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Welcome to our annual newsletter

From the Flight Deck – Rob Griffiths

Rob Griffith imageThe year has been like trying to land an Airbus in “Go-Around” mode; at least we haven’t experienced the anticipated Max 8 dive! In fact, student Occupational & Aviation Medicine enrolments actually went up during the pandemic. Being a totally online, distance learning programme, we didn’t miss a beat in our teaching and were able to help other traditionally face to face programmes to develop online teaching capacity and capability. The strengths and resilience of online learning methods in the face of adversity has encouraged us to think more about expanding what and how we teach.

We now have two 3-year Professional Master’s degree programmes, in Occupational Medicine and Aeromedical Retrieval & Transport, to accompany the flagship Master of Aviation Medicine programme. Both Professional Masters degrees are designed for doctors in the USA, where Occupational & Aviation Medicine is furthering its reputation as a leading distance educator. The MOccMed is modelled on the American Board of Preventive Medicine Complementary Pathway to OccMed Board Accreditation in the US for doctors who have completed residency training in another specialty. We have a number of US and Canadian teaching staff, and North America will be a focus for us in the future.

We have obtained a grant to develop a curriculum and consortium to teach an online Certificate/Diploma/Masters programme in Occupational Health in Animal Management. This initiative, which was turned down in 2017, is intended to avoid the kind of human-animal interface that led to the COVID-19 outbreak at the wet market in Wuhan and the Swine Flu pandemic that started near a farm in Mexico. Other expansions have been slowed or halted by the effects of the pandemic, but watch this space!

Our last Professional Visits Programme was held in Lisbon in September 2019, and will probably be a permanent victim of the “new normal”, where travel and gatherings are unpredictably and disruptively restricted and air travel remains hazardous. We are developing frameworks for eSeminars and social media to replicate the collegiality, collaboration, and fun of the PVP, to start in 2021.

Many of our staff and students are actively engaged in the COVID-19 response, and have been frantically busy this year. I would like to take a moment to thank both staff and students who have continued to give their best at a time when their professional and personal lives have been thrown into disarray. I would also like to remember those many thousands of people who have died, and stress that one of our goals has always been about achieving safety and equity, for those at work, in the air, or who are intensely unwell. May we and our graduates continue to work towards better health outcomes, through our personal endeavours.

Travel Safe

Rob

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Aviation Medicine – a message from David Fitzgerald

Airliner image

Aviation Medicine papers this year have continued largely as usual despite all the issues with COVID, which reflects strongly the robustness and utility of distance learning. Some students have found managing the balance between often busy COVID-affected careers and study difficult and we have been as usual flexible in extensions to assignments etc to compensate. Others elected to defer their papers and we look forward to welcoming them back once the dust has settled. Lecturers too have been unexpectedly busy in their professional lives outside of Otago, having often to adapt to different ways of practicing. On a personal note, the experience of learning and teaching remotely with Otago has made it particularly easy to step straight into telehealth based consultations with comfort, which I am sure many of our students past and present will appreciate. Our students can boast they have been using Zoom for years even before it became a “thing”. If only I had bought zoom shares…

AVME 711 and AVME 714 had strong enrolments this year as usual, bolstered by the students undertaking their subjects for the Certificate course to facilitate them becoming aeromedical examiners under NZ CAA. The large group, and a more substantial focus on forum contributions as provided some very helpful dialogue. The quality of work produced by our students this year is of such good quality that we should have quite a few publishable papers from our current students.

We have also had the pleasure to host some students who have been completing their Monash postgraduate studies with us this year after the cessation of that course, which added two additional papers to be taught rather at the last minute. Luckily they are a knowledgeable group already which made the teaching particularly pleasurable.

This semester we said farewell to Nicola Emslie who ceased teaching to pursue other competing interests and we have welcomed John Chalkley (formerly of Emirates, recently Air NZ and now at Qatar!) who has brought first hand experience with managing COVID-19 in the airline world, and Dave Peat who brings with him his ATC experience from NATS and aeromedical retrieval experience. It has been a bit of a baptism of fire for the two but they have risen to the teaching tasks admirably.

