Cutting Edge
Issue No 59. | June 2016
New Zealand National Board
FROM THE CHAIR
Stress and Behaviour …
and Pastoral Care
T
here has been a tremendous amount of activity within the College in
respect of Discrimination, Bullying and Sexual Harassment (DBSH)
including the launch of a campaign to bring the action plan together “Let’s Operate with Respect”. Clearly, if we apply the principle of giving
respect to those with whom we work - and on whom we so regularly rely then offending in DBSH would surely diminish. If not disintegrate entirely.
We cannot eliminate stress from our clinical and surgical activity, and there
will be times when we shift into that zone where we are decompensating
to a degree, as a result of stress. In that event we may find ourselves – or
others - behaving badly. This should be interpreted for what it is – stressful
behaviour – and it is important to learn how to recognise it and what to
do about it. To this end, there are several options available (such as the
‘Process Communication Model’) that
provide us with the tools required. I can
heartily endorse participation in this
sort of program as an insightful and
valuable experience.
Contents
1 From the Chair
3 EDSA Corner
5
Wyn Beasley writes
6 Trainees Assoc Update
7 Younger Fellows Report
8 Surgery 2016
12 Activities of the NZ
National Board
13 Obituaries Certainly, it is useful to recognise
when one – or someone - is slipping
into stressful behaviour, and to know
how to find a way to resolve it. The
stress persists, of course, but one can
manage it in a more functional manner,
which can help others enjoined in the
stress to cope better also.
So if you haven’t attended a RACS
Professional Development Seminar,
(see the RACS Website – Professional
Development), I would encourage you
to do so … it is never too late to learn!
While stress-induced bad behaviour
may be misinterpreted as bullying,
there is another type of behaviour
which is often not recognised:
unobtrusive, or ‘silent’, bullying.
The Silent Bully
Silent treatment, untoward criticism, or
underhandedness are hallmarks of passiveaggressive behaviour, where a person seems
to act appropriately on the surface, but has a
negative or obstructive attitude behind that
façade. This is not just unprofessional behavior
but is also bullying, as it makes the object of
such behavior feel embarrassed, insecure or
awkward. This is probably most commonly
manifest by some form of discriminatory remark
about a person’s appearance, race, beliefs or
sexual orientation, but can be as subtle as being
ignored (“overlooked’), or merely not responding
to emails!
Almost everybody occasionally engages
in mild passive-aggressive behaviour but
pathological passive-aggressive people tend
to use this approach as a modus operandi
when interacting with others. It springs from
pain generated in childhood, according to
Preston Ni (a communications professor and
the author of “How to Successfully Handle
Passive-Aggressive People”). Ni asserts that if a
person’s feelings of humanity are suppressed
long-term, anger eventually manifests itself
in an unconstructive way such that the silent
treatment, or limited communication, becomes
the coping mechanism.
At its core, passive-aggressive behaviour is
rooted in feeling powerless. The innate sense of
powerlessness can make some people overcorrect and turn to “hostage-taking”. They use
their clout or key position in an organisation to
push their will, according to John Townsend, a
FROM THE CHAIR (continued)
clinical psychologist and author of “Boundaries: When to
Say Yes, How to Say No to Take Control of Your Life”.
We probably all know someone in our organisation that
is highly critical and judgmental but also highly valued.
Being positive, and using soft skills such as humour and
small talk, can be an effective countermeasure to passiveaggressiveness. At the same time one should find a way to
express one’s concerns, backed up with facts rather than
judgment. In my experience this is all easier said than done.
A simpler solution is to avoid confrontation and just let it go.
While that may be a short-term answer, it does nothing to
resolve or correct the bad behavior over time.
The RACS complaints process is available to Fellows,
Trainees and International Medical Graduates (IMGs) to
report unacceptable behaviour in breach of the Code
of Conduct and seek resolution that way. RACS has
centeralised receipt of all complaints and hired a Manager
of Complaints Resolution. Those wishing to make a
notification or complaint can call 0800 787 470 (New
Zealand) or email [email protected].
