Issue No. 3 - December 2008
Training & Fellowships in New ZealandDr Jacob Munro
Training in New Zealand and Australia has undergone several changes in the last decade with progression to the fellowship now directed under the umbrella of the Surgical Education and Training scheme (SET). After 1 year as a house surgeon, potential candidates are free to apply to the Royal Australasian College of Surgeons to join SET 1. The selection process is supervised by the NZ Orthopaedic Association and involves mentor assessment and interviews. Once appointed, young surgeons are expected to obtain their Part 1 surgical exam as well as participate in several courses including the EMST. During the second year SET II, candidates must sit a second Orthopaedic Basic Science Exam (OPBS). Trainees are assigned clinical posts around the country based on their level of experience. Most will return to a larger centre for their final years in preparation for the fellowship exam (Part 2) which occurs midway through the SET V year. Most New Zealanders will participate in a fellowship overseas for a further 2 years.
NZ trained surgeons generally complete their training with around 2,500-3,000 major cases in their logbook. We have particularly strong experience in trauma and arthroplasty with most trainees completing 200-250 total joint replacements. There has been a recent drive to improve the quality of research by registrars. The aim now is for trainees to work on one project of substance through their training, culminating in publication.
Once a fellowship is completed, most will return to a post in a public hospital. New Zealand has a comprehensive health care system open to all citizens. A second private system also operates in parallel and most Consultant Surgeons will divide their time between the two systems. Academic departments are situated in the major centres.
Fellowship opportunities exist in most large centres in New Zealand. In a country of only 4.5 million people, Auckland is by far the largest city accounting for a quarter of the population. There are 4 hospitals in Auckland with Orthopaedic Departments including the National Childrens Hospital. Fellowships in Trauma, Arthroplasty, Sports Orthopaedics, Paediatrics, Spine, Foot and Ankle, Shoulder and Hand are available as well as observerships through the AO Foundation. Web-based application is encouraged. The website for the NZOA www.nzoa.org.nz is an excellent start in listing many fellowships as well as the heads of department for most hospitals and institutes.