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Whilst our recent focus has been somewhat consumed by MECA and the GPEP SECA in recent times, we have continued to work with the medical pipeline group including meeting with RMOs around the country.

The key issues raised by members at the meetings have been:

- The need for more information to be provided on where future opportunities lie and what RMOs need to make a career decision. This has ranged from simple demographic data such as, on average how old SMOs in a specialty are (and therefore the need for more shortly as they retire or not for a while if they are mostly young), to appropriate and immediately available career advice.
- RMOs (and notably SMOs) lack sufficient information relating to job prospects, and what and where current job opportunities lie.
- Many first and second year house officers are (as RMOs knew but those outside our networks didn’t)undecided as to what specialty they wish to pursue.
- RMOs are reluctant to complete runs outside Auckland because of a concern they may not get back to Auckland to complete the training necessary for their preferred specialty.
- General Practice is not considered an attractive option because:
o GPs are perceived as working long hours;
o the requirements of owning a small business are considered undesirable;
o salaries in particular, and terms and conditions in general, are considered less desirable than is the case when employed by DHBs;
o the runs considered necessary in advance of entry to general practice training are often not readily available (e.g. paediatrics), with priority given to those engaged in specialist training;
o there is a paucity of good GP role models in the DHB context.
On the first issue, Pipeline is now working to get information together to distribute to us…watch this space for that. We hope to reduce the information to a concise and easily digestible form however to give you a taste of what we are ploughing through, below is a table that records the average age of SMOs in each of the specialties and the ratio of trainees to SMOs. Some of the specialties, whilst low in SMO to trainee ratio have a small workforce so don’t need a high production of SMOs as long as the production replaces the SMOs over time i.e. as they get older! The second factor to think about is how many more or less specialists do we think we need in the future as technologies change and the manner in which we deliver care changes. So, for instance; the reduced use of cardiothoracic surgery and increased prevalence of interventional radiology. The future need for more geneticists may also be an issue we should ponder!

From the table below, and making a best guess of future possible shifts in need, interventional radiology seems a little light on the numbers training with an average age of SMO at nearly 50, and the replacement pipeline at 0.19 trainees per SMO. ORL is also an area we don’t naturally think of as a potential shortage area but the average age of SMOs is 53 whist ratio of registrar to SMO only 0.15. The gap here may not be in the desire of RMOs to train in ORL but the availability of training positions. If limited opportunity exists in DHB land, private sector training may be a very real prospect in the future.
There are a number of other specialities that the following table suggests could do with some more workforce planning; e.g. for those keen on Paediatrics, you might want to rethink!


SMO Average  Age

Vocational Trainees /# SMO

Musculoskeletal Medicine



Medical Administration



Palliative Medicine



Occupational Medicine



Sexual Health Medicine



Rehabilitation Medicine



Paediatric Surgery



Pain Medicine



Cardiothoracic Surgery



Otolaryngology/Head & Neck Surgery



General Practice



Vascular Surgery



Family Planning and Reproductive Health









Obstetrics & Gynaecology






General Surgery



Orthopaedic Surgery



Internal Medicine



Oral & Maxillofacial Surgery



Public Health Medicine






Accident & Medical Practice/Urgent Care









Radiation Oncology



Rural Hospital Medicine



Plastics & Reconstructive Surgery



Diagnostic & Interventional Radiology



Intensive Care Medicine



Paediatrics (General Paediatric)






Sports Medicine



Clinical Genetics



Emergency Medicine




It must be that time of year as we have had a rash of calls regarding TOIL (time off in lieu) days being “declined”. Therefore we have attempted to answer your questions as follows:-
When do I get a lieu day?
An employee is entitled to a lieu day if they work on a public holiday that would otherwise be a working day. You’ll get a lieu day if you work on any part of the public holiday e.g. If you start nights on Boxing Day at 10pm, you will get a lieu day even though you only worked two hours of that public holiday.
What if I’m on call on a public holiday?
If you’re on call on a public holiday , whether you get called back or not, you will get a day in lieu. The only difference is that if you are called back, you will also get time and a half for the hours worked as part of the call back.
How many hours is my lieu day worth?
Your lieu day will be for a whole working day off work, regardless of the amount of time you actually worked on the public holiday e.g. If you only worked two hours on Boxing Day, you will be entitled to a whole working day off work, whether your day in lieu is eight hours or even 16 hours.
When can I take my lieu day?
Your lieu day must be taken on a day that is agreed between you and your employer. MECA entitles you to more than the Holidays Act so don’t accept RMO managers’ “expert advice” about the Act; MECA is better and it applies. Under MECA you get to determine when you take your lieu day as long as you take into account your employer’s views as to when it is convenient. Having considered the employer’s view, if you still want to take your lieu day on the day determined by you, you can. It is this feature that distinguishes lieu days from annual leave days. You need to give your employer at least 14 days’ notice of your intention to take your lieu day.
Can I lose or forfeit my lieu days if I don’t take them?
No, you cannot. The Holidays Act says that once you become entitled to a lieu day that lieu day remains in force until you have actually taken the holiday or you have been paid out for the holiday i.e. your employer buys them back from you. Your employer cannot force you to sell your lieu days. As compared with other types of leave however a lieu day does not necessarily transfer with you when you change employers so we advise members to use them before moving DHBs. NZRDA recommends you take your lieu days, preferably within 6 months of them being earned, they are valuable as is your ability to rest.
Can my employer force me to take a lieu day?
In some cases, yes. Your employer may require you to take a lieu day on a date determined by your employer only if 12 months have passed since your entitlement to the lieu day arose. But even then, your employer can only determine the date if you and your employer have been unable to agree on a date to take your lieu day. Your employer must give you 14 days’ notice of the date on which it requires you to take the lieu day. This is why we encourage our members to use their lieu days before they use annual leave and to use them within 6 months.
How is my lieu day paid?
Your pay will not be affected when you take a lieu day.

Looking for a change

We have been contacted by members wanting help in putting their resumes together. As this is not our area of expertise we contacted Kiwistat. They recommended the following website that covers how to write a CV in general terms http://www.successfulresumes.co.nz/ (there is a lot of free stuff on that website). NZRDA is currently investigating providing more assistance to members in this regard. If you think this is a good idea, let us know.

What happens in Vegas…

Well, RotoVegas, and in this case what happens does get published to the rest of our members.
40 delegates from around the nation converged in the sulphur capital for RDA training. Day 1 started with an introduction to the “who’s who” in health and quickly grew into a competition of who could name the most acronyms. The bargaining team then gave us an update on the latest saga of MECA negotiations. We finished up at Agroventures where the team schweebed, swooped and bungeed the night away.
Des Gorman’s Pipeline was the focus of day two; we learnt all about plans afoot and came up with a few ideas of our own about how it might work: it is our future afterall. We also took part in a group activity involving designing the perfect new house officer run and then running it past the “DHB”, a tough crowd. After going over a few basics around exactly who is the NZRDA and what does a delegate do, the day finished up with some competitive luging and dinner overlooking the city skyline.
Our AGM farewelled our current president, vice-president and secretary and welcomed in new faces to our national executive. We heard from Curtis Walker on the changes over his five years as president and the hopes he has for RMOs in the future. The day finished with a dinner & prizegiving at the Regent hotel.
The final day was a practical session on interpreting the MECA (“I must not cross cover outside of ordinary hours”) and a guide on how to troubleshoot problems with colleagues & management. There were some fond farewells as we all returned to our various DHBs to implement our latest knowledge.
See you all next year!

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