking about’ our practice – which
results in a change of understanding or behaviour – can be thought of as being ‘reflective’. The
keys are: what have we noticed, what have we learned and, as a consequence, what will we do
differently in the future?
There is so much ongoing learning in our medical career that all practitioners must in some
sense be ongoing learners and ‘reflective’ – or seriously risk themselves, their patients and/or
their colleagues. The chal enge is to make the very best use of these ongoing opportunities as
they arise and to be both effective and efficient in our continuing professional development.
The medical school at the University of Otago now includes various activities of formal reflective
practice such as peer groups, mentoring and critical incident analysis. These are very useful skil s
for medical practitioners, and it is good to get into the habit of doing these activities before you
graduate.
In summarising reflective practice, careful activities of reflection help you to:
·
Understand what has happened (give coherence to the unfamiliar)
·
Re-examine your assumptions (about medical work and about self)
·
Guide action (by reviewing experience and exploration of option) To demonstrate skil s
in reflective practice, you should be able to:
·
Step back from immediate clinical situations to formal y review your experiences
·
Identify the relevant issues involved in your clinical and professional experience
·
Acknowledge your personal emotions and reactions
·
Monitor and evaluate your own skil s with respect to each point in your career
·
Move from immediate details to wider issues about the practice of medicine generally
Things you can do at any time in your career:
·
Talk over your more ‘difficult’ patients with someone else, ie share your worries and
frustrations
·
Personal writing on your working and learning experiences
·
Join a peer group and meet regularly
·
Find a mentor who you can trust and can talk with
Summary
The overal goal of these Professional Development activities is for you to be developing your
awareness and understanding of how to be a good doctor and to be developing good habits of self-
reflection and self-care which will facilitate your clinical practice as an individual and within any
team.
We wish you wel in the coming year and the years of clinical practice ahead.
Dr Nigel Thompson, Convenor (021 550 950) [email address]
25
MB ChB Programme of Assessment Policies and Procedures
For the most up to date information on assessment in the ALM6 year please refer to page 91 of the MB ChB
Programme of Assessment Policies and Procedures.
MCNZ ePort
Expectations for Trainee Interns engagement with the MCNZ ePort wil be formalised for the 2020/2021
year. You wil be notified with further information on this as details are confirmed, before December 31
2020. Updated details wil also be posted here on Med Moodle.
26
School Buildings and Facilities
Trainee Intern Common Room & Fraser Building
A room is available for your use on the 8th floor (room 8406), Dunedin Hospital, where you can leave
your belongings and relax. This room is particularly useful if you are on cal in the hospital. The access
code wil be given to you at orientation day. This room has a microwave, sandwich maker, toaster and
computers.
You can continue to use the Common Room, computer and study room and lockers available on the
first floor of the Fraser Building as wel . This facility is open to al medical students from years 2–6.
Access to the Fraser Building will be via your hospital swipe card into that wing of the building, and
then use of the access code into the locker room and/or study area. The access code will be given to
you at orientation. This number must not be given out to anybody other than second-to-sixth-year
medical students. This is for your own security. Please ensure that this door is always locked behind
you.
This common room has some lockers available, together with an adjoining room with tea and coffee
making facilities, a microwave and a fridge. Tea towels and washing up liquid wil be provided. There
is also a space next door with chairs/space to study and a bathroom, complete with shower available
for your use.
We recommend that you do not leave your valuables around, including stethoscopes etc, which tend
to disappear from time-to-time. Keys for the lockers will be available from Monday to Friday between
the hours of 9am–3.30pm, from OMS Reception, Sayers Building, at a cost of NZ$10 per key, on a
first-come, first-served basis. All keys must be returned to OMS Reception at the end of each
academic year. There is no refund when the key is returned.
I would be grateful if you would please ensure that you leave this room tidy at al times—this is your
responsibility. Please be aware that use of this facility is a privilege and not a right. Inappropriate
behaviour or abuse of the area wil not be tolerated. Please advise the Student Affairs Office (03 470
7700) if you are experiencing any problems with either of these common rooms.
General computing information
Moodle
Important information on your TI year wil be placed on Moodle. Please log on frequently:
[email address].
IT Help
Your first contact for assistance should be:
Ask Otago IT Support: [email address]
Tel: 03 479 7000
ASK Otago IT wil attempt to solve your problem over the phone.
27
Health Science Library
The Health Sciences Library, a branch of the University Library, is currently located on the first, second and
third floors of the Sayers Building (opposite Dunedin Hospital's main entrance in Great King Street). See
otago.ac.nz/library for information about the University Library.
Electronic resources
The University Library licenses access to a very large col ection of databases, electronic journals and e-books.
These can al be searched from the Library's home page otago.ac.nz/library. If you are searching from off-
campus (including Dunedin and Invercargil Hospitals) you wil need to authenticate with your university
username and password.
For access to key resources take a look at your Subject Guides
otago.libguides.com/medicine Note that some resources are available via mobile devices. District Health
Boards have their own library services to which you will also have access.
Opening hours (note these may change in 2021 and with COVID)
Semester:
7am–11pm every day
Summer School:
Monday–Friday 8.30am–10pm
Saturday 11am–5pm
Sunday 11am–9pm
Non-Semester:
Monday–Friday 8.30am–5pm
Closed on weekends
See otago.ac.nz/library/hours/ or Library notice boards for variations and changes to opening hours.
Information and Research Skil s
Through the Subject Librarian Service the library offers a range of support for individuals, smal groups and
whole classes. Contact your Subject Librarian to make an appointment
(see otago.libguides.com/liaison/healthsciences). When you are out of Dunedin for an attachment (eg in
Invercargil ), you are technical y a Distance Student. You stil have access to the Library's electronic and print
resources, and can have books and journal articles sent to you through the Distance Library Service. See
otago.libguides.com/distance for information on this service.
Borrowing material
Loan Periods
Books and journals (print): 4 weeks with 3 renewals
You can renew non-Reserve books through the My Library account link from the Library home page
otago.ac.nz/library
Reserve Col ection: 2 hours during opening hours
This material may be booked in advance and renewed if not required by another borrower. Overdue fines
(note that these may change in 2021):
Reserve Col ection: NZ$0.10 per minute
Recal ed Items: NZ$3.00 per day
Please note that we do not accept cash at the Library, you can pay fines using eftpos, or online.
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Document Delivery Service
Items which are not held in the Library may be requested at no charge (except for loans
from outside Australasia). Apply through the ‘Get it’ Document Delivery Service.
See otago.ac.nz/library/interloan.html
Students with Impairments
There is a smal study carrel – the Lee Gibson Room – available in the Health Sciences Library for students
with an impairment. Bookings must be made through the Disability and Information Support Office. Special
equipment can be made available to Health Sciences Library users through the Disability and Information
Support Office as required. See www.otago.ac.nz/disabilities/.
Please let Health Sciences Library staff know if there is any way that we can assist.
Health Sciences Library Contact details
Service Desk/Renewals [03] 479 7401
Document Delivery Service [03] 479
Health Sciences Librarian [03] 479 7403
Subject Librarians [03] 479 7407, [03] 479 7237, [03] 479 7459
Email [email address]
Twitter twitter.com/otagolibrary
Facebook facebook.com/UniversityofOtagoLibrary
29
Southland Hospital Invercargil
Arrival
On arrival, please come to the Main Entrance Public Car Park of Southland Hospital. Directly on
your right after entry into the Hospital is the Security Office where you will find your Welcome Pack.
If there is no one at Security please ask at the adjacent Emergency Department and they will contact
security staff. Security staff wil issue you with your Doctor's Residence room keys and give you your
Welcome Pack which wil contain the paperwork Southern District Health Board requires you to
complete, a map of the hospital campus and details for reporting for your first day. Free single
accommodation is available to Trainee Interns at Southland Hospital however, there is no married
accommodation.
Download a printable copy of this map (PDF 140 KB)
Travel arrangements
Please make your own travel arrangements to Invercargil . Trainee Interns will receive a
reimbursement for this travel from the Southern District Health Board following their attachment.
Please ensure you arrive in Invercargil on the Sunday night before your attachment begins, and fol ow
the instructions in this document regarding obtaining and signing for your room key. If you are
staying for the last weekend of your attachment, please ensure you let Ms Karen Erdman,
Accommodation Officer, know this. You wil then be responsible for ensuring the room has been left
clean and tidy, and the bed made up with fresh linen for the next person arriving on the day you
leave. This is your responsibility.
Orientation
On the first morning of your attachment please report to Madge Storm, Study Hub, Research and
Learning Centre, at 8.45am for orientation. A map to her office is included in your welcome pack.
Contact details:
Madge Storm Administrative Assistant
Study Hub, Research and Learning Centre
University of Otago, Southland Hospital, Kew Road, Invercargil PO Box 828
New Zealand
Tel: 64 (03) 218 1949 x 48212
Hours: Mon - Fri, 8.30 am - 12.15 pm Email: dsm.invercargil [email address]
Instructions on how to get to the Study Hub wil be in your Welcome Pack. After completion of
paperwork Madge wil take you to orientation as required.
· Library: Barry O’Cal aghan
· Infection Control: Jane Miedema
· Laboratory for MRSA test if necessary to the department for your placement:
· Medicine Department
· Surgery Department
· Obstetrics and Gynaecology - Lynley Pascoe / Annette Calder / Olwyn Thwaites
· Paediatrics - Karen Anderson / Michel e Cools
· RMO - Clair MacGregor
· Accommodation Officer - Karen Erdman
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Associate Dean (Southland)
Associate Professor Konrad Richter
Tel: 03 218 1949
Email [email address] / [email address] Should you need to see
A/Prof Richter appointments can be made through the Administrative Assistant, Madge Storm, email:
dsm.invercargil [email address], hours of work Monday - Friday 8.30am - 12.15pm (this can
change, please check). A/Prof Richter meets with the students at irregular times throughout the year.
These meetings are usual y informal and with other students and are an opportunity to feed back
any issues regarding your time in Invercargill. These meetings are usual y very productive and result in
change where this can be achieved.
The Associate Dean's office is also in the Study Hub.
MRSA clearance
MRSA is not required on students going to Invercargil unless:
· You have a skin condition
· You have had a previous positive MRSA test
· Are coming from overseas. IF you are coming back from your overseas elective, a NZ result is required.
ID / access cards
Southland Hospital has stringent access control measures in place across the campus.
It is important that you take your Southern District Health Board Identify Card with you; your
Southern District Health Board ID will be loaded onto the Southland Hospital security system on
or before your arrival and will be your means of identification and access during your placement.
Photocopier and Southern District Health Board computer use
The Southern District Health Board has no tracking on their copiers at present, so there are no copying
charges or restrictions on copying other than (1) those inherent in the Copyright Act 1994, and (2)
an expectation that only health study related copying wil be done. Southern District Health Board
computers are provided for business purposes only, which includes study. Users must comply with
the Southern District Health Board policy Internet Use, copies of which can be found on Library notice
boards.
Car parking
Parking is provided on the east side of the Doctors' Residence (gravel car park).
Students are not to park in the main public car park 8am–5pm Monday to Friday, or at any time in the
Hospice car park.
Library
The Library is situated across the car park from the main hospital in the Community Services Building.
24-hour access to the Library is available with your swipe card. Entry is via the proxy card door / staff
only entrance to west side of Community Services Building. The Library is Reference Only at
weekends, from 5pm at night to 8am the next morning, and very occasionally during normal working
hours if the Library staff are absent. Library users should present themselves at the Help Desk for
assistance and to have books, etc, issued.
The loan period is three weeks and al loans must be returned to the Southern District Health Board
31
Library before students leave Southland Hospital. There are University of Otago PCs in the Library,
one with a CD burner and a University of Otago printer. The Library is a 'Quiet Zone'. It would be
appreciated if phone cal s could be taken and made outside of the Library.