Additionally all Fellows, Trainees and IMGs should have
by now received a card with information about the RACS
Support Program including contact numbers for New
Zealand (0800 666 367) and Australia (1300 687 327). A list
of likely situations that may be addressed is provided. Some
of the less overt issues include:
• interpersonal conflict & tension;
• work-related stress & overload;
• harassment & grievances; and
• vicarious trauma.
I can imagine that some people may feel awkward speaking
to a counsellor about the more subtle activity of passive
aggressiveness, which can be difficult to pin-point. Being
ignored or persistently criticised has the effect of making
one feel unimportant or inadequate, with the net result
of effectively being disempowered, and feeling unable to
report it, especially to a ‘stranger’.
Pastoral Care
In Counties-Manukau DHB the department of General
Surgery has developed a protocol for Pastoral Care where
individuals have been identified as “go-to” people for the
kind of concerns that I have described above. This ‘Pastoral
Care’ approach is a very powerful mechanism, especially for
addressing the more subtle behavioural issues associated
with passive-aggressive behaviour. To quote from the
General Surgery Pastoral Care document:
The Department of General Surgery at CMH will actively
promote and foster relationships which are positive,
trusting and respectful and which will engender a sense of
belonging and inclusion.
We are committed to providing a safe work environment
which encourages continual improvement and learning
from errors through reflective practice and constructive
feedback. Senior staff will actively lead this process.
The Pastoral Care guidelines are widely displayed
throughout the department with contact details for a
variety of support people and the Group reports regularly
to the General Surgery Business Meeting. This program has
been presented to Fellows at the recent ASC in Brisbane.
The General Surgery initiative at CMH has already been
picked up by other Services and Departments, such as
Women’s Health and Emergency Care, and the media has
reported similar activity from Nelson-Marlborough DHB
and I understand that RACS is discussing the possibility of
having MOUs between other DHBs at present.
Such local protocols seem to me to be a splendid and
effective way to respond ‘on the ground’ to the issues
identified in the RACS Action Plan. Certainly I believe that
the College will want to be seen to be supportive of such
initiatives. I can even see a time when Pastoral Care Groups
are effectively universal among surgical departments, and
used as a ‘model’ approach for other Departments
to consider.
Randall Morton
Access to Counselling Services
Fellows, Trainees and IMGs have access to confidential counselling for any personal or workrelated issues through Converge International. Provision of services cover New Zealand and
Australia and can be in person, on the phone or via Skype. RACS will cover the costs of up to
four sessions per calendar year
to this arms-length service.
Contact Converge via phone:
1300 687 327 in Australia or
0800 666 367 in New Zealand
or via email
2
Cutting Edge | Issue No 59. June 2016
EDSA CORNER
The Medical Council of New Zealand:
Sanctions and Disclosures
Consequences of a current
HDC investigation
W
hen the Health and Disciplinary Commission (HDC)
receives a complaint about a doctor the Medical
Council of New Zealand (MCNZ) may be informed of the
complaint. The Medical Council may impose sanctions on
the doctor that may affect the capacity of the doctor to
be appointed as a supervisor and has implications for the
issue (or non issue) of a Certificate of Good Standing1.
We are all aware that HDC investigations can, on occasion,
take significant time to resolve. The Medical Council does
what it can to expedite matters, not just to ensure that the
Medical Council can make timely decisions about whether it
needs to take action itself, but because it realises the impact
on the doctor under investigation. However, the reality is that
in many cases, the Medical Council is not able to anticipate
what that investigation will reveal, let alone what the HDC’s
final decision will be. Medical Council’s approach during
the currency of an HDC investigation must, therefore, be
conservative i.e. it may impose sanctions on the doctor until
the case is determined.
With regard to the doctor’s ability to be appointed as
a supervisor the relevant policy here is the Policy on
Appointment of Council Agents2. This policy is an older
policy, which also applies to supervisors (who are deemed
Council ‘agents’). As an older policy, it reflects a long
standing policy on the appointment of doctors in the
roles of examiners, members of competence review
or professional conduct committees, supervisors or
mentors. The key principle is that if a doctor has a current
complaint or concern being investigated the appointment
will not be made until the outcome is known. The doctor
may be appointed if the Medical Council is satisfied that
the outcome of the investigation does not impact on the
doctor’s suitability to be appointed as a Council agent but
it is seldom Council will have absolute assurance of that.
