Med school training great then and now

Otago Daily Times

5 days ago

While many things about the training at the Otago Medical School may have changed over the past 150 years, many things remain the same. John Lewis compares the training of a doctor who graduated from the school in 1965 with that of a doctor who will graduate later this year.
Pete Strang describes himself as a "strange specimen".
He's not your typical doctor.
In fact, he would make a great lead character in a medical drama, about a MacGyver-like doctor who can do Caesarean sections, using nothing but a sharp stick, a torch and some gaffer tape in the back blocks of third-world countries.
Some of his experiences, working in remote parts of Papua New Guinea, are not that far off such a story line — minus the sharp stick and gaffer tape.
And the reason he was able to do it was because of the fantastic training and medical connections he made while studying at the Otago Medical School.
His reason for becoming a doctor was so he could do medical missionary work and, when he graduated from the medical school in 1965, everything he did was geared toward that dream.
Over his 40-year career, he has worked at some of New Zealand's main hospitals, been a general practitioner, a psychiatric registrar at Dunedin Hospital and, more latterly, the director of Student Health and Counselling at the University of Otago.
Interspersed with that was a significant amount of missionary work in places like the Papua New Guinea highlands and the Solomon Islands.
His training at Otago had given him the skills to do medical wonders with relatively little equipment — a risk many modern doctors may not be so keen to take, he said.
"There was a massive investment in anatomical knowledge at med school in our day.
"I suspect with the advent of scans and so on, the emphasis these days has shifted more to the analysis of scans to work out what is happening inside.
"X-rays were very helpful for us, but you still had to imagine much.
"Things tend to be a bit more concrete now and somewhat sorted. There is more of an emphasis on specialisation now.
"I am a strange specimen. I have done many Caesarean sections by torchlight in Papua New Guinea because of power failures — there was no-one else to do it.
"I have given thousands of anaesthetics and used gases, intubation, muscle relaxants, and spinal anaesthesia.
"GPs, as a rule these days, don't do anaesthesia. That is a specialist area.
"I was also doing acute abdominal surgery, laparotomies, removing bits of spear and arrows as well as bullets from people, but that again is not a GP area."
He said he often had a textbook out in front of him, to help him do surgery that he had not done before.
"I also was on the radio a lot, getting advice from specialists, sometimes as far away as Auckland.
"Plastics and burns were frightening, especially in children who fell into fires and needed skin grafts.
"The help from specialists far away was fabulous — colleagueship was very, very important.
"It may be feasible to do these things in a more sophisticated society, but not in a war zone, or in the developing world."
By comparison, trainee doctor Yuvraj Sandhu, who will graduate from the Otago Medical School at the end of this year, said he, too, was also aiming to work in emergency medicine but prehaps without the risks that Dr Strang was forced to take.
Mr Sandhu said he and his fellow students still practise procedures on each other, but he believed the things they were allowed to do to each other now, "are a lot tamer than back in Dr Strang's day".
"We learnt how to put our very first intravenous cannulas in and take bloods by practising on each other.
"Then we moved on to patients. But it is very limited to just that.
"Any kind of procedure that might be deemed too much more invasive than a needle going into the skin is something that us, as medical students, will probably not practise on each other."
He recalled how daunting it was, trying to put the needle in the right place.
The thought of harming a patient is a "scary one".
Dr Strang said in his day, they used to practise on each other a lot.
"We would have a superviser to make sure we were not going to dislocate a shoulder or other joint.
"There was a 'reality' about it."
Mr Sandhu said today's students were taught a lot about practising "evidence-based medicine", rather than the more "textbook-based" learning in the internet-free era.
"Medical knowledge at present is estimated to double every three to four years, which is insane to think about."
While there have been many changes in the way medical students are trained at the Otago Medical School, many things remain the same.
Mr Sandhu said what made Otago so special was the student culture that came with being there and having a hospital that prided itself in being not just a healthcare provider, but also a teaching institution.
"What's meant the most to me are the friendships and relationships I've built.
"Coming down to Otago as the only student from my high school was daunting, but the people I've met have become my best support system."
Dr Strang agreed. He said the relationships and support network built during his time there remained a good source of support and information throughout his career.
"The most memorable thing about training at Otago Med School was the companionship and support from fellow students — both in work and in play.
"My closest friends were all climbers, and we were away climbing a lot.
"It was a wonderful release from our study, and we had an understanding that if we got more than a C pass on an assessment, we had not done enough climbing/mountaineering ... and we were climbing very seriously."
Both said the special feeling a doctor got from helping someone in need had also remained over the decades.
Mr Sandhu said speaking with patients during some of the most significant moments of their lives was an honour.
"Whether it's being in the room when a baby is born, or with someone in their final moments, it's incredibly humbling.
"I went into medicine wanting to help people, but I never realised just how much impact you can have, even as a student.
"Just talking to someone, making them feel heard, and learning from their stories has made this journey all the more meaningful.
"I've come to believe that kindness is one of the greatest strengths a person can have."
Dr Strang and Mr Sandhu are among more than 300 doctors from around the world who have returned to Dunedin for the Otago Medical School's 150th anniversary, which starts today.
The event celebrates 150 years of medical teaching, clinical training, research and innovation across the three University of Otago campuses years of medical teaching, clinical training, research and innovation across the three University of Otago campuses — Dunedin, Christchurch and Wellington — with a range of events, including academic sessions and tours of the present facilities.
It will also provide the perfect opportunity for classes to reunite and remember what the students got up to.
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