Interview - Dr Jeff Garrett

Medicine at Middlemore... Working as a Physician at Middlemore Hospital provides a diverse working environment  with many clinical challenges that ensures our doctors are always stimulated. Whether attempting to diagnose a rare condition or to disentangle a complex presentation, or even something straightforward, there is the potential to enhance a variety of skills.

Our emphasis is on continuity of care and integrated care. Therefore, whether you are working within the acute care team, on the ward or in the ambulatory setting it remains important to remember you are part of a multidisciplinary team. 

We place a strong emphasis on clinical research (there are 7 clinical research fellows) and quality improvement initiatives. The desire to question the way we do things and to improve upon existing models of care is important.  In acknowledgement, we host an annual Science Festival and encourage junior staff to present research studies or audits.  

One of the main reasons I enjoy practising medicine at Middlemore Hospital is the humility shared by so many of our senior clinicians and nurses. I think this reflects in part, the community we care for, but also reflects the culture that has existed at Middlemore over many years. There is also very capable clinical leadership within this organisation. We have good decision makers and good infrastructure which is allowing us to develop into one of New Zealand's leading healthcare providers.

Training in Medicine...

Training in medicine allows junior doctors to acquire many skills essential in developing a successful career. There is a strong team focus in medicine and contribution at all levels is vital. Senior physicians are expected to lead or become a major contributor to the provision of infrastructure that supports good care (eg clinical pathway development, audit, IT development, e-learning modules). Internal medicine remains the important hub of any successful hospital so the wide-ranging role of the physician is essential.

Basic Trainees at Registrar level can sit their part 1 exams once they are comfortable with their knowledge base. This usually occurs 2 to 3 years into their Registrar training. The part 1 exam consists of a written exam, then around 3 months later (assuming the trainee passes their written exam) they are eligible to sit their clinical exam which (if they pass) will allow them to become an Advanced Trainee. Around 70% of our Advanced Trainees are dual trainees (which usually consists of between 3 to 4 years of training in internal medicine and their chosen subspecialty). Around 30% train purely within a single subspecialty. We recommend for them to complete one of these years abroad. Our training programme offers strong international affiliations with internationally renowned centres overseas (predominantly Australia, UK and North America)which strengthens the training scheme.

Training in medicine can allow a work life balance as long as you manage and maintain your workload effectively. After hours work can at times be onerous however there are more opportunities now to protect your responsibilities and develop a variety of interests outside of medicine. We have ensured no Senior Physician performs more than 11 weekends of call a year and we have more oncall teams than most other hospitals so that workload is more evenly shared afterhours. We encourage medicine trainees to have a life out of work to maintain a rounded personality which is beneficial for our patients.

Why Medicine?

If you want a career that will remain challenging, exciting and intellectually stimulating then medicine is a good career choice. You will be surrounded by pleasant people with a strong team focus. Medicine is an area which allows people not only with intellect but also practical skills to excel therefore it is a very accommodating area to practice and offers a diverse experience.