It is appreciated that the individual affected doctor might
have a sense that some adverse view has been formed,
or a judgement has been made; however, we have been
advised that is not the case. It’s also worth noting that this
‘limitation’ on Council roles is not a condition per se. It does
not appear on the public Register and the Council does
not actively inform others that the ‘limitation’ is in place.
If the doctor is already appointed as a Council agent the
Council will decide whether the role will continue or not
depending on the nature of the complaint and whether this
is likely to impact on the relationship. The Council does not,
except in exceptional cases, end any existing supervisory
relationship. If nothing else, the Council is aware of the
potentially adverse impact on the supervisee not just
because the supervisee would not be
able to continue to practice until a new
supervisor was appointed but the removal
would interrupt the supervision plan and the educative
supportive objectives of that plan at a potentially crucial
time for the supervisee.
The issue of Certificates of Good Standing (CGS) may also
be impacted3. Internationally, a CGS (or similar) is considered
a key aid to decisions by medical regulators faced with an
application from a doctor who has previously practiced
overseas. It provides a level of comfort that there are no
questions over the applicant’s practise of which the recipient
regulator need be aware.
It is the view of the MCNZ that given the weight placed on
a CGS, it is not unreasonable for one regulator to decline
to provide a CGS to another unless it is clear that there is
nothing that the second regulator need be aware of. It is a
form of due diligence directed to patient safety. It’s relevant
to note that the Medical Council does not go into detail about
the matter, but instead simply puts the overseas regulator
on notice. Where a CGS is declined, a Letter of Standing
is provided instead and the doctor is informed why the
CGS is not issued. The doctor is then able to explain direct
to the overseas regulator the matter that is playing out in
New Zealand. Alternatively (and frequently) the doctor will
give permission to the Medical Council to speak direct to
the overseas regulator. In addition medical regulators (the
Medical Council being no exception) will generally seek a
range of declarations and information from any applicant.
The circumstances in New Zealand that might lead the
Medical Council to decline to provide a CGS are very likely
matters that the overseas regulator would expect the
applicant to disclose anyway.
Disclosures on an application for
a practising certificate
Fellows have asked what level of disciplinary finding requires
disclosure on an application for an Annual Practicing
Certificate (APC). Doctors are asked to inform MCNZ if, since
they were last issued with an APC, they have been subject to:
I. A formal competence inquiry or a restriction or
withdrawal of credentials based on performance or
conduct, undertaken by an employer, complaints,
licensing, or professional body (other than by the
Medical Council of New Zealand and excluding any
College requirements for recertification
or reaccreditation).
2. An adverse finding in any discipline action by an
employer, complaints body, licensing body, or
Cutting Edge | Issue No 59. June 2016
3
EDSA CORNER continued
professional body other than by the Medical Council
of New Zealand or Health Practitioners Disciplinary
Tribunal.
If there were any doubt in the doctor’s mind whether
the Council would consider the situation fell within these
disclosure obligations the doctor should disclose that.
Then, having done so once, there is no need to repeat that
disclosure again. Ultimately, it’s a question of degree, but
MCNZ suggests it is better to err on the side of caution.
CPD and MCNZ Annual
Practicing Certificate
When completing an application for an annual practicing
certificate it is necessary for the applicant to inform the
MCNZ that they are compliant with a recognised CPD
program. A false declaration may result in disciplinary
proceedings, as was the case recently of a medical
practitioner found guilty by a Health Practitioners Disciplinary
Tribunal (HPDT) resulting in a substantial fine4. The fact that
a doctor was participating in a programme did not translate
to compliance. The HPDT ordered the practitioner to pay
$9000 towards the costs of prosecution after finding her
guilty of professional misconduct through actions likely to
bring discredit to the medical profession. The charge arose
out of the practitioner making five false declarations to the
Medical Council of New Zealand about compliance with her
CPD requirements. In imposing the costs award (though
no other penalty), the HPDT said it was sending a message
that health practitioners must comply with CPD and other
regulatory requirements for maintenance of standards
punctiliously and regularly, with authorities able to rely on
the accuracy of any statements by the practitioner on their
annual practicing certificate application. The now-retired
practitioner’s name was suppressed.
