An elective studying Rheumatology in Auckland & Rotoura, New Zealand
Dr Kai Ren
The hospitals
I spent my seven week elective (April-May 1998) in Auckland and Rotorua. The SpR on the surgical team to which I had been attached in my third year had come from New Zealand and had told me of a specialist rheumatology hospital in Rotorua. As I had and interest at the time in rheumatology as a potential career, I decided to arrange my elective in this specialty, and split it between the large teaching hospital in Auckland for the first 3 and a half weeks and the specialist hospital in Rotorua for the remainder.
I am afraid that I can remember little of the administrative side of organising the elective, as it was some time ago! However, I do not remember it being particularly problematic, although Auckland Hospital required that I was certified as MRSA free, so this needed to be done by occupational health at Addenbrooke’s Hospital.
I was attached to a consultant at the hospital to whom I needed to report when I arrived. To my dismay, it turned out that this consultant was on sick leave when I arrived and had not informed any others that I was coming! To their great credit, another consultant and his team took me under their wing and were very welcoming. I joined ward rounds, sat in clinics and attended student teaching sessions and hospital meetings such as the Grand Rounds. The type of work was fairly similar to that of a UK rheumatology department.
Accommodation in Auckland was provided in the student and junior doctors’ accommodation block. This was basic but comfortable, with a sink, bed, desk and wardrobe in the rooms, shared bathrooms, laundry facilities, and a huge kitchen.
Half way though my time in New Zealand I moved down south to Rotorua. As you may have heard, it is an area of major geothermal activity, and smells of “rotten eggs”. Actually, it really is not that bad, and does not have that stomach churning organic stink of rotting food. You get used to it quickly, and stop noticing it. Occasionally, there are earth tremors, which are not really alarming.
It was something of a culture shock to arrive in this quiet little town, and the hospital on the edge of the lake.
There was some confusion about where I was to stay, and I was initially told that arrangements had been made for me to stay at a local backpacker hostel for the first night, and I’ve no idea what after that. In the event, I was put up in the hospital itself, in a hospital bed in a side room off the day ward! This was quite bizarre! I was given a quick tour of the hospital which had only three wards – an elective orthopaedic surgery ward and a rheumatology ward, and the day ward. There were three consultants, one specialist registrar and an RMO.
hospital accommodation - rotorua
The SpR and RMO were wonderful people – very laid back, friendly, keen to teach and anxious to make sure I felt at home and happy. Again I went to ward rounds, attended clinics, and also spent a couple of sessions in theatre (all the elective orthopaedic surgery in Rotorua took place here rather than at the general hospital up the road). The hospital makes use of the hot springs and “geothermal mud” as part of their therapy, in the form of a hot mineral water pool, mud packs, Aix massage, steam baths and also they make use of warm wax to treat pain in the finger and toe joints.
steam bath
There is a large Maori population and this ethnic group seem to be very prone to gout, and I do not thing I have ever seen such badly damaged joints from gout since my time there. I became very slick at joint examinations and learnt how to do joint aspirations and injections.
I was treated to an Aix massage one quiet afternoon, a massage with coconut oil under jets of very warm water which was very pleasant! One quiet day, the SpR and RMO took me down to their local golf course, where instead of bunkers, there are fenced off pools of bubbling mud, which swallow your ball for ever.
Spare time
In Auckland, there were several other medical students, one from my medical school, some from the UK doing electives, and some from other countries. My evenings were spent socialising with them. Auckland is a typical Westernised large city, with the usual entertainments you would expect.
In Rotorua, being the only student there, I was generally by myself, in the quiet, deserted wing of the hospital. It was rather odd, having been surrounded by people in Auckland, to be suddenly alone and for the first few days I wondered how to fill my time. In the end, it turned out to be nice to have time to read books that I had meant to read for ages but had never quite managed to find time, watch television, improve my pool skills on the day ward pool table, and sometimes entertain the patients with a bit of terrible piano playing. I would usually go to bed quite early, as in the morning I would be woken at half past five by the clatter of the cleaners coming to tidy the day ward, and so I was usually up by six. I would go out for a stroll by the lake if the weather was good, see the sun rise, and be back by seven for some breakfast and a shower, by which time the medical staff and day patients would be arriving.
I had a few afternoons off here and there to look around both Auckland and Rotorua, and every weekend got away to other parts of the country, including the Northlands (where another friend was doing here elective), the Coromandel, Tauranga, Wellington (more medic friends!), and Kaikoura for whale watching on the South Island. On my elective I did not manage to explore much of the South Islands, something I rectified on a later holiday after finals. As an extra bonus, the Easter Bank Holiday weekend fell in my elective, which meant a long weekend to travel. I travelled with other students from Cambridge for four of the weekends, and alone for the two. During one of these weekends I met some other tourists from the UK and travelled around with them for the two days.
It is very easy to travel by bus, and relatively cheap. At the start of the week, I would make some plans as to where I wanted to go, book a ticket and some accommodation on perhaps Thursday afternoon and head off after work on Friday. Travelling alone in New Zealand felt very safe, although one night I arrived in Tauranga, asked the taxi driver to take me to a backpacker hostel I had chosen, to be asked, “Why on earth are you staying there?” Not good. I arrived to find a rather seedy looking bar/hotel which had some dormitories and single rooms. I had booked a dormitory bed, but seeing that I was alone, the barman (who seemed a nice chap) said, “Er, I think maybe I’ll give you your own room.” By this time I was getting bad vibes about the place, so after a quick meal, I barricaded myself in the room, put my head under the pillows to drown out the sound of the night club below me, and turned in for the night. The next day I found better accommodation in an entertainingly named backpacker hostel called “Just the Ducks Nuts” whose logo can be seen on this website: www.justtheducksnuts.co.nz, where I had absolutely no problems sharing a dorm with some Japanese lads who were staying and working for several weeks
My Impressions of New Zealand
New Zealand is a beautiful country and if you enjoy outdoor activities it is one of the best places in the world. The backpacker hostels frequently make it easy for you to get out, providing plenty of information on things to do, where to go, and often renting out bikes which are a very good way of getting around. Car rental is cheap. The bus network is cheap and has good coverage. Trains are few, and more expensive, with just a few trains each day running between major towns/cities.
The people are incredibly friendly. One patient took a friend and me sailing in his boat off the Northlands one weekend. A couple invited me and two other friends to their house for a bite to eat after coming across us in the street while we were looking up at the sky trying to find the Southern Cross! On my flight back, I fell into conversation with a couple who lived in Wellington, who gave me their address and asked me to contact them if I ever went back to New Zealand. I contacted them when I was back in New Zealand on holiday between finals and starting my house jobs, and they gave me a tour of Wellington. I also went to stay with the couple who had helped us with the Southern Cross, in their lovely farm house by Lake Wanaka. I have utterly fallen in love with the place and may consider trying to move there at some point in the future.
