This page is about the Department of Primary Health Care and General Practice contribution to the University of Otago medical degree.
The Department of Primary Health Care and General Practice is involved in teaching students at all levels in the Advanced Learning in Medicine (ALM) course in Wellington. Students attend the Wellington campus for ALM years 4, 5 and 6 of the MBChB degree.
Advanced Learning in Medicine (ALM)
The ALM course is modular with rotating block modules through the three years and vertical modules running throughout the course.
The Department is responsible for the block modules in Primary Health Care and General Practice in all three years of ALM. These block modules are further described below and allow continuity though the ALM program. The vertical module Professional Development and Ethics (PDE) is also convened and administered in this Department. Two other vertical modules: Addiction Medicine and Clinical Decision Making also have close links within the Department.
Teaching in the Department is research informed and also drives educational research. Recent research topics have included the teaching of Chronic Condition Management , Palliative Care teaching , Interdisciplinary teaching , and the teaching of Genital Examination. The courses is regularly evaluated and changes made as needed.
General practice is taught in conjunction with Public Health – each discipline taking primary responsibility for 5 weeks of the combined 10 week module. This involves clinical tutors in the community, as well as tutors from a number of different disciplines within the School
Based at the Wellington School, this 2 week module allows for consolidation of principles of Primary Health Care and General Practice and preparation for the extended clinical placement in the Trainee Intern year.
Students are exposed to advanced General Practice concepts such as travel medicine, management of sexual assault and injecting drug users. There is also a strong emphasis on professionalism including communication, interdisciplinary practice and medico-legal issues.
Clinically focused preparation for the TI year includes skills such as prescribing and minor surgery, as well as clinical teaching for genital examinations and common musculoskeletal conditions.
The Trainee Intern General Practice module is a 6 week module, plus one week equivalent of Urgent Care experience which may be co-located or a stand-alone week.
Contracts are in place with a number of teaching practices in rural areas and provincial towns in the lower North Island to ensure you get the quality teaching and good clinical experience necessary to meet the educational objectives of this module. Trainee Interns are sent placement options in August of the previous year.
Tairāwhiti Interprofessional Education Programme (TIPE)
Health Workforce NZ is funding this collaborative project with several training partners - the University of Otago (UoO) and Eastern Institute of Technology (EIT) in Tairāwhiti. This very successful programme brings undergraduate students from eight different health disciplines together to learn and gain clinical experience working with Māori communities and other health providers in rural New Zealand. The IPE programme has now completed the pilot and Health Workforce NZ has announced continued support until 2018
TIPE is a fully interprofessional programme for senior health professional students started in 2012 which includes students from Medicine, Nursing, Occupational Therapy, Pharmacy, Physiotherapy, Dietetics, Dental and Oral Health students all in their final year courses. Trainee Interns are resident in Tairāwhiti or Wairoa for 6 or 7 weeks and will have a general practice clinical home whilst in Tairāwhiti. The IPE portion of the programme is for 5 weeks and is designed to provide a variety of experiences within a students own discipline, with other disciplines and within a variety of settings, (e.g. rural, chronic conditions management, and hauora Māori).
As part of their studies, all third year University of Otago medical students take part in a Community Contact Week (CCW.) During this week students immerse themselves in a small town or area (in small groups across the South Island and lower North Island) for several days to learn as much as they can about that community and how wider health and social needs are being met within each of these communities. An emphasis of the week is on understanding how the community perceives its own health needs and how the special features of the community influence the way in which health care services are provided. These are not intended to be solely health care based visits. Each of the three Otago Medical Schools (Dunedin, Christchurch and Wellington) place about 100 students each.
Wellington CCW has been in place in its current form since 2009 and students are placed in one of the following areas: Newtown and surrounding areas, Porirua, Kapiti Coast, Wanganui, Palmerston North, Wairarapa, or Lower Hutt. During this week, students will assess the needs of that particular community: access to local and secondary medical care, the range of other services in the town supporting health and wellbeing. This is an important aspect of being a doctor; learning how context and environment are crucial in causing and preventing ill health.
What do the students get from these placements?
"All of my experiences in the community were extremely positive, and I felt everyone made us feel very welcome. I think experiences such as these are all too rare in our course, and this program was by far the most enjoyable part of the third year course thus far."
"Seeing the problems in the community caused by gaps in the healthcare system. Also, witnessing the effects of domestic violence and substance abuse upon families."
"Gaining an understanding how different health organisations work together to care for patients, particularly outside of hospital. It was also really great to have some real world experience with patients that never end up in hospital, but still need a lot of care.""Getting to meet such a variety of people from different organisations. I really enjoyed the wide range that we visited such as the fire service, which was a really amazing experience, and then the farming school, the physio and the GP. It allowed me to get a variety of perspectives and I learnt something different from each place"
Professional Development and Ethics is run as a vertical module with curriculum time allocated throughout years 4, 5 and 6. This module is convened by Dr Ben Gray and co-taught with Dr Angela Ballantyne, the bioethics senior lecturer. In this module we introduce students to an 'Ethical Decision Making Framework' that it used through the programme to help students break down clinical ethics scenarios and understand how to integrate ethical principles into healthcare practice.
Ethical issues are a part of all clinical practice – in everyday, extraordinary and controversial situations. Teaching is through a mixture of whole class lectures, specialised tutorial sessions, and reflective small discussion groups focusing on professionalism.
The curriculum covers material on health law, as well as material on main bioethical themes, such as research, tissue donation, genetics, ethics and the elderly, ethics and children, abortion, and mental health. Professionalism teaching looks at trust, healing, the student code of practice, advocacy for patients and how to manage patient confidentiality. The small discussion group sessions give the students the opportunity to discuss any ethical related issues that they may have encountered. As part of this module, we collaborate closely with Dr Estelle Jaine, the convener of Clinical Decision Making to enable students to put everything together and make sound ethical and clinical judgments. We aim to develop critical thinkers who can identify ethical issues, weigh competing values, and justify their decisions with reasoned arguments.
Assessment for this module includes an ethics essay in 4th year, a clinical ethics essay in 5th year based on the students own experience; a 4th year joint group assignment using the ‘Ethical Decision Making Framework,’ and a 'Thought Provoking Episode Report' (TPER) in both 4th and 5th year.