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Fraser Jeffery
NZMSA President 2019
Trainee Intern
University of Otago
It has been a steady year of progress for the New Zealand Medical Students’ Association (NZMSA) in 2019. Last year, our long advocacy campaign with the Government to raise the student loan lifetime limit reached a satisfying conclusion. This result demonstrated the importance of a strong students’ association to carry advocacy across multiple teams and “generations” of medical students. With that issue off our agenda for the first time in eight years, we have had the opportunity to outline some new priorities this year. Alongside our regular advocacy work in the areas of wellbeing, workforce, and education, we have had a strong interest in the role that gender plays in our medical education and the make-up of NZMSA’s leadership. In this review, I will give you a taste of what we have been working on.
Gender in medicine
A group of Wellington medical students conducted a survey in 2017 that demonstrated the inequity in learning opportunities and experiences across gender groups (1). The report highlighted the difference in experiences that students may have during medical school, depending on their gender. It showed how female medical students felt their gender would have a significant impact on their future career path, which was disheartening to see so early on in their careers. This is an issue that our organisation cannot ignore, particularly as the report found that medical student culture was also part of the problem. This aligned with qualitative research from the senior doctors’ union and the Association of Salaried Medical Specialists (ASMS), which examined how gender affected the careers of some female doctors in ways that they regretted (2).
The experiences of different genders in medicine will come as no surprise to many of our students. It is an issue that pervades all levels of our medical culture. Unfortunately, we are not going to change this overnight, but we must raise awareness and have a conversation about how we change the culture. To begin this, the NZMSA ran a Gender in Medicine focus month during May, featuring thought-provoking excerpts from the report and a series of podcasts with NZMSA executive members discussing the issue with experts in this field. Work in this area will continue in years to come.
Wellbeing
The wellbeing and mental health of medical students has been a priority for the NZMSA for many years and will continue to be for the foreseeable future. The issue has been well documented and awareness is relatively high. Last year we sought to understand some of the drivers of medical student wellbeing and how we experience university support services through the NZMSA Wellbeing Survey. The report of the survey outlined several recommendations for the NZMSA to act on and focus our work on. We have made great progress in advocating for clear and reasonable university policies around the expectations of clinical working hours for our students (now in place for Otago University trainee interns), improving support for medical-student parents, and getting our ASMS-NZMSA Mentoring Programme off the ground. We hope these small steps will help make a tangible difference to the wellbeing of medical students. More work needs to be done and will be an ongoing focus for the NZMSA.
NZMSA’s leadership diversity
The makeup of NZMSA’s leadership is important to enable us to effectively represent and advocate for the breadth of our community. The consequence of good representation was demonstrated this year through one of our executive members, Bryony Harrison, being a parent and leading advocacy work in improving support for fellow parents in medical school. Without Bryony being a part of our team, we may well have never looked at this area. However, over the last few years, we have recognised that our team has not always had good representation of our medical student cohort. This is important as there is likely a flow-on effect whereby leaders in medical school become leaders later in their careers. There is good evidence to suggest that the higher up the medical hierarchy, the more male dominated it is (3). We need to ensure that our organisation is not contributing to that problem. In alignment with our Gender in Medicine focus month, this year we have been encouraging an environment in our elections where all members can contribute and serve. The NZMSA has also been looking closely at how we can collaborate better with the many other groups that represent medical students.
Workforce – unions, contracts, ACE and the Ministry of Health
The workforce portfolio has been one of the busiest this year. Firstly, we now have two junior doctor unions following the formation of the Specialty Trainees of New Zealand in addition to the New Zealand Resident Doctors Association. Both have their own contracts in the form of a Multi-Employer Collective Agreement (MECA). We saw the NZMSA as playing an important role in giving clear advice to trainee Interns about what options they have. We did this through developing a resource following discussions with both unions and the District Health Boards (DHBs). The NZMSA does not hold a view on either of the unions or the contracts they have negotiated. Ultimately, trainee interns will need to make a decision that suits their circumstances and we hope that we have helped to keep them informed through this process. We will continue to keep in touch with all the stakeholders to ensure that trainee interns are well informed.
Before trainee interns receive their first job offer, they first apply through the Advanced Choice of Employment (ACE) system, which matches them with one of 20 hospital placements across the country. The NZMSA has been involved in the Reference Group that governs ACE since its inception and we continue to play an active role. Unfortunately, this year the ACE Roadshow, an event designed to allow medical students to meet with DHB staff and Resident Medical Officers, was greatly limited with no DHB attendance due to concurrent strike action. We are working diligently behind the scenes to try and ensure improvements are made for next year, as we know how important this event is for medical students in making an informed choice for where they want to work.
The NZMSA has also been keeping an eye on the wider health workforce plans at the Ministry of Health. This part of the Ministry has gone through a significant restructure recently and we will seek to ensure that the voice of the future workforce is heard wherever possible. Promising progress is being made in the area of our rural health workforce as well. It is hoped that the Rural Health Training Hubs proposal will help improve rural opportunities to eventually help alleviate an impending crisis in the rural doctor workforce.