A PVP planned for late 2020 clearly was not able to eventuate, but we will keep our ear to the ground as to what we are able to run in 2021. Offering our students some direct practical exposure to the aviation medicine workplace environment has traditionally been a strength of the OAMU and we aim to offer this in as practical a fashion as possible.

What next year will bring remains to be seen. On the one hand, the redundancies seen in the airline environment recently across the world may reduce our pool of airline students somewhat. On the other hand, aviation medicine is always a very fascinating area of medical practice and we always have a very diverse group of students from different backgrounds and going in different directions. One of our strengths as mentioned above is the flexibility that our online learning environment affords which will be a continuing strength.

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Occupational Medicine – a message from Lily Knightingale

Quarry image

Occupational Medicine (OM) in a post-pandemic world remains to be seen. I envisage increased importance/respect and requests for our involvement in decision making – e.g. workplace layouts to reduce cross infection, hygiene recommendations, zoom meetings to reduce international travel etc.etc.

Assessment of fitness to return to work, including what restrictions, is better placed with OM doctors rather than GPs as we know the workplaces better.

With Public Health staffing so low, it may well be that OM contributes to contacting, travel recommendations.

I know multiple friends have described to me, and I noted personally, that going into lockdown was easier than coming out of lockdown! Anxiety about contact with others, personal space violations, meeting people with cough/cold/flu symptoms yet anxious in case it might be undiagnosed COVID.

I believe the next 12–18 months of mental health sequelae are yet to be realised. In most countries (if not all?) Mental Services are already stretched too thinly with long waiting times. If there is a COVID deluge, then those services will be stretched further and individuals exposed to longer waiting times. In such scenarios, OM doctors and GPs will be relied upon in the meantime.

In closing, I truly believe that things will probably be changed forever - less need for international meetings, some telehealth consultations continuing etc.

Good luck for the post-COVID world that lies ahead!

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2019 Professional Visits Programme

Students and staff at airbus image

Every year, until the pandemic, Occupational & Aviation Medicine has held an annual residential school, or Professional Visits programme. In 2019, a 2 stage programme was developed, the aviation medicine class visiting Toulouse, France, and all three streams with a busy programme in Lisbon, Portugal. In Toulouse, the group met with Airbus, ISAE SUPAERO aviation and space University, MEDES Institute of Space Physiology and Medicine, and CADMOS Operations Centre for microgravity research on the International Space Station.

In Lisbon, the full class received lectures at the national airline, TAP Air Portugal, and engaged in a number of experiential activities, including industrial site visits, air ambulance service attachments, aeromedical retrieval dispatch centre, airport operations, air force base, engineering, and a car manufacturing plant.

The PVP provides an excellent opportunity for networking, and is a great way to refresh student motivation. There are a range of organised and self-arranged social activities, and a final formal dinner where we get to thank our hosts for the week, and conduct a charity auction. All participants bring an item to be auctioned within the group, with the proceeds going to a local charity.

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From the Research Desk in 2020

Rescue helicopter image
Photo credit: Tony Ward.

While our teaching programmes have been able to continue with little disruption it has not been quite as straightforward for researchers, though with relatively short periods of ‘lockdown’ in New Zealand it has generally meant studies ‘taking longer to complete’ as opposed to being put on hold indefinitely. We ourselves have been teaching and learning by distance for many years and were already very comfortable with using technology to interact. However, it was new for many of the research stakeholders we consult with, and of course for many potential research participants. In fact, for me a slight positive to come out of the current pandemic is that it has become ‘acceptable’ to have slightly different protocols and ‘ways of doing things’ for many aspects of planning and undertaking a study. As one small example, it is now quite ‘normal’ or ‘familiar’ to suggest to potential research collaborators, research participants, or stakeholders that we will undertake all or most interactions ‘virtually’. It not only maximises efficiency in terms of time and travel but also facilitates collaboration (and the acceptability of this) with those outside our geographical space.