Barry O’Callaghan (Assistant Librarian) and Jeremy Andrews (Library Assistant) work in the Southern
District Health Board Library and look forward to meeting you. Please do not hesitate to seek their
assistance if you think they can be of help.
Dunedin Campus computer facility in Invercargill
Students wil have access to computers in the Library, Clinical Services Building, Paediatric
Department and the Doctors' Residence. Please keep these areas tidy. Please take your pop numbers,
passwords, etc, with you regarding your own email to enable you to access and check it. Printing and
scanning facilities are also available in the library at no charge. Printing and scanning is also available
in the Study Hub using your Uni ID card.
Troubleshooting of the Dunedin Campus computers (apart from paper and toner resourcing) should be
through the University of Otago's Ask Otago IT Support – [email address].
Madge Storm looks after paper and toner requirements in the Doctors Residence.
Computer help in Invercargill
For any further assistance the process is the same as if you were in Dunedin. The Invercargil computers
are remotely control ed by the Dunedin Campus ICT Support Group so we can often fix your problems
quickly.
Doctors' Residence
An envelope containing your room keys and information about staying in the Doctors' Residence will
be waiting for you at Security with your Welcome Pack. The Doctors' Residence cannot be entered
unless the correct security code is used at the entrance door. This wil be with your Room Key. Prior to
leaving Dunedin you will be asked to sign an agreement that you will abide by the rules of the
Residence when you col ect your key. The Residence has three levels, each level with its own shared
kitchen, ablutions and lounge areas. The ground floor is general y used for on-cal medical staff and
fourth-year medical students. Trainee Interns are usual y on Level 2. DO NOT SWAP ROOMS DURING
YOUR STAY, as rooms are planned out for the year. If there is a problem with your assigned room
please discuss with Karen Erdman. You room key must be returned to the Security office when you
leave. Failure to do so will incur a $25 replacement fee.
Each room contains:
· Bed, mattress, and bed linen
· 4-drawer tallboy, wardrobe
· Small study table, chair
· Heating
Fresh bed linen and towels are available at all times; however al residents are responsible for cleaning
their own rooms. Vacuum cleaners are available. Residents are also responsible for keeping the kitchens,
lounge / TV areas clean and tidy. ISS clean the ablution areas four times per week. There is also a laundry
and auto-washers, tubs, and a drying room.
Kitchens are equipped with:
· Electric range and microwaves
· Fridge / freezer
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· Instant boiling water
· Cooking utensils, cutlery, crockery, cupboards for food storage
No tea, coffee, milk, etc, is provided. Reasonably-priced meals and other snacks are available at the
café in the hospital. There is an expectation that you will keep the kitchens, lounge and your personal
bedrooms clean and tidy at al times. Cutlery and crockery must be returned to the kitchen areas
and washed immediately after use. Please also clean the ovens inside and out, microwaves and
refrigerators, stovetops, inside and outside microwave with cleaning products provided on a daily
basis. When you leave throw out any unwanted food items. Uncovered food items in the cupboards
or on the bench will encourage mice.
Rules for the Residence
· DO NOT CHANGE ROOMS, stick to your assigned room
· Do not shift any furniture from the lounge, kitchen, or bedrooms
· No bicycles are to be stored in the bedrooms
· Turn off al taps
· Wash, dry and put away all dishes immediately after use; do not leave them to "drip dry"
· Clean out all refrigerators regularly
· Wipe down benches, microwaves (inside and out), stove tops and ovens after each use.
· Under no circumstances is cooking to take place in bedrooms or any other areas other than
kitchens. All bedrooms and corridors are fitted
· with smoke detectors, which are connected directly to the fire brigade. Jug kettles are also not
allowed in the bedrooms.
· Please be considerate of other residents and keep the noise levels at a minimum between the hours
of 10 pm and 7 am.
· At any time when the fire alarm sounds continuously all occupants are to evacuate the building.
Failure to leave a building when a fire alarm sounds may result in disciplinary action being
taken. You are not only endangering your own life but those of the response teams.
The Fire Service allow for two false alarm cal outs every year; a NZ$1,000 invoice is sent to the Southern
District Health Board on the third. Should the cause of any cal out be due to neglect then this invoice
bill wil be passed onto the person responsible.
Evacuation board
When entering the Doctors Residence use status board to indicate your presence by sliding appropriate
room number to “IN”. When exiting Doctors Residence use status board to indicate your absence by sliding
appropriate room number to “OUT”. This is very important as if a Fire Alarm is activated Security and the
Fire Service know how many people are in the Residence.
Bike security
There are under cover bike stands available beside the Doctors' Residence. There is no enclosed locked
area available. Bikes left at any of the bike stands around the Hospital are at the owner's risk.
The Otago Medical School, Dunedin Campus and the Southern District Health Board have made a
significant joint investment in the provision of these facilities for your use. To ensure their continuing
availability, the Residence wil be checked for cleanliness and damage on a regular basis. Failure to
maintain the expected standard of tidiness and basic hygiene wil result in individual charges for
cleaning and/or damage. You wil be required to sign a form indicating that you wil abide by the rules
of the residence.
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Videoconferencing Room
The Study Hub has two AV rooms for your zoom tutorials. Very occasional y these may have prior
bookings and you may have to do your zoom session in one of the other rooms. If there are any
problems with the link to Dunedin please contact Madge or fol ow the help instructions nearby. It is
important that you report any problems or poor quality immediately. Dunedin Campus is committed
to providing a good quality link so that you continue to be involved in the Dunedin based teaching
programme.
Zoom room
The zoom rooms and situated in the Study Hub. If there are any problems with the link to Dunedin
please contact Madge Storm, or fol ow the help instructions nearby. It is important that you report
any problems or poor quality immediately. The Dunedin Campus is committed to providing a good
quality link so that you continue to be involved in the Dunedin based teaching programme.
Contacts
Dunedin Lecture Theatre Technicians (Fraser Brown and Michael Tanner) - 03 479 7086 - or contact
Fraser direct on 021 279 0740, or Michael on 021 279 7086 you may text them during a presentation.
Paediatrics zoom link
All zoom links wil take place in the Study Hub.
Complaints and/or concerns
If at any time during your stay in Invercargil you are concerned about anything in regards to the course,
personal or otherwise, please direct these issues to Madge Storm 03 218 1949 ext 48212 / email
dsm.invercargil [email address], office hours Monday to Friday 8.30am–12.15pm; or contact the
Student Affairs Office at Dunedin Campus 03 479 7700/ email [email address].
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Student welfare and services
Student Affairs Office – Sayers Building – Otago Medical School Administration
The Student Affairs office is headed by two Associate Deans’ for Student Affairs, Dr Penny Eames and Dr Tess
Patterson. Although Dr Eames mainly sees ALM students, Dr Patterson ELM students, there is a cross-over.
They are responsible for al student matters relating to their personal, academic or pastoral care and is assisted
by the Manager of Student Affairs, Jil ian Tourel e. Jil is also able to assist and guide you in these matters, and
to refer on as appropriate. The responsibilities of the Student Affairs Office include matters such as leave of
absence, progress and assessment, final year electives, coordination of the sixth year programme, OUMSA
activities and coordination of timetables. Appointments to see the ADSA can be made via Erin at
oms.studentaffairs@otago / 479 7420.
Medical Education Unit - Sayers Building – Otago Medical School Administration
The Medical Education Unit (MEU) is involved in the planning and administration of the curriculum for medicine,
years 4 - 6. Relevant staff you may contact include:
Associate Professor Ralph Pinnock (Director, Medical Education Group and Associate Dean, Undergraduate
Education)
Associate Professor Kristin Kenrick (Assistant Director, MEU & Y6 Co-Convenor, General Practice & Rural
Health)
Dr Megan Anakin (Lecturer)
Ms Angela King (Administrator Client Services (4th & 5th year).
MEU provides:
· Assistance to the Dunedin Campus with curriculum planning, development, and logistical support
· Curriculum and educational support to 4th , 5th and 6th year students
· Course evaluations
· Invercargil and Timaru travel reimbursements (Years 4 and 5)
· Teaching staff support and development
· Input to OMS initiatives on course development
MEU are involved in regular meetings with student representatives. You can bring any concerns or suggestions
about curricular matters to us through them or directly.
Student Affairs, across the three campuses, has been working with our IT experts to get a new Moodle ‘Student
Support’ page up and running.
The page includes some brief information about Student Affairs, some wel being resources (at the moment links
to other sites), contact information, and a link to be able to report concerns about intimidating behaviour in
the learning environment.
We very much welcome any comment about suggested developments and resources that people have found
useful that we could link from the page.
The issues of reporting intimidating behaviour and implementing the informal reporting mechanism
recommended by a workshop of students and staff, were what drove this development initial y. The document
endorsed by the Otago Medical School Executive is on the page, as is a link to a reporting form. When someone
submits a form, an email goes to Student Affairs who col ate the forms and pass them on to the newly formed
Behavioural Assessment Team for discussion about action. We wil email students regularly to remind them to
use the reporting form if incidents of concern have occurred. You may choose whether to put your name,
email, or student group on the page. These details would al ow some feedback to you on what action was
taken.
The reporting form is housed outside of Moodle, and is confidential and secure - it is not linked to your identity in
any way unless you decide to include your name or other details.
Support for students is always available from Student Affairs. Just get in touch using the contact details on the
page.
35
Also on the page is a link to announcements on student support and wel being. We hope as time goes on to
use this more and more to tel students about support and wel being initiatives and information.
Feedback is welcome!
Otago University Medical Students’ Association Inc (OUMSA)
In order to cater for ALM students’ needs, OUMSA’s structure has changed to include and ALM Exec:
President: Madison Hutton [email address]
Vice President: Jack Forsythe [email address]
Education Officer: Kelsey McNabb [email address]
Social Officer: Emily Seddon [email address]
Welfare Officer: Kate Saunders [email address]
TI Education Rep: Harshith Kondakindi [email address]
5th Year Education Rep: Jake Ward [email address]
TI Social Rep: Marieke Kruiswijk [email address]
5th Year Social Rep: Kate Emett [email address]
TI Welfare Rep: Georgia Hoten-Walker [email address]
5th Year Welfare Rep: Renne Ashton [email address]
The New Zealand Medical Association (NZMA)
NZMA is the only doctors’ organization that represents you at every stage of your career, and in whatever medical
specialty you choose. The NZMA is a strong and effective voice in national health and social policy issues. Our advocacy
is heard and does make a different.
The NZMA is a strong supporter of medical students and works closely with the NZMSA. We sponsor student events and
activities including career evenings, conferences, workshops and projects. Most importantly, we listen to and express
issues such as education and training, the medical workforce pipeline and government health policy. Our advocacy aims
to ensure that the environment in which you learn, train and work benefits you and the health system as a whole.
You are an NZMA member through your NZMSA and OUMSA membership. The NZMA represents the doctors of
tomorrow, today. As a member, you are helping to shape your future as a medical professional, project your career
investment and ensure your voice is heard. NZMA members are part of a professional community of doctors. During
your studies, through graduation and beyond, we are here to represent and support you.
Please refer to our website for further information: nzma.org.nz.
Class representatives
Each year a group of students is divided into four groups for administration purposes. Each of these groups should
nominate a ‘class representative’ one of which for each year should be the OUMSA rep. The main role of the student rep
is to facilitate the flow of communication between the group, the rest of the class, the reps in the years above and below,
OMS and vice versa. Reps sit on a number of important committees and the School values their input. The quality of
feedback to and from students is greatly influenced by the class reps and this wil become more important as curriculum
and assessment changes are considered. By sharing the workload between the reps the individual commitment need
not be too time consuming. The knowledge gained of the working of Otago Medical School and curriculum development
is invaluable. The class reps also carry out organization of social events and the Graduation Ball.
