Rural hospital medicine
Rural hospital medicine is determined by its social context, the rural environment, the demands of which include professional and geographic isolation, limited resources and special cultural and sociological factors. It is invariable practised at a distance from comprehensive specialist medical and surgical services and investigations.
A broad generalist set of skills, knowledge and attitudes are needed to deliver optimum patient outcomes in rural hospitals. Unlike rural general practice, rural hospital medicine is orientated to secondary care and is responsive rather than anticipatory and does not continue over time.
Vocational training in rural hospital medicine is undertaken through the Division of Rural Hospital Medicine of New Zealand (DRHMNZ), which is a sub-faculty of the Royal New Zealand College of General Practitioners (RNZCGP). Once DRHMZ training is completed, the doctor is awarded the Fellowship of the DRHMNZ (FDRHMNZ).
Am I able to apply to work as a recognised specialist in New Zealand?
To apply for vocational registration in rural hospital medicine, you would need to hold:
- the FDRHMNZ qualification; or
- an international postgraduate medical qualification in rural hospital medicine, where your combination of qualifications, training and experience is assessed against the standard of the FDRHMNZ.
What standard will I be compared against?
To obtain the FDRHMNZ, the trainee completes 6 years of training:
- 2 years of general medical experience, which must include experience in at least six of the following:
- cardiology, dermatology, ENT, emergency medicine, general medicine, general practice, geriatrics, musculoskeletal, obstetrics and gynaecology, orthopaedics, paediatrics, palliative care, psychiatry, rehabilitation, respiratory medicine, rheumatology, rural hospital, rural general practice
- 4 years of advanced medical training, during which time 5 ‘domains’ are covered:
- the rural hospital context, including cultural competency and Maori health
- communication
- clinical experience, covering basic clinical skills, adult internal medicine, emergency medicine, aged care, child and adolescent, surgery, musculoskeletal (including orthopaedics), radiology, anaesthetics, obstetrics and women’s health, palliative medicine, rehabilitation, ophthalmology, dermatology, psychiatry and mental health, oral health, population health
- professionalism and ethical practice
- scholarship, including research and evidence based practice
- completion of the Early Management of Severe Trauma (EMST), Advanced Paediatric Life Support (APLS) and Advanced Cardiac Life Support (ACLS) courses required by the end of advanced medical training
- FDRHM awarded on satisfactory completion of examination and training requirements
- participation required in the DRHM continuing professional development programme
Note: completion of papers from the Postgraduate Diploma in Rural and Provincial Hospital Medicine (University of Otago) and the Postgraduate Diploma in Community Emergency Medicine (University of Auckland) form important parts of the training programme. Trainees may apply to have their prior learning recognised in order to shorten their training programme.
I want to make a vocational registration application
If you wish to make a vocational registration application, please refer to the Vocational Registration Homepage and select the Option appropriate for you.
Am I able to apply for other types of registration?
You may be able to apply for more than one type of registration. To find out which is the best fit for you, please use our self assessment tool