“A lot of time goes into the supervision I received, especially in the Cardiac Cath Lab. It’s very structured because procedures such as angiograms are invasive, so we must work as a team to achieve the best outcome.”
Dr Michael said he can now do the basics, such as assessing someone’s heart arteries for major blockages that might require advanced therapies. However, more complex cases, like implanting stents in people’s hearts, were undertaken by the senior medical officers.
“Sometimes, this could also involve patients going directly to Auckland via helicopter if an unstable picture evolved. It was all great to witness and learn from first-hand.”
While the cardiology trainee role was a Monday-to-Friday position, Dr Michael also undertook shifts in the emergency department or medical wards out of hours, which he believes is vital for a trainee post because all the services are integrated.
“All specialities come under the general medicine service, so it’s important to understand the hospital, know what services are available and how the wards work. It is easy to submerge yourself into your chosen speciality, but that can lead to a lack of understanding other hospital pressures.”
After spending a year in Northland, Dr Michael believes the main benefit of training in a smaller centre was having the option to split his time across different fields of cardiology, depending on inpatient demands.
In contrast, at larger centres in Auckland, trainees typically spend six months solely focused on a single module such as cath lab, echocardiograms or electrophysiology.
He found no barriers to performing mandatory procedures, including over 400 angiograms, 200 echocardiograms, cardiac MRIs, and CT scans. This should help lay solid foundations for training success on his return to Auckland.
“I felt very fortunate with this placement as I was able to seize all opportunities for learning.”
Another main insight into the year was having the chance to work inside the local community and understand the diverse needs of Northland patients - including attending rural clinics at Bay of Islands, Dargaville, Kaitāia and Rāwene hospitals, Dr Michael said.
“Until you work in Northland, it is difficult to understand the geographical spread of patients, their cultural environment and the inequity they face on a daily basis.”
The region has a significant burden of cardiovascular disease in New Zealand, and he hoped for continued training, research and educational growth in the district.
While Whangārei Hospital’s Cath Lab is unique because of the numbers seen and small waiting list, it has cutting-edge services like a cardiac MRI, which is a vital investigation for patients of this sized population.
Dr Michael is excited for the next trainee to experience this role and the fantastic people who make up Whangārei Hospital.
For him, though, the next six months will be spent working as a research fellow at Middlemore Hospital. After this, he will undertake several other posts in Auckland to complete his training.
Whangārei’s advanced cardiology training has been a substantial project accredited to Dr Peter Ruygrok at Auckland City Hospital. Locally, Dr Raewyn Fisher has also been instrumental in ensuring Northland was part of the regional training scheme.
Similar one-year programmes are offered in the Tauranga and Nelson districts.