Student with impairments
If you have permanent, recurring or temporary impairment that may affect your study please let the Student Affairs Office
know, as wherever possible they wil try and meet your needs.
36
In addition, the staff at Disability Information and Support provide learning support, advice, advocacy and information to
students with permanent, recurrent or temporary impairments. More information is available on request at
[email address]
International student support
The University’s International office provides a wide range of support to international students. They can be found in the
Archway West Building or contact [email address]
Māori Centre – Te Huka Mātauraka https://www.otago.ac.nz/maoricentre/index.html
The Maori Centre is a support service for all students of iwi descent. The Centre also aims to encourage Iwi Māori to
participate and succeed in tertiary education. The Centre offers support for academic, cultural and social needs from
pre-enrolment through to graduation and operates from a kaupapa Māori base (Māori philosophy).
Pacific Island Research & Student Support Unit https://www.otago.ac.nz/pirssu/index.html
The Pacific Islands Research & Student Support Unit (PIRSSU) currently looks after approximately 500 Pacific
students from New Zealand and the Pacific region studying in the Division of Health Sciences. We offer
excellent training in health professional and al ied health programmes, nurture successful research careers,
and offer quality pastoral care in an inclusive cultural environment. We look forward to welcoming you to our
Pacific community in Health Sciences.
Student Health Services https://www.otago.ac.nz/studenthealth/index.html
Student Health is central y located on campus in a purpose-built facility. We have approximately 50
staff, comprising nurses, general practitioners, counsel ors, psychiatrists and administrative staff.
We endeavour to provide the best health care possible in a manner that is competent,
compassionate, confidential, timely and in an atmosphere of mutual responsibility and respect.
We provide daily urgent and routine appointments. If patients need to be seen in our urgent daily
clinic they wil always be triaged (phone cal or face to face) by a nurse before being booked an
appointment with a health professional.
Consultation fees do apply (details are available on our website) and charges are reduced with a
Community Services Card (CSC).
The Dunedin Urgent Doctors and Accident Centre is available for after-hours emergencies. Higher
consultation fees apply for after-hours services.
Emergency Psychiatric Service at the Dunedin Public Hospital provides urgent mental health care 24
hours a day.
Please refer to our website for services/charges
37
General Information
Administrative details
The Trainee Intern Course Convenor/Advisor is Professor Rob Walker in the Department of Medicine. He is
responsible for maintaining an overview of each student’s schedule of attachment for the year and to ensure
the best possible educational experience for that students. Professor Walker also approves elective choices.
The Trainee Intern Course Coordinator is Jillian Tourelle. Jil coordinates al aspects of the sixth-year medical
course including your programme/timetable. Al queries relating to the timetable must be directed through
Jil .
The Trainee Intern Electives Coordinator is Sheryl Foster. Sheryl coordinates the elective protocols, receipt
of your elective reports and supervisors’ assessments.
If a TI has difficulties of an academic or personal nature, advice may be sought from either Professor Walker
or Dr Eames, ADSA or from Student Health Counsel ing Services.
General Notes
TIs are ful -time students who are required to complete a period of training in practice settings to gain the
necessary experience to al ow them to complete the educational requirements of their qualifications. In
order to be in good standing, a TI must comply with the fol owing:
· Be enrol ed with the University
· Hold honorary staff status with any District Health Board to which that student is attached
· Be a member of a recognized medical indemnity programme (MPS)
· Be diligent and punctual in attendance and participation in designated clinical activities including
acting house officer duty as appropriate.
Note: absence for whatever reason must be explained to the Course Convenor/Consultant and departmental
administrator of the respective Module.
Notices/updates
All timetable updates, handbooks, term dates, forms, policies etc wil be available on Moodle. Please check
this on a daily basis for al regular updates.
Student Leave
It is expected that al students wil attend al scheduled learning experiences. This particularly
applies to all laboratories and tutorials in ELM and all block and vertical module teaching in ALM. It is
however acknowledged that a student may wish to have leave from time to time to attend to personal or
extracurricular matters.
Staff and students have agreed that the process of applying for and having leave approved,
should be easy, and without unnecessary barriers. The approval of leave and the decisions about any catch-
up work needed should be fair and reasonable and involve discussion where necessary with the student.
38
Application for Leave
Students are required to seek approval for al leave and once approved, should notify in advance,
appropriate convenors/administrators, supervisors or tutors. Where possible, planned leave should be
requested six weeks in advance.
Leave requests are submitted on line https://medschool.otago.ac.nz/course/view.php?id=1760§ion=6
If the leave requested is for longer than 3 days it also needs approval from the Associate
Dean (Student Affairs). Normal y, this would involve a brief meeting with the Associate Dean.
If students wish to discuss the process of applying for student leave, the Student Affairs Office can provide
information.
Consideration of Leave Application
When staff are considering approval of leave applications, the fol owing points wil be taken into
consideration:
· Learning or professional development opportunities afforded by the activity
· The family or community importance of the student attending the activity
· Whether the student has extenuating personal circumstances
· Whether the student is participating in a national or international sporting or cultural
· event
· Whether the student is presenting, organising or representing a group at a
· conference or meeting
· The proportion of the module being requested as leave
· The reason the activity cannot be undertaken during scheduled holidays
· The length of leave relative to the activity
· The importance of missed teaching or assessment, and the student’s ability to catch
· up on missed activities
· The student’s total leave in that year and any other leave in that module
· Whether the leave wil benefit the wel being of the student
If a student’s application for leave is denied by the module convenor(s), or any catch up required is seen as
being unreasonable by the student, the student may appeal to the Associate Dean (Student Affairs). An
ultimate appeal of a leave decision by the ADSA, can be made to the Dean of the campus in ALM or the
Director of the ELM programme in ELM.
Sick Leave, Bereavement Leave or other Emergency
If a student is unable to attend learning sessions or their attachment due to il ness or other
reasons the appropriate tutor(s), module convenor(s), the ELM Administrator (for ELM students) and the
Student Affairs Office must be notified on the first day of the absence and on any subsequent days. This is
the student’s responsibility. It is important not only because of the missed learning opportunities, but also
because staff frequently arrange clinics and patients to be available for students so need to know if the
student wil not be present. A medical certificate is required for any student absence because of il ness for
more than 3 days. It is important that students absent themselves from work if il , in order to avoid infecting
vulnerable patients. The length of time taken for bereavement leave is also considered on an individual
basis. Please note that evidence of bereavement should be provided i.e.: copy of death certificate, death
notice etc.
39
Dealing with Missed Sessions
Please note in ALM it is the student’s responsibility to arrange any necessary catch up with the relevant
module convenor(s). Normal y, in ALM, an approved absence of one or two days on a module would not
need to be made up, provided no essential teaching sessions or experience was missed. Above one or two
days, if missed content/experience cannot be completed within the module, this may lead to a module result
of ‘Incomplete’ and a plan made to al ow completion. Unexplained absences or absences when leave has
already been turned down, may be considered as unprofessional behaviour when it comes to assessment
decisions.
Public Holidays
If a Trainee Intern is required to work public holidays with their team, they should be al owed
one day’s leave in lieu of this, to be taken at an appropriate time within the same module. This should be
discussed with the senior members of the team to arrange a day that is beneficial for al parties and where
there is unlikely to be significant loss of learning opportunities
Attendance at clinical rounds while unwel
It is unprofessional to expose patients to risk of infection. Students scheduled for a clinical round whilst
unwel should consider the welfare of those with whom they wil be in contact, both patients and col eagues.
If in doubt, please seek advice of staff.
Sixth Year TI Grant
All enrolment procedures MUST BE COMPLETED prior to the commencement of the Trainee Intern year on 23
November 2020. Trainee Interns wishing to join the University student clubs, obtain cheap airfares etc., must
also pay the OUSA levy.
Trainee Intern Training Grant - Information regarding entitlement to payment
The training grant comes from Vote Education funding and is only administered by the University of Otago for
the Dunedin, Christchurch and Wel ington Campuses. The funds are forwarded to the University monthly and
are distributed to the Trainee Interns’ bank accounts for payment on the 1st Wednesday of each month. The
process for banking the Trainee Intern grants is that these are banked on the evening of the 1st Wednesday of
each month via the bank transfer service. In real terms this means that they wil have access to the funds from
the fol owing day although they may be available late in the evening of the date they are processed.
The training grant is $26,756 per annum, tax-free and paid in 12 monthly payments of $2,229.66. This grant is
non-taxable. It is important to note that those intending to apply, or receiving Student Al owance payments
through Studylink, understand that the training grant is classed as income, and you do not qualify for both.
The Trainee Intern year normal y runs from approximately mid- November for a period of 12 months. The first
payment is made on the 1st Wednesday of December (2 December 2020) and the first in November (3
November 2021) the fol owing year.
The elective quarter cannot be paid in advance, as the funds are only received for payment monthly.
If there is a need to resit one or more 5th year examinations, there wil be a delay in commencing the TI year
for one quarter, or even repeating the 5th year. The Training grant wil begin when the student commences
sixth year.
40
Information from Study Link
If you get a Medical Trainee Intern Grant, we may count some or al of it as income. How much we count as
income will depend if the grant is paid to you as a lump sum or monthly payment.
Lump sum payment
If it’s paid to you as a lump sum, we won’t count any amount that you use to pay for either your:
· course fees
· course costs that are over and above normal course costs, eg:
· air fares
· additional accommodation when on placement.
The rest of the grant will be divided into a weekly amount. This weekly amount will be counted as income for
your Student Al owance. If you’re unsure whether your course costs are over and above normal course
costs, cal us - 0800 88 99 00 Monday to Friday, 8am to 5pm to discuss your situation.
Monthly payment
If it’s paid to you monthly, the entire payment will be counted as income. The monthly total wil be divided
into a weekly amount and the weekly amount will be counted as income for your Student Allowance.
Grant eligibility
Eligibility for the grant is determined by whether or not an individual is assessed for domestic fees. Those
assessed for international fees are not eligible for the grant.
The 6th year training is classified as a 'restricted course'. This means that funding for the entire year is
predetermined based on eligible students at the start of each year. Therefore it is not possible to achieve
entitlement during the course of the training year even if there is a change in eligibility status.
Any interns transferring to or from Auckland Medical School wil be paid the grant by the School teaching the
6th year of the course, so please ensure you check with the TI Course Co-ordinator to ensure al of your details
are forwarded so you may be paid.
You may be required to work in the wards by the District Health Boards as acting House Officers. This is a
requirement of your course and no extra payment is made for this.
If you require a letter for evidence of income of the Training Grant by banks, referees, for loans etc., then
please email Jil ian Tourel e, the TI Course Co-ordinator, at the University of Otago, who wil be happy to
provide these. Her email address is: jil ian.tourel [email address]
Communication
Checking your student email
It is important to check and clear your student email on a regular basis, particularly when you are on
elective. Any correspondence from the Medical School wil be via Moodle or your student email. If you have
any problems please contact ASK-IT.
41
Cel phones, iPads or Laptops
Use cel phones, iPads or laptops in a considerate manner: receiving cal s, texting, tweeting and/or updating
your FB status during tutorials is not acceptable behaviour.
Social medial and the medical profession
The Internet immediately connects us with the public domain and we must continue to avoid
making comments or posting material that could be interpreted as breeching the boundaries of
patient-doctor confidentiality.
While blogging, tweeting, and other social networking avenues are, for the most part, well
intentioned, there is the potential for these activities to have future adverse consequences. As
members of a professional community with high ethical standards, any comments, images and
material you may leave on a personal page could embarrass you when seeking future employment.
