Spec Med - Auckland

Cardiology and Gastro
3 weeks of cardiology is fairly relaxed - no case history or presentation expected for a pass. You can choose what you want to turn up to and learn - being at clinics with consultants was most useful. You should try to see some procedures as well. On average, one tutorial per week.

Gastroenterology was a bit more involved - two short case histories. More expectation to turn up to ward rounds and team meetings. Clinics were good for learning and patient interaction - we got to see patients first and present them to the consultants at times. Endoscopy sessions worthwhile turning up to. One week of liver transplant team can be busy if you are lucky - might get to see liver transplant as well.

Endocrine and Respiratory
Endocrine is pretty hard core, with a timetable that gives you a place to be down to the half hour, every day. Not much time for self directed learning! the consultants are all super friendly and a lot of time is spent sitting in with them in clinic. They book new patients specifically for the students to see at some of the clinics, which is nice. Most of the time is spent at Greenlane, so get to know the clinic support staff. You'll also spend some time with the Endocrinology Registrar, consulting on inpatients. You have to complete 3 vignettes: basically a one page discussion of a case (briefly) and an aspect of the case. You also have to do a 15 minute presentation on a topic of your choosing (related to a case you've seen), and keep a log book of all the patients you see.

Respiratory is a real luck of the draw depending on which consultant you get. There are 5 respiratory consultants and at any time, two of them are doing the ward work. One team looks after the CF patients. There is a separate TB team as well. Its just like being on general medicine really, with the expectation that you'll attend ward rounds and clerk in the new admissions. Not too much formal work to do, we had to do an observed history taking and examination (which was good OSCE practice).

Haematology and Immunology
Though the very words spell cold sweats and incontinence for most, this attachment at auckland was good value. Coordinated by Marion Empson (immunology) and Dr Peter Browett (who is a bloody hilarious guy), you're expected to do a short case history and a case discussion. They give you a pretty outlined timetable with various clinics etc, but are pretty cruisy about whether or not you decide that your time is worthwile spent there. As this was one of the worst-learnt areas of my medical knowledge, a little practical experience helped to put all those disgusting flow-diagrams into a clinical perspective. Lots of livers, spleens and nodes for short case practise, even if you have to gown and glove because they're so neutropoenic.

Renal/Rheumatology (2011)
Not a bad rotation - quite handy for getting your head around the complexities of Renal medicine (and it's in the exam which is helpful). For Renal you do a 15 minute presentation, and basically go to clinics, teaching sessions and a ward round or two. Not much hands on patient experience, and we didn't really clerk any patients from the ED, but nevertheless was useful to get your head around Renal.
Rheumatology was pretty good, you only have to go to 2-3 clinics a week, and write up a case history of one of the patients on the ward (of which there are only ever 2-3 max). Marked by Dr Nicola Dalbeth so you have to make it your best work!

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