R Lander FRACS
Executive Director for Surgical Affairs (NZ)
1. Personal Communication: David Dunbar, Registrar to the
Medical Council of New Zealand 2016
2.Medical Council of New Zealand: Policy on Appointment of
Council agents (eDOCS 44516)
3. Medical Council of New Zealand: Policy on providing a
certificate of good standing (eDOCS 44620)
4.http://hpdt.org.nz/portals/0/med14298pdecisionweb.pdf
New Zealand Prostate Registry Launches
F
riday 17 June marked the official launch of the New
Zealand Prostate Registry. Stephen Mark, Chair of
Urological Society of Australia and New Zealand (USANZ) –
New Zealand Section, who, with others, has been involved
in setting up the New Zealand Prostate Registry says “this
initiative is an exciting collaborative project which will
deliver improved patient care”.
Thanks to funding from the Movember Foundation, and with
support from the USANZ, RACS and the Ministry of Health’s
Prostate Cancer taskforce, the initiative aims to improve
the quality of care that men with localised prostate cancer
receive across New Zealand.
With an initial project manager based in Canterbury, the
New Zealand Prostate Registry plans to be expanded to
every patient, public and private, within two years, with local,
funded, administrators entering demographic diagnostic
and treatment data into the Prostate Cancer Outcomes
Registry - Australia and New Zealand (PCOR-ANZ) within
Monash University.
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Cutting Edge | Issue No 59. June 2016
The PCOR-ANZ aims are to:
• Monitor, benchmark and report annually on the
outcomes of prostate cancer treatment and care.
• Provide risk adjusted, evidence based data to clinicians,
hospitals and decision makers on prostate cancer
clinical practice that fosters and evaluates improved
quality of treatment and care for men diagnosed with
prostate cancer.
• Foster research leading to improvement in care and
survival; ideally enabling comparisons across countries.
De-identified data will be reported back to clinicians and will
include benchmarking from New Zealand and Australia.
The data within the PCOR-ANZ will be used for research
purposes, subject to privacy laws and data access policies.
The Movember Foundation is the largest funder of
Men’s health initiatives worldwide. Visit them at https://
nz.movember.com/ to see how you can be involved with
Movember 2016.
WYN BEASLEY WRITES ...
T
ON MOVING HOUSE
he College’s new headquarters building was
commissioned, with suitably generous exhibition of
consumables, at the beginning of March. Given that the
building over which we now have naming rights was a pub
in a previous incarnation, such an exhibition was both
appropriate and (on a warm sunny evening) welcome.
We now live on the edge of the celebrated Courtenay Place
quarter of Wellington; we are just across the road from the
Embassy theatre, where the Peter Jackson blockbuster films
(particularly the Tolkien series) were launched; and we get
a massive dose of sunlight which will be valuable as winter
draws on. In the best New Zealand tradition, the building is
painted black, and it bears the name of the College in large
white lettering.
About three blocks to the south, Elliott House sits awaiting
its new occupants. The intended scheme involves, it is
understood, its conversion to four apartments (there is
a row of four new letterboxes just inside the gate, and the
bronze rendering of the College arms, high on the north wall,
has gone) but rumour has it that planning permission has
been slow to emerge from the labyrinth of the Wellington
City Council. The only developments that occur rapidly in
Wellington seem to be those that will affront citizens with an
interest in preserving green open spaces round the centre of
the city.
It is possible, looking back, to identify three phases in the
evolution of the College’s New Zealand headquarters: the
first was the ITINERANT phase. Before, and in the period
shortly after the Second War, meetings of the Dominion,
(later New Zealand) committee were held mostly in
Wellington, and the ‘office’ consisted of the Secretary’s spare
suitcase. On occasions when a committee meeting was
held at the time and venue of a clinical meeting, the office
suitcase travelled with the Secretary.