Any photos of patients, aspects of patient care, procedures, etc, must not be placed on social media.
This includes material that you might gather while you are on elective overseas. The 'rule of thumb'
in this situation is to behave exactly as you would in New Zealand. The standards that you wil be held
to account over, are the same.
Recording of patient interview and clinical presentations
Recording of patient interview or clinical demonstrations by students is not permitted under any
circumstances. Patients have not been asked for permission and it is inappropriate for students or others to
request permission at the time of the demonstration. Please ensure that you respect the confidentiality
implicit in all clinical demonstrations.
Graduation
Graduation application process
In order to graduate and receive your certificate you must apply by logging in to your eVison portal and
respond to your graduation invitation which wil be sent to your student address from the Graduation Office.
You MUST respond even if you do not wish to attend a graduation ceremony. Please refer to the Graduation
website for further information eg dates, hiring regalia etc.
https://www.otago.ac.nz/study/graduation/index.html
Draft Graduation weekend programme – Saturday 11 December 2021
Friday evening
Medical Graduation Bal
Saturday
9.30 am
Graduation Brunch – Atrium, Commerce Building, corner of Clyde Street and Union
Street East
10.20 am
Colquhoun Lecture Theatre – reading of the Oath, OMS prizes & Campus photos
11.15 am
Graduation procession/ceremony – Assemble Dental School
12 pm
Marshal ing of graduands
1 pm
Ceremony begins
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Dunedin Campus Trainee Intern Graduating Dinner & Prize-giving
This event is held on the last Thursday of the fourth quarter eg Thursday 18 November – commencing at 6.30
pm. Prizes for students from the Dunedin Campus wil be presented.
House Officer positions
Information can be found at the Advanced Choice of Employment (ACE) website:
https://www.kiwihealthjobs.com/ace/graduate-doctors.
House Officer jobs will commence in January 2022. Information regarding the ACE road show and application
process for positions is sent out by ACE, via the Student Affairs Office around February.
Useful tips:
· Decide where you wish to go and why. If it is a smal er and popular hospital, such as Nelson, take measures
to increase your chances of success. Plan your elective to spend some time there. Visit the hospital March-
April for a long weekend and meet the intern-supervisor and coordinator of the RMOs. Tel them why you
are keen to go there.
· If you wish to remain in Dunedin, make sure you contact/visit the RMO unit and advise them of this. They
will arrange for you to meet the intern supervisor.
· Remember it is your clinical ability that has a big impact on the decision-making. How wel do you work
with the ward team? Do you carry your share of the workload and get on with the tasks required, even if
this means finishing at 5.30 pm or later? How wel do you use your clinical knowledge and make
appropriate decisions? Al these things are watched closely and add to the review process.
· Choose your referees careful y. They wil be commenting on the above issues. Make sure you ask them
early. As your job is a hospital job as a house officer, your ability as a TI on the wards is important – choose
someone who can comment on this as wel .
· Any concerns or questions please contact Professor Rob Walker.
Students on first-quarter elective are strongly advised to get references and their CVs put together before they
go in order to have these ready in time for applying for jobs on their return. For ideas on how to put a CV
together and interview skil s, please check out the fol owing https://www.otago.ac.nz/careers/index.html
Probationary medical registration
Application information for probationary medical registration wil be distributed around July by the Student
Affairs Office.
JPs on Campus
From time to time, students may require services of a JP. Further information can be found at
https://www.otago.ac.nz/studentservices/otherservices/otago018289.html
43
Assessments in TI year
For further information, please refer to the MB ChB Programme of Assessment
Policies and Procedures on
Moodle – Assessment https://medschool.otago.ac.nz/course/view.php?id=1760
Course Objectives
Personal Attributes
· The capacity to be a critical thinker, capable of weighing, evaluating and integrating new
information into his or her understanding of issues.
· The ability to evaluate his or her own professional functioning and to act to remedy
limitations of knowledge, skil s and attitudes throughout his or her career.
· The ability to extrapolate from knowledge and principles to solve new problems.
· An awareness of his or her professional limitations, and a willingness to seek help when these
limitations are met.
· The ability and wil ingness to learn and to appreciate that learning continues throughout life.
· The ability and wil ingness to facilitate the learning experience of individuals, groups and
communities, both within and beyond the health sector.
· Information literacy, including the ability to locate, evaluate and use information in a
range of contexts.
· The ability to be organised and the skil s for time management, so that time and resources are
used effectively and efficiently.
· A dedication to appropriate ethical behaviour, based on a wel -developed awareness of his or
her own moral values, and knowledge and application of principles of medical ethics.
· An awareness of his or her own needs as a person, how health needs might impact on competence
to practice and an ability to access appropriate support or healthcare for him or herself.
· A commitment to the fundamental importance of the interdependence between research,
medical knowledge and professional practice.
· A commitment to advocate for the health needs of individuals and communities.
Interactive Attributes
· A caring and empathetic attitude to others.
· Respect for, and an ability to co-operate with col eagues, competence in teamwork and an
understanding of the roles of other health professionals and healthcare teams.
· A respect for patients and a dedication to work with patients to optimise their health and
wel being.
· Respect for, and an ability to respond to the cultural context and aspirations of patients,
col eagues, other health care workers and communities.
· An understanding of and an ability to respond to the obligations of the Treaty of Waitangi.
· Oral and written communication skil s, including an ability to communicate effectively with
individuals, groups and communities, both within and beyond the health sector.
44
Disciplinary Attributes
· A sound knowledge of the philosophical, scientific and ethical principles underlying the practice
of medicine and an ability to apply this knowledge as part of competent medical practice.
· A sound understanding of the legal framework surrounding medical practice in New Zealand.
· A sense of social responsibility and an understanding of the contribution of doctor, health
services, society and political influences to the health outcomes of patients.
· A commitment to the principles of patient-centred medicine.
· Knowledge of factors impacting on inequalities in health outcomes.
· Knowledge of factors impacting on the health status of Māori and other cultures.
· Skil s in eliciting, documenting and presenting the history of a patient's problems and the
relevant physical examination findings.
· Skills in problem solving and formulation of differential diagnoses.
· Skil s in the management of common medical conditions, including; informing and negotiating,
the performance of relevant clinical procedures, assessment of prognosis, prescribing skil s,
knowledge of drug therapy and care of the dying patient.
· Skil s in the management of emergencies and other serious medical conditions.
· An awareness of, and the skills to manage, uncertainty in medical interpretation and
decision making.
· An ability to maintain proper boundaries between personal and professional roles.
· An understanding of the role played by individuals and society in the development of disease
and the maintenance of well-being.
· A sense of social responsibility and an understanding of the roles and functions of healthcare
institutions in the social and political environment.
· An appreciation of the global perspective of medicine, and an informed sense of the impact of
the international community on New Zealand and New Zealand's contribution to the
international community.
MB ChB Assessment Policy & Procedures (COVID Edition)
We recommend you refresh your memory of the introduction (pp 9 – 38) and the section on assessment in
ALM, and closely read the section relating to assessment in ALM6:
https://www.otago.ac.nz/medicine/current-students/resources/policies-guides/index.html
Guide to academic conduct
Introduction
Over the course of your studies you wil be required to submit a wide variety of work in a range of
styles and formats. The purpose of this guide is to introduce you to good practice and help you avoid
poor or unacceptable academic practice.
The Academic Grievance Procedure For Students, section 3.1.5 requires that, 'A clear statement on
the nature and unacceptability of academic dishonesty, including cheating, plagiarism and
fabrication or falsification of data wil be provided to the students by the course co-ordinator or
the department.' This appendix fulfils that requirement.
For further information please refer to
https://www.otago.ac.nz/study/academicintegrity/index.html
45
University of Otago Medical School Prizes and Dunedin Campus Prizes and
Awards
Otago Medical School
Batchelor Memorial Medal and Prize in Gynaecology and Obstetrics
Founded by members of the Otago Division of the British Medical Association, who, in 1916, subscribed
the sum of £119.14.6 to provide medals and prizes to perpetuate the memory of the late Dr Ferdinand
Campion Batchelor, Lecturer in Midwifery and Diseases of Women 1883–1909, and Professor in 1909.
A medal and prize are awarded annual y by the University Council on the recommendation of the Pro-
Vice-Chancel or (Health Sciences), to the student who obtains the highest mark in oral assessments
in the subjects of Gynaecology and Obstetrics held in conjunction with the final-year examinations
for the degrees of Bachelor of Medicine and Bachelor of Surgery. The value of the Prize wil be as set
down in the current prize schedule and an engraved medal.
Stanley Batchelor Memorial Prize in Surgery
The Stanley Batchelor Memorial Prize was founded by Mrs Stanley Batchelor, who, in 1942, donated
the sum of £150 to the University Council to perpetuate the memory of the late Dr F. Stanley
Batchelor. The capital of the fund was increased in 1960 when Mrs Batchelor's son, Mr L.C.
Batchelor, donated £50 to the Council to augment the fund. A further sum of NZ$100 was donated
in 1973, both by Mr Batchelor and Mrs J.M. Elworthy to increase the value of the prize. The prize
is awarded annually by the University Council on the recommendation of the Pro Vice-Chancel or
(Health Sciences), to the Trainee Intern who has the highest aggregate mark from assessments of
performance on surgical attachments and a viva in Clinical Surgery. A student who has not obtained
passing assessments in all the subjects of the final year of the Medical course shal not be eligible
for the award of the prize. Any balance of income shal be added to the capital. The value of the Prize
will be as set down in the current prize schedule.
Colquhoun Memorial Medal in Clinical Medicine
This prize was founded in 1935 by the past students of Dr Daniel Colquhoun, who was Professor of
Medicine from 1883 to 1918 and Emeritus Professor from 1919 until his death in 1935. The medal is
awarded annual y by the University Council on the recommendation of the Pro-Vice-Chancel or (Health
Sciences), to the medical student in the final year who gains the highest marks in Clinical Medicine in
the end of year examination.
The Rita Gardner Travelling Scholarship in Medicine
Established in 1908 as the "Travel ing Scholarship in Medicine", and amended in 1989 to its present
title. The Scholarship shal be awarded annually to the student in the graduating class who has
gained the highest aggregate of marks in the Second Year, Third Year, Fifth Year and Final
Examinations for the degrees of Bachelor of Medicine and Bachelor of Surgery. The holder of the
Scholarship shall within eight years from the date of the award proceed to some recognised school
or schools of Medicine or other institution or institutions approved by the Dean of OMS outside New
Zealand and shal prosecute graduate studies there for a period of at least one year. In exceptional
circumstances, with the approval of the Dean, the Scholarship may be tenable in New Zealand.
T W J Johnson Memorial Prize in Clinical Medicine
This prize was founded in 1958 when an anonymous donor gave the sum of
£1000 to the Council to establish a prize as a memorial to the late Dr T.W.J. Johnson, the first
Medical Travelling Scholar. This prize is awarded annually by the University Council on the
recommendation of the Pro-Vice-Chancel or (Health Sciences), to the medical student who in the
final year of the course, gains the highest marks in Clinical Medicine in the end of year examination.
The value of the Prize wil be as set down in the current prize schedule.
Emily Hancock Siedeberg Memorial for the Best Overall Woman Student
Established in 1996 on the 100th anniversary of the graduation from OMS of Emily Hancock Siedeberg.
46
The prize is funded from money contributed by the late great nephew of Dr Siedeberg. The prize shal
be awarded annual y by the University Council on the recommendation of the Pro-Vice-Chancel or
(Health Sciences) to the female student in the graduating class who has gained the highest aggregate
of marks in the second year, third year, fifth year, and final examinations for the degrees of Bachelor of
Medicine and Bachelor of Surgery. The value of the prize is as set down in the current prize schedule.
