HOSPITAL STAFFS

Dominion, Volume 25, Issue 272, 12 August 1932, Page 12

HOSPITAL STAFFS

Shortage of House Surgeons PROBLEM FOR BOARDS A New Scheme Adopted a success Faced with a shortage of house surgeons, hospital boards in the main centres, it is stated, are experiencing great difficulty in securing as complete staffs as desirable. In Wellington the position lias been met by employing students in their sixth year as resident dressers, with a view to their engagement next year as surgeons. It is hoped that under this policy an ample supply of able and experienced men will be guaranteed for the future. Dr R. Campbell Begg, chairman of the house committee of the Wellington Hospital Board, when interviewed yesterday, said that the shortage of house surgeons was due to various causes, some of them dependent on the situation of the country and some on the lack of co-ordination of the legitimate requirements of various grades of hospitals. Doctors, he said, who qualified in England, were as a rule prepared to spend two or more years on the resident staff of hospitals, as this was really necessary to complete their training and the experience was valuabe m their future career. Experience Abroad. The New Zealand graduate, on the other hand, was rightly anxious to get' away to Great Britain as soon as possible in order to get house surgeon’s work there as the experience was undoubtedly of more value to him than any he could obtain in a young country such as this. The consequence was that he was, as a rule, only prepared to stay one year as resident in. New Zealand, and as the number of graduates each year was governed largely by the demand for medical practitioners in the country, there were not enough men to meet the demands of the hospitals. If the men were prepared to stay two vears as house surgeons, that, of course, would double the supply. In addition to this factor, Dr. Begg -aid, the numerous hospitals under individual control all competing for the small available supply of resident medical men, created an undesirable position. The smaller hospitals, where the experience was not so good, had to offer larger and larger salaries to tempt young graduates to take up the positions, and so induce them to sacrifice the essential experience to be gained in the large hospitals for the immediate financial gain. A Maximum Scale? This position was not conducive to the creation of a body of thoroughly equipped medical practitioners, and should be met by a definite allotment or quota of graduates to the different hospitals as well as the fixing of a maximum scale of remuneration to be offered. The amalgamation of the existing hospital districts so as to form a fixed number, each centred on a large base hospital, would help to solve the question. There would never be more graduates than the demand for general practitioners and if the proportion of public hospital beds was too great for the population there would always be a shortage of young medical personnel, Dr. Begg said. In Wellington the difficulty had been overcome by employing students in their sixth year as resident dressers. As the period required for graduation was until recently five years, these men were just as experienced as the graduates under the old system. They were doing excellent work and had now the value of the clinical assistants which was a new feature of the medical organisation. The latter were men who had had considerable experience overseas, had taken their senior qualifications, and had recently started /practice in Wellington. They stood under the position of senior assistant and formed the third member of each surgical, medical, and special team. Scheme Proved Its, Value. “This innovation,” continued Dr. Begg, “has proved its value. Next year we shall be able to employ as house surgeons those who are at present acting as dressers. . They will then be fully qualified and, glad to continue the very valuable experience which the hospital •is able to give them. By this policy of employing promising students as dressers and later as house surgeons and finally as surgeons, physicians and specialists, we shall have a guarantee for the future that there will be an ample supply of very able and experienced men always available to fill the higher posts as they fall vacant. “That the standard we set for full surgeons and physicians is very high is undoubtedly the right policy,” he added. “No one can pe a senior surgeon or physician until eight years after qualification or fourteen. years after he has commenced the study of medicine, and then only if he has taken one of the senior surgical or medical qualifications and thereafter served as assistant to a senior in a large hospital for five years. This should set a standard of medical service for the hospital which might well be taken as being up to the very highest hospital standard anywhere.” Medical Work Questioned regarding the operations of -the Medical Committee of the Wellington Hospital, which had been set up as part of the new organisation, Dr. Begg said that the committee had been working very hard in organising the new medical departments into which the work of the hospital had been divided. The heads of these, departments had put in a great deal of time in perfecting the organisation of their own departments and in securing the smooth working of the departments with each other so that all possible knowledge and equipment was brought to bear in the interests of each patient. Dr. Begg said that as in every period of transition difficulties had cropped up, but these were being overcome, and he hoped very soon the machine would be working perfectly to the great benefit of the hospital and patients. One of the duties of (lie Medical Committee was to organise meetings of the whole staff. These -raff meetings really represented the parliament to administer the actual clinical work of the hospital. The staff itself had agreed by vote that it was just aS important for every member of the medical staff to attend these meetings as it was for members of the board to attend the meetings of the hoard. It was just as necessary a duty for the surgeons, physicians, and specialists as attending any other parr of the clinical work.