In the early l960s the mobile office was discarded in favour
of a room in one, and shortly the other, of the two blocks of
medical chambers on The Terrace; in the second of these
the surgeons and physicians cohabited peacefully for a time,
but surgical ambition ran to ‘a home of our own’ and, in 1968,
Benny Rank visited Wellington during his presidency and cast
an eye over a building in Boulcott Street – a heritage building,
indeed, which had come on to the market. On inspection the
place looked a bit daunting, and its asking price was equally
daunting. So we retreated to the room on The Terrace.
But then came the HOSPITAL phase. Nursing was no
longer a monastic profession, and the old nurses’ home
in the grounds of Wellington Hospital had vacant space,
which was available at ‘mates rates’ while its ultimate fate
was being considered. Both the College and the Faculty of
Anaesthetists – which was rapidly expanding in this period
– found it handy of access. We must have been acceptable
tenants, because the hospital authorities paused while they
were planning the Clinical Services Block (known as B block),
long enough to contemplate
enclosing the area round the
lift towers, to create a walk-up top
floor, and this was made available to
the Colleges. The Surgeons and Physicians linked
up once more, and the O & G College became a nominal third
partner in a suite of rooms that were, to a degree, outfitted to
meet our joint needs.
A meeting of the New Zealand committee in the
‘penthouse’ of the Clinical Services Block
The arrangement worked well, apart from one occasion. In
1982 the GSM [nowadays the ASC] was held in February in
Christchurch, and the normal February Council was tacked
on the end of it – in Wellington, at the new headquarters. The
committee room on the top floor was not big enough for the
entire Council (though that was only about half the size of the
present Council) so we laid out the ‘new’ Council table and
associated chairs in an open space outside the dedicated
area and gave councillors the necessary elbow room. Two
things went wrong. Councillors had the habit of discarding
agenda papers as they were dealt with, and our waste paper
disposal was quite unequal to the demands made on it. And,
although we locked the floor up each night, we did not reckon
on the greed of nameless persons who had, or achieved,
out-of-hours access and filched half a dozen of our newly
constructed and elegantly carved chairs. We never felt quite
the same about block B after that.
Forward a decade, and we entered the third, or PUBLIC,
phase of our corporate existence. We had yearned, over
some years, for the attractive Georgian house in Kent
Terrace, but it had been beyond our reach. It had been built,
this house, as the home and consulting rooms of Dr James
[later Sir James] Elliott, on land he had procured from the
Kirk Session of Kent Terrace Presbyterian Church, of which
his father, the Rev. Dr Kennedy Elliott had been the founding
minister; and it had been designed by a promising architect
– James’s old school friend, Grey Young, complete with
modern technology such as a speaking tube at the front door
(for out of hours patients) and a ‘motor house’ at the back.
After Sir James became too frail to live there, the house
became the headquarters of the Rover car company, then
Cutting Edge | Issue No 59. June 2016
5
Wyn Beasley Writes continued
evolved through various owners to the point of a seismic refit
which ‘broke’ the developers at the time of the 1987 crash.
The College bought it in 1990, named it Elliott House
(naturally) and moved in the following year, securing the place
at somewhat less than it had been unable to afford before
the seismic refit! – and that was really our only successful
deal, because the departure of the Anaesthetists after they
became a separate college was a costly divorce, and various
amendments to the seismic code in the new millennium
called for further outlay and ended in a yellow-stickered
white elephant. During the College’s tenure the ‘New Zealand
committee’ became the ‘New Zealand National Board’ – and
no national board should occupy a white elephant with a
yellow sticker.
So the College moved into temporary accommodation on
Courtenay Place, in the eloquently named Symes de Silva
building; which suffered from ‘architectural personality
deficiency syndrome’, but was made as presentable as
possible inside. The experience of premises on the east, that
is to say airport, edge of the central city had convinced the
College of the value of tactical siting, and so the most recent
move has been a short one in distance – but in terms of time?