Psychological Medicine Prize
A sum of money is available annually for the provision of a prize in Psychological Medicine. The
award, which is restricted to candidates completing the final examination for the degrees of
Bachelor of Medicine and Bachelor of Surgery, wil be made by the University Council on the
recommendation of the Pro-Vice- Chancel or (Health Sciences), on the basis of performance in
Psychological Medicine in the sixth year including an oral examination. The prize is the sum set down
in the current prize schedule for 'Distinction' in Psychological Medicine.
J M Watt Prize in Paediatrics and Child Health
This prize was established in 1977 in honour of Professor James Michael Watt, the holder of the first
Chair of Paediatrics and Child Health established in New Zealand (1966). The prize wil be awarded
by the University Council on the recommendation of the Pro-Vice-Chancellor (Health Sciences), for
the first time in 1978, and thereafter annually, to a final year student from one of the three Clinical
Schools of the University of Otago. The award wil be made to the best candidate in the Paediatric
distinction viva examination, taking into consideration the student's interest and excellence
throughout the preceding clinical years. The value of the Prize will be as set down in the current prize
schedule.
Dunedin Campus
Marjorie McCallum Medal in Medicine
This award was founded in 1923 by the Hon. Richard McCal um as a memorial to his daughter who died
while she was a medical student at the University of Otago. The medal is awarded annual y by the
University Council on the recommendation of the Pro-Vice-Chancel or (Health Sciences), to the final year
Medical student in Dunedin who is awarded the highest marks in Clinical Medicine in a special end of
year prize examination.
James Renfrew White Prize in Orthopaedic Surgery
The prize fund was established in 1976 by a bequest of NZ$3,000 from the late Miss Ida G. White in
memory of her brother, the late Mr James Renfrew White, a graduate of OMS who was Director of
Orthopaedic Surgery for the Otago Hospital Board and Lecturer in Orthopaedic Surgery from 1920
until 1948. The prize is awarded annual y by the University Council on the recommendation of the
Pro- Vice-Chancellor (Health Sciences), to the student who has served his or her clinical years in Dunedin
and who while a sixth year student, in the opinion of OMS on the recommendation of the Head of
Section of Orthopaedic Surgery, has demonstrated the most outstanding clinical ability and
scholarship in the field of orthopaedic and trauma surgery. The prize wil be awarded only if there is
a candidate of sufficient merit. The value of the Prize wil be as set down in the current prize
schedule. Any surplus of income may be added to the capital of the fund or may be used at the
discretion of the Council for increasing the value of the prize or for awarding an additional prize. The
Council shal have the power to alter these regulations should changed circumstances render such
action necessary, provided that the name of the prize shall not be altered and that the wishes of the
donor shal be observed to the ful est possible extent.
Patricia Buckfield Prize in Paediatrics
Dr Patricia Buckfield MB ChB (NZ), MD Otago, MRCP, FRACP, DCH (FRP&S) was a senior lecturer in the
Department of Paediatrics and Child Health at the University of Otago in Dunedin between 1967 and
1981, following postgraduate training in Neonatology in the UK. She introduced the new technique
of neonatal ventilation to the Special Care Baby Unit in Dunedin. She was a dedicated and caring
paediatrician, who based her MD thesis on the perinatal events of approximately 20,000 babies who
47
were born in Dunedin City. A one-year cohort of this sample formed the basis for the Dunedin
Multidisciplinary Child Development Study, which has achieved international recognition and is stil
ongoing. She also saw the need to provide extra assistance for children and their families where there
were concerns about the child's developmental progress. She was instrumental in setting up the
Vera Hayward Centre, which forms the base for the Dunedin Hospital Child Development Service.
During her time in Dunedin she was an enthusiastic and inspiring teacher of undergraduate and
postgraduate students from Health and many other disciplines. In her later professional years she
continued her interest in developmental paediatrics and worked as a Developmental Paediatrician
in the Puketiro Centre at Porirua. During her professional career she made an outstanding
contribution both to clinical and to academic paediatrics. The prize consists of books, instruments, or
education aids to a value of $600, and a book voucher to the value of NZ$100.
Sir Gordon Bel Prize in Surgery
This prize is named after the second Professor of Surgery at the University of Otago, who held the
Chair from 1925–1952. Sir Gordon Bel was born in Marlborough, trained in Edinburgh and practised
for most of his life in Dunedin. He was a very eminent and practical surgeon, whose career spanned
many of the important developments in Surgery. The prize consists of books and instruments to a
value to be advised.
Paediatric Artistic Expression
This prize was introduced in 2010 by Professor Barry Taylor. It is awarded to a Trainee Intern who
chose to submit an original artistic creation in their final assessment for their Paediatric Longitudinal
Case: The Child with the Chronic Condition, which is commenced in fourth year and completed in
fifth year. This prize recognises the Trainee Intern who showed outstanding artistic expression. The
prize is a book voucher to the value of NZ$50.
Mary Shaw Surgical Prize
Established in 1992 by a bequest of NZ$2,500 under the wil of Mary Christiana Shaw (nee Manning)
who was born in Invercargil in 1912. In 1932 she married James Thomson Shaw, General Manager
of the Southland Savings Bank from 1952 to 1970. In 1964, while Mr Shaw was General Manager,
the Board of the Bank established the Southland Savings Bank Medical Foundation for the
furtherance of medical education and research in Southland. Mr and Mrs Shaw had two sons: John
Donald Shaw, a mining engineer in Brazil, and James Henry Farquhar Shaw BMedSc MD (Otago) FRACS,
a surgeon in Auckland. Mrs Shaw died in Auckland in 1992. The prize of NZ$200 is awarded annual y by
the University Council, to the student undertaking the sixth year of the course for the degree
Bachelor of Medicine and Bachelor of Surgery, as a Trainee Intern in Dunedin or Invercargil who, in
the opinion of the clinical teachers concerned, displays the greatest industry and competence in the
Surgical attachment.
Stanley Wilson Prize
Established in 1982 by Dr Elizabeth Whitcombe, a graduate of OMS, for the purpose of furthering
the study of Medicine at the Dunedin Division of the OMS, and in particular to recognise the
contribution made by a former teacher, Mr Stanley Wilson, over many years, to the science and
teaching of surgery at OMS. The prize consists of books, instruments or education aids to the value of
NZ$750, and is awarded by the University Council on the recommendation of an Advisory
Committee, comprising the Dean of OMS, the Professor of Surgery in the OMS at Dunedin and the
Chairman of the General Medical Staff of the Dunedin Hospital. The prize is awarded annual y to a
medical undergraduate in OMS at Dunedin who best presents in his or her final year a clinical
presentation in the Department of Surgery having general medical interest and a reference to
pathology.
Sir Bernard Dawson Prize in Clinical Obstetrics and Gynaecology
Sir Bernard Dawson held the Foundation Chair in Obstetrics and Gynaecology at the University of
Otago in Dunedin from 1932–1950. He was responsible for putting the academic discipline of
48
obstetrics and gynaecology firmly in place in New Zealand and he was knighted in 1948 for his
services to Obstetrics and Gynaecology in this country. The prize consists of educational
material/aids to a value to be advised.
Professor Basil James Prize in Psychological Medicine
Professor Basil James was professor and head of the Department of Psychological Medicine from 1969–
1981. Professor James persuaded the general medical staff that psychiatry should also have a prize, as
did medicine and surgery, whose prizes had come from family bequests. These negotiations occurred in
the late '60s. The prize consists of books to a value to be advised.
RNZCGP Otago–Southland/JAD Iverach Prize in General Practice
Five prizes were awarded in Preventive and Social Medicine prior to 1974 by the New Zealand Faculty
of the Royal Col ege of General Practitioners and from 1974 to 1977 by the Otago-Southland Faculty
of the New Zealand College of General Practitioners. These were replaced in 1978 by a single prize
in the discipline in General Practice. The Prize will be awarded at the annual Trainee Intern Prize
giving and Farewel by the Head of the Department of General Practice, Dunedin Campus, for the best
student performance during the undergraduate course in General Practice. This assessment will
include the fourth, fifth and sixth years of the course. The Prize consists of an engraved medal and
$1,000. There is also a $500.00 prize awarded to the runner-up, and two highly commended prizes
of $250.00.
JAD Iverach Prize in Medicine
Captain Douglas Iverach was an infantry soldier at the First World War and received an MC. After
the war he went through OMS and went to Scotland on qualification, specialising in Medicine. He
came back to Dunedin and was appointed to the Honorary Staff of Dunedin Hospital, practicing as a
general practitioner from the Savoy. He was so thorough in his examination, so if GPs were worried,
they would seek his opinion. There were no ful time specialists as such in those days. By the referrals
to him, he became known as a specialist. In May 1965 the J A D Iverach Memorial Fund was started
from which an annual prize would be awarded to the best sixth year medical student in clinical
medicine. There were some cash donations by grateful patients but most of the contributions made
by his family were made in shares. The prize consists of a presentation gift.
Inkster-Ross Memorial Prize
The Inkster-Ross Memorial Fund was established in 1946 by Lady Muriel Ross of Dunedin as a
memorial to her father Samuel Macaulay Inkster M.D. and to her mother Amy Inkster. The gift was
established to further medical research with an emphasis on the field of preventive medicine. The
Inkster-Ross Memorial prize was re-established in 2011 to recognize the research achievements of
final year medical students as they complete a health care evaluation project. Working in groups,
students undertake research to address a problem in the delivery of health care. The prize is
awarded annual y by the Department of Preventive and Social Medicine to the group who undertake
the highest quality research.
Elective Report Award
The Trainee Intern Elective Report Award was established in 1984 (by Professor Don Wilson) and
sponsorship was obtained in 1992 from Mr Russel Duff, Managing Director of VIP International Travel
in appreciation of the ongoing close links between VIP Travel and medical elective students. This
sponsorship is continued today by the School. The prize consists of a book voucher to the value of
NZ$50 to the Trainee Intern who has submitted the best elective report during the year, which has
been chosen by our electives committee.
University Bookshop Prize for Best Student Contribution to Medical Education
Established in 1985 by the Directors of the University Book Shop Otago Ltd. The prize is awarded
annual y by the University Council to the student who has made the most significant contribution to
undergraduate medical education in OMS during the past year. A nomination shal be made by the
49
Dean after consultation with the Staff/Student Curriculum Committee. The value of the Prize will be
as set down in the current prize schedule.
John Russel Ritchie Prize (to be confirmed if available in 2021)
John Russell Ritchie worked as an Anaesthetist at Dunedin Hospital from 1938 until his retirement
in 1975. He was the Director of Anaesthesia at Dunedin Hospital for over 25 years and was appointed
to the first professorial position held by an Anaesthetist in New Zealand. During his time in Dunedin
he was an enthusiastic and inspiring teacher of undergraduate and postgraduate students from
Health and many other disciplines. He is famous for contributing to worldwide anaesthesia safety
with his invention of the Ritchie oxygen failure warning device which in either its original or a
modified form became a standard part of al anaesthesia machines. The prize for the best student
performance in Anaesthesia and Intensive Care was first awarded in 1976. Fol owing the 2002
reorganisation of the curriculum and departments the prize was held in abeyance. It was decided to
re-institute this prize from 2006 at Trainee Intern level. The criteria for this prize include:
• That the prize be awarded, after an oral interview, to the top-placed candidate who has performed to a
level of excellence in the interview and during their attachment in Anaesthesia and/or Intensive Care as a
Trainee Intern.
• Those to be interviewed are nominated by sub-groups of the Section of Anaesthesia and Intensive Care. It
is not a prize, which a trainee can apply for of one's own volition.
• Trainee Interns have to have completed one or more Trainee Intern attachments in Anaesthesia or
Intensive Care in Dunedin to be nominated.