Understandably, some of our planned research in the Aviation Medicine space has been impacted by the current pandemic. Two small projects (evaluating health promotion and peer assistance networks for airline staff) are currently on hold due to a combination of major airline workforce attrition and deployment of collaborating airline medical staff to more pressing roles like managing border and flight crew protocols. One project has been able to commence however, a qualitative study of the mechanisms of support for Airline staff with addiction.

In Occupational Medicine we have two Master’s projects currently underway: one examining the role of Occupational Medicine physicians in a pandemic response, and the other focusing on return to work following operative versus non-operative management of lumbar disc prolapse. A potential PhD project is currently in development to examine health sector occupational health and safety during a pandemic.

In Aeromedical Retrieval we are currently supervising two student projects, a PhD examining non-technical skills in the obstetric flight setting) and a Master’s project examining staffing profiles of primary aeromedical services in New Zealand.

As Rob alluded to in his message from the flight deck, the current uncertainties also limit our opportunities for meeting as a group, attending conferences and/or presenting research. Within the OAMU we are working on developing new frameworks for collegiality and collaboration using eSeminars so please watch this space. I’m sure in many disciplines the topic of permanent eConferences will also be robustly debated. One paper I recently read makes reference to a Nature reader poll where more than 80 per cent of respondents said they favoured some scientific conferences remaining virtual going forward (Bottanelli F, Cadot B, Campelo F, et al. Science during lockdown – from virtual seminars to sustainable online communities. Journal of Cell Science. 2020;133(15):jcs249607). Another discusses the potential advantages associated with virtual conferences from the perspective of those who have moved their conferences to a virtual format in 2020 (Houston S. Lessons of COVID-19: Virtual conferences. Journal of Experimental Medicine. 2020;217(9)).

Such advantages include improved accessibility and opportunities for researchers of all levels of experience and seniority to attend conferences (not limited by capacity, financial or travel restrictions); the likelihood that potentially over-committed experts in the field will actually accept invitations to present their work; the reduction of time ‘wasted’ in travel; the opportunity for senior researchers who attend many conferences to have a schedule that is simply ‘less hectic’; an ability for researchers to achieve greater global reach for their work; and finally a greatly reduced carbon footprint.

That’s all from the research desk for now. I hope those of you on the opposite side of the world are enjoying a good summer/autumn. Certainly some of us down under in NZ are looking forward to more daylight and warmth as we head into Spring and Summer!

Publications

Eason, J., Ward, H., Danko, O., Richardson, K., Vaitkute, R., & McKeon-Carter, R. (2019). Early-onset sepsis: can we screen fewer babies safely? Archives of disease in childhood.

Alves, P. M., Lindgren, J. A., Streitwieser, D. R., Anzola, E., Ahmed, N., & Nerwich, N. (2019). Quality of Electrocardiograms Obtained in Flight by Airline Flight Attendants. Aerospace medicine and human performance, 90(4), 405-408.

Krook, C., O’Dochartaigh, D., Martin, D., Piggott, Z., Deedo, R., Painter, S., ... & Armstrong, J. N. (2019). Blood on board: The development of a prehospital blood transfusion program in a Canadian helicopter emergency medical service. Canadian Journal of Emergency Medicine, 21(3), 365-373.

Myers, J (2019). Fatigue in critical care clinicians (Doctor of Philosophy), University of Otago, New Zealand.

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Join ACOEM as an Active Member!

The American College of Occupational & Environmental Medicine encourages occupational health practitioners from around the world to join its Active Membership, and there is a dedicated International Section with its own events at the American Occupational Health Conference. Doctors who meet the eligibility requirements and have been Active Members for at least 3 years can then apply to become Fellows, and use the post-nominals FACOEM.

Note that specialty Board Certification is awarded by the ABPM and not ACOEM, and being a FACOEM does not necessarily mean that you can register as a medical practitioner in any of the US States. Nonetheless, ACOEM hosts an excellent conference (virtually in 2021) each year, publishes a monthly journal, the Journal of Occupational & Environmental Medicine (JOEM), and provides a welcoming "professional home" to international medical graduates.

Join ACOEM

Read more about the Occupational and Aviation Medicine Unit