On past experience, there will be another move one day …
But meanwhile we have regained naming rights.
RACS Trainees Association update
K
ia Ora. I hope you are well. It’s been an eventful three
months for me! Other than welcoming our beautiful
daughter three months ago, I sat the Part II fellowship exit
exam for orthopaedics and am pleased to report that I
passed. I would like to extend my Congratulations to all
trainees who got past the mark. What an achievement!
For me this has been a culmination of a 15-year journey
that started at medical school. For others it may have been
longer. On reflecting on that journey there has been a lot of
good times but also some challenges. I would like to thank
my family for all the support over the lead up to the exams.
Although I strived to achieve some balance, I cannot
help but admit that my wife experienced the “Exam
Queen’s
Birthday
Honours
Widow” syndrome too. I would like
to especially thank all those who
have stood by all candidates sitting
their exams. A huge effort goes
into preparing candidates by local
faculty and my thanks go out to all
who gave their time freely to do so.
For those who have not passed,
my sympathies go out to you. A
true measure of fortitude is the response to the challenges
we face. At this time, I pray that you find the courage and
strength to get back up and get back into training. As my wife
says, sitting exams is a “team sport”. The whole team will
need to regroup, refresh and restock. I wish you peace to put
that failure behind you and confidence as you approach your
next sitting.
From a wider RACSTA perspective, there have not been many
new issues. As you may know, there was an HDC response
last year to an Ophthalmology fellow’s complication which led
to a change in the consent process at a DHB. Most trainees I
have spoken to are concerned by this report and its possible
implications on training. To date, this does not appear to have
had an impact on training, but it remains a significant issue
and I will be chasing it up through the National Board and will
update the wider group in due course.
Associate Professor Patrick Alley
- for services to health
Flexibility in training is something that the RACSTA board
is currently exploring based on feedback from the end of
run training assessments. I have heard from a trainee who
experienced difficulties with the application for interruption
of training process. This is an especially important topic as
it is core to the issue of flexible training. This issue will be
discussed further at the upcoming RACSTA board meeting in
June. In the interim, if you have feedback on your experience
regarding interruption of training, and/or know of people who
have struggled with it, I would be grateful if you would share
those experiences with me.
Dr Nadarajah Manoharan
- for services to health
As always my kindest regards. I pray you have a safe
three months.
- Congratulations
Officer of the New Zealand Order of Merit (ONZM)
Emeritus Professor Bryan Parry
- for services to colorectal surgery
Members of the New Zealand Order of Merit (MNZM)
Mr Garnet Tregonning
- for services to orthopaedics
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Cutting Edge | Issue No 59. June 2016
Ramez Ailabouni
RACSTA NZNB rep
[email protected]
Younger Fellows Report
K
ia ora tatou. On the back of the successful Preparation
for Practice workshop last year we are in the process
of organising the workshop for 2016. The proposed date
is Wednesday 24 August and the likely venue is Wellington
at the RACS offices. We would like the programme to be
as dynamic as possible and to reflect what it is that you
as Younger Fellows or final year trainees want to know
about setting up in practice. Therefore we are asking
for suggestions for topics that you would like to see
Cathy Ferguson finishes
role as NZ Censor
The New Zealand National Board would like to thank Cathy
Ferguson for her outstanding work as the New Zealand
Censor for the past eight years. Cathy, who took up the
role in November 2008, has interviewed 137 applicants for
vocational registration over that period. She chaired her last
vocational registration interview in April (pictured). We wish
Cathy all the best for her new appointment as Chair of the
Professional Development and Standards Board.
addressed. Furthermore if you
are interested in attending please
let Justine Peterson know at
[email protected] .
The College has also recently
released its updated resources on
mentoring. If you are interested in
this topic, hunting for a mentor or willing to be a mentor for
a trainee we encourage you to visit the College website for
some helpful information.