• The areas assessed for the award of this prize now takes into account the candidates clinical work,
academic/research aptitude, professionalism and a Viva relating to topics in Anaesthesia, Pain
Management, Intensive Care and Resuscitation at the end of the Trainee Intern year. The prize consists of
books, instruments or education aids to a value to be advised.
• Those to be interviewed are nominated by sub-groups of the Section of Anaesthesia and Intensive Care. It
is not a prize, which a trainee can apply for of one's own volition.
• Trainee Interns have to have completed one or more Trainee Intern attachments in Anaesthesia or
Intensive Care in Dunedin to be nominated.
• The areas assessed for the award of this prize now takes into account the candidates clinical work,
academic / research aptitude, professionalism and a Viva relating to topics in Anaesthesia, Pain
Management, Intensive Care and Resuscitation at the end of the Trainee Intern year. The prize consists of
books, instruments or education aids to the value of NZ$500.
Kōtahu – Centre for Hauora Māori Excel ence Awards
The kete (baskets) of knowledge comes from ancient tauparapara (legend) which relates to the
exploits of Tane-nui-a-rangi in his pursuit of knowledge. Tane, the progenitor of mankind, of the
forest, ascended from earth to the heavens and obtained the three kete of knowledge. Tane returned
to earth with the knowledge, and there created humankind from the earth.
To many, this is a simple mythological story which seeks to explain how humankind gained its
knowledge of things both earthly and spiritual from the gods. The story is the beginning of the stories
of the Whare Wananga, which describe how this earthly realm came to be, and how everything in it
came to be ordered as it is, including how humankind was created by Tane.
To some it is a metaphor for the ideal life, a journey of striving for knowledge and education and
enlightenment, to become better people. In this context it graphical y depicts three aspects of
knowledge achieved in the Hauora Māori medical curriculum within the Dunedin Campus, preparing
students to make a difference for Māori, whanau and communities.
Three kete wil be offered annual y – Dunedin TI Year:
· Ko te kete Tuauri - Knowledge of Ritual, Memory, and Prayer (Cultural Connection) – For a student that
shows a commitment to enhancing Hauora Māori concepts such as culture, te reo, and
whakawhanaungatanga
·
Ko te kete Tuatea - Knowledge of Making a Difference (Addressing Equity) - For a student that shows a
commitment to improving health equity and chal enging the status quo for Māori
· Ko te kete Aronui - Knowledge to Help Others (Positive Solutions) – For a student that shows initiative
creating positive solutions for improving Māori Health Awards funded, students nominated, and chosen
by Kōhatu - Centre for Hauora Māori staff.
50
Working in a Clinical Setting
Clinical Education: Chaperoning
It is necessary to consider the desirability of a chaperone when patients are being examined or interviewed.
This is especial y true if the patient is of the opposite gender, a child or otherwise disadvantaged.
Chaperoning during consultation when a staff member is present is the responsibility of the member of staff.
A patient should always be asked if they would prefer the consultation to take place with a chaperone present.
Students should arrange with a col eague of the opposite gender in their group, to accompany them if they
wish to examine or interview a patient (to ensure protection of both student and patient).
More specific guidelines are as fol ows:
Adult Patients
• In principle, chaperones should always be used when students are undertaking consultations on members
of the opposite sex.
• If a chaperone is not readily available the patient should be asked whether they prefer a chaperone to be
present. If so, the consultation should not proceed until a chaperone is available.
• In al circumstances, but particularly when a chaperone is not present, the nature of the examination to
be carried out should be explained to the patient and verbal consent obtained to proceed. It is also useful
to explain the steps in the examination process to the patient as the examination proceeds.
• If a chaperone is not available for the whole examination it is useful to have a chaperone check periodical y
that al is wel .
• Persons eligible as chaperones may include medical students, nursing staff of the opposite sex, or some
other appropriate person, if consented to by the patient.
• Any problems which cause difficulty, concern or embarrassment during the consultation should be
reported to the Associate Dean for Student Affairs.
Children
• Consultation with children of the same or opposite sex should in principle always be done with a
chaperone present.
• In circumstances where a chaperone is completely unavailable the consultation should take place in a
relatively open setting (ie not behind completely-closed curtains).
If there is any suggestion from the patient that there may be a matter for complaint this should be careful y
recorded in the patient's notes, signed and witnessed. This should also be reported to the Associate Dean
Student Affairs.
Dress and appearance
It is appropriate here to reiterate the importance of suitable dress, not only in the School and on
the wider hospital campus, but particularly in the patient areas. At al times appearance is likely
to be one of the ways by which people in the hospital assess the School, and must meet the
standards that your patients expect. Appropriateness to clinical work must always be considered
51
and is part of the requirement of your continued honorary staff status with any District Health
Board.
You reflect on dress expectations, whether your own dress fits the work of clinical students and
the required respect for patients. If in any doubt, please talk to your col eagues or the staff on
your attachment. Members of staff may expect conformity with particular standards within their
departments and wil discuss dress with students should they deem it necessary.
Cultural y-sensitive issues
Students are required to participate in al laboratory, practical and clinical activities, which includes activities
that may not be usual to your culture. In the professional classes, some aspects of the teaching wil require
individuals to practice certain techniques on each other, which may require you to partly undress and may
involve body contact between students. Training is done under close supervision and al students are required
to participate, as it is essential for their acquisition of clinical skil s. Assistance from students experiencing
difficulties in this area is available, on request, from the relevant Campus.
Dress requirements in theatre
Specifical y, in disciplines such as surgery, medical students wil be required to conform to standards
of dress that meet the high levels of hygiene in operating theatres. Personal garments, such as
headgear worn outside the theatre situation, must be replaced by alternative sterilised garments
provided by the hospital to meet accepted standards of infection control and asepsis. Students must
also adhere to the stringent protocols of scrubbing to involve hands and both forearms to at least
elbow level.
Professional behaviour: General
Remember, it is part of the requirement of your continued status with health providers that your
behaviour towards staff and patients is always of the highest standard. Please remember to show
consideration to others around the hospital, in lifts and other public places. You are easily recognised
as students, and people look to you to show a good example.
Professional etiquette and practical ethics for clinical education (teaching, learning & assessment)
The Medical School, hospital, and community providers aim to provide medical students with a
welcoming learning environment, and to encourage clinical staff who teach medical students
(supervising clinicians) to act as role models for professional behaviour and professional practice.
The fol owing guidelines outline the general policy on the standards to be observed in clinical
education. They are to be read in conjunction with the policies and procedures of host institutions,
the University of Otago's Ethical Behaviour Policy, and the provisions of the Code of Health and
Disability Services Consumers' Rights as wel as of the Health Information Privacy Code.
Patient rights in general
A patient has the right to be explicitly informed about the specific education activity in which the
patient may be participating. The supervising clinician is responsible for informing the patient
about education activities, in particular about any procedures in which a medical student may
participate under supervision.
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Consent for clinical education
The patient's welfare and interests are always the overriding consideration. Patients are typical y
generous in their willingness to support medical students' learning and often themselves benefit
from the process. Consent for clinical education obviously involves an element of permission but
it also extends to assisting patients to understand why a particular learning/ teaching activity is
valuable.
The fol owing points address these aspects:
• Patients must be informed that they may be involved in students' learning
• Patients have the right to choose, or to decline, to be interviewed, examined or cared for by a
medical student, or to be involved in any other way in medical education
• Patients have the right to know the name and professional standing of any person, staff or
student, who wishes, for teaching purposes, to interview them, examine them, or carry out any
procedure
• Patient consent for clinical education must be obtained by the supervising clinician (or other staff
member). This should be done in a setting out of sight of the student(s) to avoid placing undue
pressure on patients. Patients have the right to withdraw from the clinical education activity at
any stage and may change their mind between consent with the supervising clinician and
subsequently seeing the student.
• In the case of children, their parent, guardian or other legal representative may, on their behalf,
make the decisions and receive the information summarised in the above four bullet points.
Competent children may consent or decline on their own behalf.
• Patients of diminished capacity or children who have yet to attain full competence have the
right to be informed and to be involved, to the extent to which they are able, in any decision
to participate or not.
• Where appropriate, an oral consent obtained should be recorded in the patient's notes; a written
consent should be documented in the notes.
• If a patient is not competent to give a consent, consent for clinical education should be
obtained from the same person who gives consent for interventions on behalf of that patient.
• Medical students should wear their name badge and carry their ID card in all clinical settings.
When introducing themselves to a patient by name, they should explain that they are a medical
student, confirm that the patient is wil ing to proceed, and seek an explicit permission on each
occasion and consultation is needed.
• Medical students who are observers or who undertake examinations under supervision or who
assist with procedures under supervision while a patient is sedated or under general
anaesthetic are required to meet with the patient beforehand and, with assistance from the
supervising clinician as appropriate, obtain a written consent. Where a genital examination is
performed by a student(s) while the patient is under general anaesthetic, at most two students
[who have obtained prior written consent] may do so.
• Medical students should be aware that the standard consent procedures may need to be
abbreviated or waived in emergency situations.
Clinical examination of patients
Most patients wil have been advised that they should expect to be approached to assist in the
clinical education of medical students. However, students should note that they do not have an
absolute right to examine any patient. When you commence a new clinical attachment check with
your tutor or supervisor on the procedure to be followed in approaching patients. This may vary
53
slightly according to the clinical discipline involved.
• In general, if you have been allocated a patient, or patients on one of the modules, you should:
• Introduce yourself and obtain the patient's consent to interview and examination
• Be cognisant of racial and cultural sensitivities
Sensitive examinations (includes breast, rectal, vaginal examinations and those of the external
genitalia) in competent awake patients require explicit consent. This can be verbal but should be
documented in the patient’s notes.
It is essential that there should be no possibility for the consent to have any element of coercion
(e.g., it may be harder for a patient to refuse if the patient is asked after undressing or in front of a
student).
Sensitive examinations under anaesthesia require formal written consent obtained in advance and
signed by the patient. It is essential that there should be no possibility for the consent to have any
element of coercion (e.g., asking in front of a student may make it harder for a patient to refuse).
Without such consent a student cannot undertake such activity.
Professional behaviour: Supervision
A supervising clinician is expected to brief medical students about their role in patient care. Often
this will already be known (for example some issues are spelt out in this handbook), but if it is not
clear, or the requirements of a particular context are different from usual, medical students are
encouraged to seek explicit guidance about what is expected of them, paying particular attention
to the following:
Dress code: Any requirements to be observed or avoided
Introductions: Any particular style, especial y if the medical student's relationship to the team needs
to be made explicit
Accountability: Who is responsible for the medical student(s) and who is able to deal with queries
and concerns
Emergencies: Any procedures medical students are expected to observe in the event of an
emergency
Standard precautions: Medical students wil need to be warned of situations in which there are
particular infection control issues and advised of the appropriate precautions to observe
Risk of violence: Medical students should be given prior warning of patients with a known history of
violence with adequate briefing on protocols for ensuring personal safety
Chaperones/support persons: Medical students should be given guidance as to when a child or adult
should be offered a chaperone/support person and who may appropriately serve in that capacity
Boundary issues: Medical students should be advised of any clinical settings in which there is special
reason to maintain robust professional boundaries
Debriefing and reflection on clinical and professional development: Medical students should be
encouraged to seek, and be offered prompt opportunity for debriefing after significant critical
episodes, and opportunities to reflect on what they have learned, how they are learning it, and their
development of professionalism.
Ethical issues: Medical students benefit from the opportunity, whether initiated by staff or students,
54
to discuss ethical issues generated by a specific case or experience.