And a quick mention of the rest…
This year we ran a number of successful events including Beyond the Medical School Gates, Clinical Leadership Forum, Medical Education Summit and Sports Exchange. Our flagship event, the NZMSA Conference, was held in Auckland and was a fantastic weekend of speakers and social events. Many thanks must go to Cain Anderson and his team for putting on such a superb event. Next year’s conference is to be held in Christchurch for the first time since 2014. Sports Exchange is returning to Dunedin as well.
We have made a written submission to the Select Committee on the Zero Carbon Bill, advocating for strong action on climate change. We will also be making an oral submission to the Committee later this year. Our own carbon consumption will also be the subject of a new internal policy later this year that aims to increase the carbon offsetting of NZMSA-associated travel.
One area that we would like to improve in is the evidence base that informs our advocacy work. Traditionally, we have used informal surveys to better understand the issues affecting medical students. However, these surveys have seldom been methodologically sound. In order to improve this process, the NZMSA is collaborating on a summer studentship project at the University of Auckland as a pilot with a hope to be involved in more projects in the future. We have also signed a Memorandum of Understanding with the New Zealand Medical Student Journal to improve the collaboration between our two organisations.
As always, if there is something you think the NZMSA should be advocating on, please do not hesitate to get in touch with one of the team. Your first port of call should be your local NZMSA representative but any of us would love to hear from you.
It has been an absolute pleasure being the NZMSA President for 2019. Being involved with many fantastic teams of medical students over a number of years has been a great privilege. Thank you to all those who have contributed to the NZMSA this year. I believe the work we have done will make a difference to medical students now and into the future. I look forward to seeing what Ellie Baxter (NZMSA President 2020) and her team achieves next year.
References:
About the author
Fraser is a Trainee Intern based at the University of Otago's Christchurch campus and has been the NZMSA President for 2019. He has been involved with the Association across the last four years, first as a member of the Dunedin conference team in 2016 and then as a Vice President and Christchurch Representative. Outside of medicine he enjoys tramping, photography, football and running. Next year he will be a PGY1 House Officer at Christchurch Hospital.
Correspondence
Fraser Jeffery: president@nzmsa.org.nz
Fraser Jeffery
NZMSA President 2019
Trainee Intern
University of Otago
It has been a steady year of progress for the New Zealand Medical Students’ Association (NZMSA) in 2019. Last year, our long advocacy campaign with the Government to raise the student loan lifetime limit reached a satisfying conclusion. This result demonstrated the importance of a strong students’ association to carry advocacy across multiple teams and “generations” of medical students. With that issue off our agenda for the first time in eight years, we have had the opportunity to outline some new priorities this year. Alongside our regular advocacy work in the areas of wellbeing, workforce, and education, we have had a strong interest in the role that gender plays in our medical education and the make-up of NZMSA’s leadership. In this review, I will give you a taste of what we have been working on.
Gender in medicine
A group of Wellington medical students conducted a survey in 2017 that demonstrated the inequity in learning opportunities and experiences across gender groups (1). The report highlighted the difference in experiences that students may have during medical school, depending on their gender. It showed how female medical students felt their gender would have a significant impact on their future career path, which was disheartening to see so early on in their careers. This is an issue that our organisation cannot ignore, particularly as the report found that medical student culture was also part of the problem. This aligned with qualitative research from the senior doctors’ union and the Association of Salaried Medical Specialists (ASMS), which examined how gender affected the careers of some female doctors in ways that they regretted (2).
The experiences of different genders in medicine will come as no surprise to many of our students. It is an issue that pervades all levels of our medical culture. Unfortunately, we are not going to change this overnight, but we must raise awareness and have a conversation about how we change the culture. To begin this, the NZMSA ran a Gender in Medicine focus month during May, featuring thought-provoking excerpts from the report and a series of podcasts with NZMSA executive members discussing the issue with experts in this field. Work in this area will continue in years to come.
Wellbeing
The wellbeing and mental health of medical students has been a priority for the NZMSA for many years and will continue to be for the foreseeable future. The issue has been well documented and awareness is relatively high. Last year we sought to understand some of the drivers of medical student wellbeing and how we experience university support services through the NZMSA Wellbeing Survey. The report of the survey outlined several recommendations for the NZMSA to act on and focus our work on. We have made great progress in advocating for clear and reasonable university policies around the expectations of clinical working hours for our students (now in place for Otago University trainee interns), improving support for medical-student parents, and getting our ASMS-NZMSA Mentoring Programme off the ground. We hope these small steps will help make a tangible difference to the wellbeing of medical students. More work needs to be done and will be an ongoing focus for the NZMSA.