At the ASC in May our College launched Surgical Career
Transitions: A guide to opportunities and challenges. This
guide highlights the key issues that are pertinent to the
various stages throughout the career of a surgeon. The
framework starts from when a surgeon enters practice as
a Younger Fellow, through to the midcareer stage and then
into the Senior Surgeon or final ten years of practice. Each
phase is explored by the four career themes of Surgical
Practice, Life-long Learning, Professional Standards and
Personal and Professional Integration. Each theme is linked to
the RACS core competencies, surgical roles, resources and
educational opportunities available to support surgeons as
they experience these issues throughout their careers.
As part of efforts to improve communication of Younger
Fellow issues we are seeking representatives of the
various craft groups. The idea is to have Younger Fellows
communicate important issues for the various specialties so
that these can be communicated to the various committees
of RACS on which we have representation. If you are
interested in helping me with this then please contact me on
the email below.
As always I am grateful for your feedback on any issues
related to younger fellows so that I can represent these within
our College. Please feel free to contact. Nga mihi nui,
Andrew MacCormick
[email protected]
L-R: Allan Keast, Simon Bann, Celia Stanyon, Cathy
Ferguson, Justine Peterson, Craig MacKinnon,
Rebecca Garland.
Website:
http://www.surgeons.org/member-services/interest-groupssections/younger-fellows/
Cutting Edge | Issue No 59. June 2016
7
SURGERY 2016
Thursday 4 and Friday 5 August 2016
Millennium Hotel, Queenstown
Getting The Measure Of Outcomes
The information age has ushered in an era of immense data collection. As systems have become
increasingly interconnected, our ability to measure and analyse has improved dramatically. Whether
it is an individual monitoring their own health via a FitBit, or a nationwide audit of surgical outcomes,
the increased availability of data presents new opportunities to measure success – or identify where
improvements can be made.
Information provides us with the power to improve, the power to influence, and the power to mislead.
As public demand for surgical outcome data increases, how do we ensure that this information is
used to drive improvement, rather than to confuse and misinform? This issue and much more will
be explored at Surgery 2016: Getting the Measure of Outcomes. Register and book your travel and
accommodation today to avoid disappointment.
Dr Maxine Ronald – Ethnic Outcome Disparities in New Zealand
A practising general surgeon based in Whangarei, Dr Maxine Ronald (Ngapuhi) is also the Deputy Chair
of the RACS Indigenous Health Committee and a founding member of the RACS Māori Health Steering
Group. Maxine is passionate about equity, Māori health, and reducing ethnic outcome disparities
that currently exist in New Zealand. When compared to other ethnic groups in New Zealand, Māori
have a greater incidence and mortality rate for disease such as diabetes, cardiovascular diseases
and cancers, and a considerably shorter life expectancy. The full extent of disparity in regards to the
surgical health of Māori is not currently known – as part of the Māori Health Steering Group, Maxine
is committed to measuring these outcomes to better inform how equity can be achieved.
Join Maxine Ronald at Surgery 2016 alongside an exciting inter-disciplinary
line-up of speakers including:
Suzanne Beuker, a Nelson urologist recently returned from the UK who will be asking what
NZ can learn from the NHS experience of faster cancer waiting times.
Khalid Mohammed, an orthopaedic surgeon and the Assistant Supervisor of the NZ Joint
Registry, will be exploring the wide reaching effects of a the registry.
Andrew Connolly, a general surgeon and the Chair of the Medical Council of New Zealand,
will be speaking on the essential role of clinical leadership in service redesign.
Leona Wilson, an anaesthetist and the Chair of the Perioperative Mortality Review
Committee, will be presenting on the use of perioperative mortality data to improve
surgical outcomes.
View the full line-up of speakers in the provisional programme and register
online on the New Zealand page of the College website.
Follow and participate in Surgery 2016 on Twitter with the hashtag
#racsnzasm
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Cutting Edge | Issue No 59. June 2016
Whose Outcomes?