Privacy and Confidentiality
Medical students are expected to observe the same high standards of confidentiality and respect for privacy
as govern the behaviour of all doctors and healthcare professionals. These standards are set in the Privacy
Act (1993) and the Health Information Privacy Code (The Privacy Code or HIPC)(1994).
The Privacy Code outlines specific rules regarding the collection, storage and disclosure of health information
in relation to identifiable patients. The basic rule is that no information about any patient should be given to
any other person without the permission of the patient concerned. This applies to al health information and
not only to that which the patient might regard as particularly sensitive. It applies to the simple fact that an
individual is a patient in the hospital or GP rooms as well as to details of their condition. It also includes
situations such as reports to lawyers, NZ Police, ACC and various other statutory bodies. There are some
limited and specific exceptions where disclosure of information without the consent of the patient is
permitted or authorized by law and you wil learn about these over the next years of your training.
It is important to remember that patients share information with health professionals within a relationship of
trust and in order to assist the professional to help them with their health problem. Respecting that trust and
maintaining respect for privacy and confidentiality is fundamental to the doctor-patient relationship and
achieving the best outcome for the patient.
Access to notes and handling of written material
Students should only access patient notes with the consent of the patient and where the patient is under the
care of the team to which the student is attached. Notes of patients not under the care of the team should
not be accessed except where the student has an alternate legitimate reasons to do so and also has specific
consent from the patient.
Official patient hospital records must never be taken away from the clinical areas or out of the hospital.
Photocopying of patient notes by medical students is not permitted in any circumstances. Material written
by students which may contain patient-related information (eg case histories) should not have any ‘unique
identifiers’ (eg name, date of birth, address or national number). If these notes require work outside the
hospital (eg library) great care must be taken to ensure they remain secure and private. Once patient related
notes are no longer required they should be disposed of in a secure fashion in one of the bins provided by the
SDHB.
In addition to legal restraints around patient related health information, students are required to discuss any
matters referring to the Dunedin Campus and SDHB with the Dean BEFORE disclosing information to outside
agencies or bodies.
The fol owing points should be also kept in mind:
Medical students should refrain from giving a patient a blanket guarantee of confidentiality, as this
may contravene their accountability to their supervising clinician. Whether information is acquired
at interview or from the clinical record, patients have a right to know the use(s) that wil be
made of the information [written assignment, oral presentation to a tutorial group, one to one
discussion with a tutor, etc], and what steps wil be taken to assure the privacy of the information
[such as de-identifying]. Medical students should make sure when, if at al , a copy of an assignment
should be placed in the patient's notes, and patients should be informed of this
55
Medical students should be meticulous in assuring the security of written assignments and other
notes relating to patients, even if de-identified, and should regularly dispose of material which has
passed its use by date through an approved destruction process.
Care should be taken to ensure that discussion of a patient for clinical education takes place in a
secure setting where what is said cannot be overheard by others and where there is thus no risk of
what is discussed being mis-interpreted.
Under no circumstances is a medical student permitted to take photographs of a patient or patient
information, or to make any video or audio recording of any interaction with or observation of a
patient. If photographs or recordings are needed for educational purposes, they will be sought by
the supervising clinician using current protocols.
Release of Information
Various pieces of legislation including the Health Information Privacy Code and Health Act, outlines
circumstances where personal details may be released without the consent of the patient or their
representatives. The Privacy Act does not apply if release of information is required under other legislation.
For example, the notification of infectious diseases is required under Section 74 of the Health Act.
Medical students must not release any information under these provisions without first consulting the senior
clinician working in this area. Students who make unauthorized disclosure of personal health information wil
be subject to disciplinary action.
Students are required to consult with the Associate Dean of Student Affairs BEFORE disclosing information
about the School or any of the DHB institutions to the news media.
Medical student rights
Medical students have the right to decline to participate in clinical teaching/or patient care if there are
concerns, ethical or otherwise about the activity; concern about their own competency, lack of knowledge,
or lack of understanding of the duties/tasks/responsibilities involved; or conscientiously believe there is a lack
of explanation or supervision.
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Code of Conduct and Integrity (District)
(Code supplied at TI orientation – read and signed by student)
Policy Purpose
This policy outlines the expected standards of behaviour and conduct
of al people involved in the operation of Southern District Health
Board (Southern DHB).
Policy Applies to
All employees of Southern DHB, Board and Commissioner Team
members, temporary employees and contractors, must comply with
this Code. It also applies to any person who is involved in the
operation of Southern DHB, including joint appointments, volunteers,
those people with honorary or unpaid staff status and prospective
employees applying for employment.
The Code of Conduct, ‘the Code’, should be read in conjunction with
the Code of Conduct and Integrity for the State Sector, and with
relevant organisational policies, which al employees must comply
with.
Associated Documents
• Disclosure of Interests Policy District (27894)
include:
• Delegation of Authority Policy (District) (21584)
• Disciplinary Policy (District) (55569)
• Effective Working Relationships (District) (100004)
• Email, Internet and Information Security Policy (District) (22497)
• Fraud Policy (District) (25546)
• Health and Safety and Welfare Policy (District) (15851)
• Media Policy (District) (16106)
• Private Practice Secondary Employment and Other Business Activities
Policy (District) (19707)
• Private Practice Secondary Employment and other Business Activities
[Guidelines] (District) (81064)
• Protected Disclosures / Whistle-blowing Policy (District) (19708)
• Procurement and Purchasing Policy (District) (11400)
• Sensitive Expenditure Policy (District) (48567)
Related Legislation
• Code of Conduct and Integrity for the State Sector
includes:
• Employment Relations Act
• Health and Safety at Work Act 2015
• Human Rights Act
• Protected Disclosures Act
• Official Information Act
• Privacy Act
Other:
• WorkSafe New Zealand
Good Employer
Our obligations under the Crown Entities Act 2004 are to act as a
Statement
‘Good Employer’ as defined under section 118 of the Act.
The Act defines a good employer as an employer who operates a
personnel policy containing provisions generally accepted as necessary
for the fair and proper treatment of employees in al aspects of their
employment.
Southern DHB is committed to the principles of natural justice and
values all employees and treats them with respect.
57
Expectations
Southern DHB is committed to the highest level of integrity and ethical
standards in everything that we do. As employers and employees we
must be fair, honest, impartial, responsible and trustworthy at all
times. We must always conduct ourselves in a manner consistent with
current ethical, professional, community and organisational standards
and in compliance with all legislation.
This Code of Conduct does not cover:
• every ethical issue that we might face; or
• every law and policy that applies to the Southern DHB.
The objective of the Code of Conduct is to:
• provide a benchmark and general standard for our behaviour.
• provide clarity about expectations of honesty and integrity.
• support the Southern DHBs’ reputation and image within the
community; and
• make us al aware of the consequences if we breach this policy.
Responsibilities under the Code of Conduct
We are al responsible for implementing and upholding the Code in
our workplace, regardless of our position or role.
All employees are responsible for ensuring that their behaviour
reflects the standards of conduct in the Code and builds a positive
workplace culture. This is inclusive of all employees including clinical
and non-clinical.
All managers which includes clinical, nursing and allied health leaders
and directors have a special responsibility to support employees in
achieving those goals, by leading by example and assisting employees
to understand the Code. It is essential to maintain open
communication lines with organisations representing our employees
regarding the Code.
In this Code, a manager is any employee with supervisory
responsibilities.
All of us must have a working knowledge of the laws and policies that
apply to our work, including the Code of Conduct.
Obligations under the Code of Conduct
Work to the Best of
• Perform your duties to the best of your ability with care,
Your Ability
competence and efficiency. Avoid behaviour which impairs your
work performance and/or undermines the integrity of your
col eagues.
• Maintain proper standards of integrity and conduct in the
performance of your duties. Be open about reporting potential
issues or mistakes.
• Be present and actively engaged in your duties at Southern DHB as
required and be absent only with appropriate approval, taking
leave only for the purposes for which it is intended.
58
• Carry out any lawful and reasonable instructions you are given and
work as directed. Implement policies and practices that apply to
your work. Work within appropriate delegations of authority.
Implicit in this is an obligation to obey the laws of New Zealand.
• Avoid behaviour which endangers or causes distress to other
people or otherwise contributes to disruption in the workplace
and/or avoid behaviour which might impair their work
performance.
• Do not engage in alternative employment or self-employment
without appropriate authority, whether or not in a similar area of
work or your work for the Southern DHB. See the Private Practice,
Secondary Employment and other Business Activities Policy
(District) (19707).
• Avoid being a member of any organisation which may impinge on
the proper performance of your duties or be in conflict with the
interest of the Southern DHB.
Maintain a Safe Working • Consider the safety of yourself and others in the workplace at al
Environment
times.
• Comply with instructions given for workplace health and safety,
including using any personal protective equipment supplied.
• Support and promote actions and initiatives in the workplace which
enable hazards and risks to be identified and isolated, eliminated or
reduced.
• Ensure that your use of alcohol or other substances in your private
time, outside of work does not impair or impact on your work
performance or endanger the health and safety of others.
• Accessing, transmitting, storing or downloading any form of
pornographic, sexual y explicit, sexist, racist, demeaning or other
inappropriate material using Southern DHB resources is strictly
prohibited and serious penalties, which may include dismissal, wil
apply.
• Staff and contractors must wear Southern DHB formal
identification (ID) at al times.
Act Professional y
• Act honesty and professional y and abide by any code, protocols or
set of standards relevant to the practice of your duties or
profession. For clinicians, this includes staying within your clinical
scope of practice and, where they exist, working within agreed
practice guidelines or research based protocols.
• Southern DHB expects that al employees wil act in a highly
professional, honest and ethical manner and in compliance with
the Code of Health and Disability Consumers’ Rights.
• Maintain al qualifications/licences that are a requirement of your
position (including registration and annual practising certificates)
and provide evidence of these on an annual basis or when asked to
59
do so. Inform your manager immediately if there are any changes
(if your certificate is revoked or amended in anyway or you cease to
have a valid practising certificate) or restrictions placed on your
practice, including any professional disciplinary proceedings or
litigation that may impact on your employment or professional
registration.
• Provide required information for police clearances such as VCA
checks when requested (on a 3 yearly basis).
• Where applicable, ensure that your right to work in New Zealand is
maintained by ensuring relevant working or residence visas are
valid and maintained according to immigration requirements. You
may not undertake any work/duties on a visitor visa in New Zealand
and Southern DHB under any circumstances.
• Advise Southern DHB in writing of any pending criminal or civil legal
action that may be taken against you and that may reflect on us.
• Keep your appearance and presentation clean, tidy and appropriate
for your work role, and in line with relevant uniform and dress
policies and occupational safety/infection control and health
requirements.
Avoid Conflicts of
• Avoid making any decision for the Southern DHB where you have
Interest
any interest in the matter other than the Southern DHB’s interests.
See the Conflict of Interest Guidelines (District) (81067).
• Disclose in writing any business activities outside the Southern DHB
and actual or perceived conflicts of interest. See the Disclosure of
Interests Policy (District) (27894).
• Do not use your role or position to gain an advantage in your
private life, for example by arranging jobs/ transfers/ benefits for
family or friends.
• Do not let any outside interests adversely affect the performance
of work related duties.
• Disclose any relationship you have or form with any person who
directly or indirectly reports to you.
Don’t Accept Gifts,
• Never ask others for any reward other than what Southern DHB
Benefits or Rewards
pays you or any other entitlements you receive as an employee.
• Gifts of money are not to be accepted under any circumstances.
• No gift, regardless of monetary value, should be accepted if it could
potential y cause or be perceived by others as causing you to feel
an obligation to the gift giver. This is particularly relevant if you are
involved in current tendering/purchasing processes involving the
parties who may be offering the gift.