NZMSA’s leadership diversity
The makeup of NZMSA’s leadership is important to enable us to effectively represent and advocate for the breadth of our community. The consequence of good representation was demonstrated this year through one of our executive members, Bryony Harrison, being a parent and leading advocacy work in improving support for fellow parents in medical school. Without Bryony being a part of our team, we may well have never looked at this area. However, over the last few years, we have recognised that our team has not always had good representation of our medical student cohort. This is important as there is likely a flow-on effect whereby leaders in medical school become leaders later in their careers. There is good evidence to suggest that the higher up the medical hierarchy, the more male dominated it is (3). We need to ensure that our organisation is not contributing to that problem. In alignment with our Gender in Medicine focus month, this year we have been encouraging an environment in our elections where all members can contribute and serve. The NZMSA has also been looking closely at how we can collaborate better with the many other groups that represent medical students.
Workforce – unions, contracts, ACE and the Ministry of Health
The workforce portfolio has been one of the busiest this year. Firstly, we now have two junior doctor unions following the formation of the Specialty Trainees of New Zealand in addition to the New Zealand Resident Doctors Association. Both have their own contracts in the form of a Multi-Employer Collective Agreement (MECA). We saw the NZMSA as playing an important role in giving clear advice to trainee Interns about what options they have. We did this through developing a resource following discussions with both unions and the District Health Boards (DHBs). The NZMSA does not hold a view on either of the unions or the contracts they have negotiated. Ultimately, trainee interns will need to make a decision that suits their circumstances and we hope that we have helped to keep them informed through this process. We will continue to keep in touch with all the stakeholders to ensure that trainee interns are well informed.
Before trainee interns receive their first job offer, they first apply through the Advanced Choice of Employment (ACE) system, which matches them with one of 20 hospital placements across the country. The NZMSA has been involved in the Reference Group that governs ACE since its inception and we continue to play an active role. Unfortunately, this year the ACE Roadshow, an event designed to allow medical students to meet with DHB staff and Resident Medical Officers, was greatly limited with no DHB attendance due to concurrent strike action. We are working diligently behind the scenes to try and ensure improvements are made for next year, as we know how important this event is for medical students in making an informed choice for where they want to work.
The NZMSA has also been keeping an eye on the wider health workforce plans at the Ministry of Health. This part of the Ministry has gone through a significant restructure recently and we will seek to ensure that the voice of the future workforce is heard wherever possible. Promising progress is being made in the area of our rural health workforce as well. It is hoped that the Rural Health Training Hubs proposal will help improve rural opportunities to eventually help alleviate an impending crisis in the rural doctor workforce.
And a quick mention of the rest…
This year we ran a number of successful events including Beyond the Medical School Gates, Clinical Leadership Forum, Medical Education Summit and Sports Exchange. Our flagship event, the NZMSA Conference, was held in Auckland and was a fantastic weekend of speakers and social events. Many thanks must go to Cain Anderson and his team for putting on such a superb event. Next year’s conference is to be held in Christchurch for the first time since 2014. Sports Exchange is returning to Dunedin as well.
We have made a written submission to the Select Committee on the Zero Carbon Bill, advocating for strong action on climate change. We will also be making an oral submission to the Committee later this year. Our own carbon consumption will also be the subject of a new internal policy later this year that aims to increase the carbon offsetting of NZMSA-associated travel.
One area that we would like to improve in is the evidence base that informs our advocacy work. Traditionally, we have used informal surveys to better understand the issues affecting medical students. However, these surveys have seldom been methodologically sound. In order to improve this process, the NZMSA is collaborating on a summer studentship project at the University of Auckland as a pilot with a hope to be involved in more projects in the future. We have also signed a Memorandum of Understanding with the New Zealand Medical Student Journal to improve the collaboration between our two organisations.
As always, if there is something you think the NZMSA should be advocating on, please do not hesitate to get in touch with one of the team. Your first port of call should be your local NZMSA representative but any of us would love to hear from you.
It has been an absolute pleasure being the NZMSA President for 2019. Being involved with many fantastic teams of medical students over a number of years has been a great privilege. Thank you to all those who have contributed to the NZMSA this year. I believe the work we have done will make a difference to medical students now and into the future. I look forward to seeing what Ellie Baxter (NZMSA President 2020) and her team achieves next year.
References:
- Bosson A. Wellington Medical Students’ Association gender in medicine survey 2017 [Internet]. University of Otago; 2017. Available from: http://legacy.nzmsa.org.nz/wp-content/uploads/2018/09/Gender-in-Medicine-2017-report-final.pdf
- Chambers C. Feeling one step behind: the lived experience of women in the senior medical workforce [Internet]. The Specialist. 2019;(117). Available from: https://www.asms.org.nz/wp-content/uploads/2018/12/12200-The-Specialist-Issue-117-WEB.pdf
- Zhuge Y, Kaufman J, Simeone DM, Chen H, Velazquez OC. Is there still a glass ceiling for women in academic surgery?. Annals of surgery. 2011 Apr 1;253(4):637-43.
About the author
Fraser is a Trainee Intern based at the University of Otago's Christchurch campus and has been the NZMSA President for 2019. He has been involved with the Association across the last four years, first as a member of the Dunedin conference team in 2016 and then as a Vice President and Christchurch Representative. Outside of medicine he enjoys tramping, photography, football and running. Next year he will be a PGY1 House Officer at Christchurch Hospital.
Correspondence
Fraser Jeffery: president@nzmsa.org.nz