• All gifts or benefits received must be reported to your manager,
who will advise on the correct course of action. All gifts are to be
recorded on the gift register as per Delegation of Authority Policy
(District) (21584). Failure to do so may result in disciplinary action.
60
Show Respect for
• Treat al people with respect, courtesy and honesty, and give
Others
everyone a fair hearing.
• Respect the dignity, rights and views of others, including different
values, beliefs, cultures and religions.
• Don’t act or speak in a way that is likely to cause offence to others.
• Do not discriminate against or harass members of the public,
clients, visitors, patients or col eagues because of their age, sex,
marital status, ethnicity, disability, religious or ethical beliefs,
colour, race, political opinion, employment status or sexual
orientation.
• Have zero tolerance for bul ying and rudeness. Bul ying behaviours
include attacks that are direct and personal as well as indirect and
task related. Examples of bul ying can be found in the Worksafe
New Zealand ‘Bul ying at Work: Advice for Workers’ quick guide.
• Avoid behaviour which can be considered to be intimidating,
undermining or victimising.
• Avoid any unwelcome or offensive sexual behaviour including:
banter or jokes of a suggestive/sexual nature, unwelcome touching,
patting or pinching, regular hassling for a date, sexual y offensive
images or text or e-mail messages or other forms of media,
intrusive questions about personal sex life.
Maintain Confidentiality • Treat al information about a person who is receiving or has
of Information
received a public health service with the strictest confidence. This
requirement for confidentiality continues to apply even after you
have ceased working for the Southern DHB.
• Personal and sensitive information must be responsibly and
transparently col ected and managed in accordance with the
privacy principles applicable to the Southern DHB.
• Only access or release information about a patient, client or
employee when it is part of your job, it is lawful or when specific
consent is given.
Avoid Violent and
• Southern DHB has zero tolerance to violence in our workplaces.
Aggressive Behaviour
This is not just limited to physical violence. To achieve this, violent
and aggressive behaviour wil not be tolerated towards patients,
clients, other employees, students or members of the public.
• Employees do not have to tolerate violent and aggressive
behaviour towards them, and have the right to expect to work in a
safe and healthy work environment.
Manage Time and
• Manage your time and Southern DHB resources efficiently and with
Resources Efficiently
regard to relevant policies.
• No private practice wil take place during Southern DHB paid time,
or on, or using Southern DHB facilities, medical consumables or
equipment without a formal contractual arrangement approved by
the CEO.
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• Show reasonable care in using, or al owing the use of, Southern
DHB’s property, resources or funds.
• Employees who make decisions involving financial resources on
behalf of the Southern DHB should ensure that they are doing so
within the scope of their delegated authority and within policies
and procedures for the acquisition, use and disposal of resources.
• Don’t incur any liability on behalf of Southern DHB without proper
authorisation and within any approved limits specified in the
Delegation of Authority Policy (District) (21584).
• All equipment, resources and consumable items are only to be
used for the work and business of Southern DHB unless prior
written authorisation has been obtained from your manager.
• Limited, occasional and brief private use of local telephone cal s,
personal cel phones, computers and the Southern DHB’s e-mail
and intranet systems are acceptable as long as it does not affect
your work, the work of others, or the reputation of Southern DHB
and is conducted in accordance with this Code and other relevant
policies.
Standards of Behaviour and Performance
If you are unclear about the standard of behaviour and conduct that is
required of you as it relates to the Code you should discuss the
situation with your manager, Human Resources or senior
management.
As professional incompetence and/or misconduct are reported to
appropriate registration authorities, it may lead to disciplinary action
by the relevant professional body as wel as disciplinary action under
this Code of Conduct.
Misconduct
The fol owing are examples of ‘misconduct’ and not intended to be an
exhaustive list:
It should be noted that the examples listed below as misconduct may
also be considered as ‘serious misconduct’ depending on the nature
and severity of the breach.
Misconduct includes, but is not limited to:
a) failure to maintain an acceptable level of work performance.
b) failure to maintain an acceptable level of attendance at work.
c) refusal to perform duties or to fol ow a reasonable and lawful
instruction.
d) habitual y arriving late for duty.
e) being absent from your assigned place of work during working
hours without authority or legitimate reason.
f) failure to provide your manager with timely notice of absences
such as sickness, or that you are unable to commence work at the
normal time.
g) sleeping while on duty (unless authorised by the employer).
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h) failure to observe health and safety requirements, including the
requirement to proactively and promptly report personal injury,
injury to others, damage to Southern DHB or patient property or a
hazard that may cause harm.
i) improper use, wastage or damage of Southern DHB resources or
property including wasteful expenditure of Southern DHB
funds/time.
j) unauthorised use of fire protection or safety equipment.
k) reporting for work unsuitably dressed, or in such a condition that
you are unable to perform required duties in a safe and proper
manner.
l) inappropriate or disruptive behaviour in the workplace.
m) unreasonable behaviour towards other people, including abusive,
threatening or offensive language and any form of harassment
including sexual or racial.
n) posting offensive or inappropriate information on noticeboards or
electronic media. See E-mail, Internet and Information Security
Policy (District) (22497).
o) smoking on Southern DHB premises.
p) failure to hold a current drivers licence and/or to carry a current
drivers licence on their person at al times whilst driving a motor
vehicle belonging to the employer on a public road.
q) failure to provide sufficient information and or respond to a
request to enable the renewal of a VCA check as required (core
workers).
r) other breach of this or other policies.
Serious Misconduct
The fol owing are examples of ‘serious misconduct’ and is not
intended to be an exhaustive list:
a) not being in possession of or eligible to hold a required annual
practising certificate.
b) working without a valid work visa.
c) breach of professional protocols or standards whether established
by the Southern DHB or the relevant professional body.
d) carrying out private patient work during Southern DHB paid time
and /or using Southern DHB premises or equipment or use of
Southern DHB time, facilities, premises or equipment to undertake
other employment.
e) inaccurate recording of leave, or failure to record leave taken.
f) failure to report to the appropriate manager or supervisor any
accident or incident at work involving actual, or risk of, personal
injury, or damage to property.
63
g) unauthorised possession of drugs (including alcohol) in the
workplace.
h) reporting for work under the influence of alcohol or drugs or
driving the employer’s vehicles under the influence of alcohol
and/or drugs.
i) violence of any form including assaulting or threatening to assault
anyone in the workplace.
j) possession of patient, client or Southern DHB property without
proper authorisation or possession of another person’s property
without that person’s consent.
k) any form of theft or fraudulent action.
l) being in possession of offensive weapons in the workplace.
m) the unauthorised disclosure of or access to confidential
information.
n) any attempt to mislead the Southern DHB, or any employee, or a
patient/client, or a member of the public in connection with the
Southern DHB’s business. This includes falsification of attendance
records or submitting false claims for expenses or reimbursement,
or providing incorrect information at any stage.
o) acting outside of your delegated authority.
p) exacting, attempting to exact, or accepting any fee, reward,
gratuity or remuneration, other than the salary or al owance
pertaining to the employee’s employment agreement, on account
of anything done in the execution of the duties.
q) deliberate or negligent behaviour adversely affecting the safety of
a patient, client, visitor or another employee.
r) using Southern DHB computers to make unauthorised copies of
any computer software, or for any other unauthorised purpose.
s) admitting to, or being convicted of, any offence which can
reasonably be considered as bringing the Southern DHB into
disrepute or, brings into question the employee’s suitability for
continued employment.
t) accessing, transmitting, storing, downloading or displaying any
form of pornographic, sexual y explicit or inappropriate material
using Southern DHB equipment or resources.
u) implying or making actual threats of overlooking an employee or
potential candidate for future work opportunities or promotion as
a result of that employee or potential candidate declining the
sexual advances or similar actions of any person in a position of
authority.
v) victimising, intimidating or bullying any employee, or a
patient/client, or a member of the public.
Private Conduct
As a general principle, personal behaviour outside of work is of no
concern of Southern DHB, except where it interferes with work
performance, where the individual is identifiable as a representative
64
of the Southern DHB, or where the behaviour reflects on the standing
or integrity of the Southern DHB or the employee’s profession or
trade, or constitutes a breach of the law.
Employees should not bring the Southern DHB or their profession into
disrepute through their private activities.
An employee must make the Southern DHB aware of any such
instances as soon as possible.
Consideration
Whether actions fal into the category of misconduct or serious
misconduct wil depend on the circumstances in each case. In making
judgements of this kind, regard should be given to the fol owing
factors:
• The nature and circumstances of the activity.
• The position, duties and responsibilities of the employee.
• The consequences of the activity on the employee to fulfil his/her
duties and responsibilities.
• The effects of the activity or its consequences on working
relationships with col eagues, patients, outside contacts and the
general public.
Breaches of the Code of Conduct
We are al responsible for trying to avoid escalation of inappropriate
behaviour that may result in a breach of the Code, and for dealing
with workplace conflict through timely and appropriate
communication that addresses the behaviour in a constructive way.
You are expected to cooperate with any investigations being
conducted in relation to an al eged breach of the Code.
Managers must make fair, transparent and consistent decisions in
response to an al egation of a breach of the Code and the action to be
taken in response to a breach. In determining the action to be taken
the nature and seriousness of the breach wil be considered.
Some possible consequences of a breach include:
• informal or formal counsel ing.
• disciplinary processes (including opportunities to improve, written
warnings, and summary dismissal).
• referral to registration boards or other regulatory authorities
especial y in the case of those employees providing direct patient
care.
• referral to the Police (in cases of suspected criminal activity) or
relevant government department e.g. immigration.
If you are concerned about a possible breach of this Code, your
manager should be able to help you.
If you are concerned about approaching your manager to discuss the
issue, you can also talk to:
• Human Resources.
• Your professional leader.
• Your union or employee representative.
65
• A speak-up supporter, or
• The State Services Commission's integrity and conduct help desk;
phone (04) 495 6722 or e-mail: [email address]
Only those who need to know wil be made aware of the situation.
Southern DHB is committed to protecting any person who raises
concerns or provides information about a breach of the Code or any
other organisational policy from retaliation or reprisals. In some
circumstances, an employee who makes a disclosure about serious
wrongdoing will be afforded anonymity as provided for in the
Protected Disclosures Act 2000. This Act makes it a criminal offence
to take a reprisal against any individual who makes a protected
disclosure. Please refer to the Protected Disclosures and Whistle-
blower Policy (District) (19708) for ful guidance.
I have read and understand the Code of Conduct and Integrity.
_________________________________________________
______________
(Name) (Date)
66
Key policies and regulations related to the MB ChB
These are available at https://www.otago.ac.nz/medicine/current-students/resources/policies-
guides/index.html
The fol owing list highlights some of these for your particular attention.
•
Code of Practice for Fitness to Practice Page
•
Code of Professional Conduct for Medical Students at the University of Otago Page
•
Medical Council of New Zealand Policies and Information for Medical Students Page
•
Harassment Policy Page
•
Privacy and Confidentiality Page
•
Academic Integrity Page
•
Copyright (Infringing File Sharing) Act 2011 Page
•
Drugs and Other Legal Offences Page
•
Ethical Behaviour Policy Page
•
Other Otago Medical School Policies of note Page
•
Policy and Procedure for Transfers Between Schools of the Otago Medical School Page
•
Policy and Procedure for Transfers Between Otago and Auckland Medical Schools Page
•
Policy on transmissible and blood-borne infections for medical students, based on Medical Council
guidelines
67
ALM
6ti
Dunedin Campus- Otago Medical School
Advanced Learning in Medicine Sixth Year
Trainee Intern Handbook
For further information:
Student Affairs Office
Dunedin Campus - Otago Medical School
University of Otago
PO Box 56
Dunedin 9054, New Zealand
Tel 64 3 479 7700
Email [email address]
Document Outline