Surgery 2016: Getting the Measure of Outcomes – 4-5 August 2016, Queenstown
O
utcome data can be a powerful tool for measuring
success, identifying weakness, and driving
improvement. Should such information be accessible only
to the medical profession, or do the public have a right to
access this data as well? Join this discussion at Surgery
2016 as an expert cast of presenters delve into this topic
during a session titled “Whose Outcomes?”:
Peter Griffin, an award winning technology reporter,
columnist and blogger, will be presenting on the
importance of medical experts speaking up in the
interests of public health.
Alan Merry, anaesthetist and Chair of the Health
Quality and Safety Commission, and John Edwards,
New Zealand’s Privacy Commissioner and specialist
information lawyer, will be exploring whether surgical
outcome data should be made available to the public.
David Grayson, an Otolaryngology Head and Neck
Surgeon at Waitemata DHB, will be discussing the role
that surgeons can play as leaders for improvement.
Don’t miss out; book early to secure RACS’ great group room
deal for the Millennium Hotel in Queenstown.
Pre NZ ASM Workshops
FOUNDATION SKILLS FOR
SURGICAL EDUCATORS
Wednesday 3 August 9am – 4.30pm
Copthorne Hotel, Queenstown (across the road from
the ASM venue - Millennium Hotel)
The Foundations Skills for Surgical Educators is an
introductory course to expand knowledge and skills in
surgical teaching and education. The aim of the course is
to establish the basic standards expected of our surgical
educators within the College. The course will further
knowledge in teaching and learning concepts and look at
how these can be applied into the participants own teaching
context.
This free one day course is targeted at senior Trainees, IMGs
and new and existing surgical supervisors who teach. The
Foundation Skills for Surgical Educators course is the first
educational response to the RACS Building Respect and
Improving Patient Safety Action Plan and is a mandatory
requirement for all surgeons involved in teaching.
For more information refer to the College website.
SURGICAL PIONEERS
Wednesday 3 August 1pm – 6.30pm
Copthorne Hotel, Queenstown (across the road from
the ASM venue - Millennium Hotel)
The First World War, one of the deadliest conflicts in
history, paved the way for major technological, political
and economic change. One hundred years later, the 6th
presentation on New Zealand Surgical Pioneers covers the
profound effect this conflict had on the development of
Orthopaedic and Plastic surgery.
Other presentations cover Gordon Bell one of the founding
Fellows of the College of Surgeons of Australasia and
Auckland Pioneers of Surgery Arthur Guyon Purchase and
Thomas Copeland Savage.
Join an experienced faculty of speakers for three informative
and interesting sessions exploring the people and events that
shaped the future of surgery.
Friends and partners are most welcome to attend both
Surgical Pioneers and the informal dinner held in the evening.
To register visit the College website.
Cutting Edge | Issue No 59. June 2016
9
SUCCESS IN THE FELLOWSHIP EXAMINATIONS
Congratulations to New Zealand based Trainees who were successful in the May exams in
Auckland and Brisbane.
General Surgery
Neurosurgery
Savitha Bhagvan
Wai Keat Chang
Nicola Davis
Sean Liddle
Ian Lord
Benedict Mackay
Thomas Morgan
Avinash Sharma
Nicholas Smith
Sanket Srinivasa
Mark Stewart
Deborah Wright
James Dimou
Orthopaedic Surgery
Ramez Ailabouni
Jarome Bentley
James Blackett David Kieser
Che Siu Lim
Thomas Maxwell
Surendra Senthi
Francis Ting
Plastic and
Reconstructive
Surgery
Andrew Davidson
Urology
Manmeet Saluja
Continued from Page 12
Māori Health Action Plan
An advisory group consisting of NZ fellows, trainees and
staff has been established to work on the actions in this
plan. Meetings are being arranged with several iwi; a potential
researcher has been identified (although funding is yet to be
located); a meeting has been held with senior staff from the
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Cutting Edge | Issue No 59. June 2016
NZ and bi-national medical colleges to gather information
and share ideas on what is happening at present; and
planning is underway for a Māori logo and name. At its recent
meeting with Vocational Education Advisory Bodies the
MCNZ reiterated its commitment to cultural competence
and, as part of that, genuine partnership with Māori to
achieve excellence in medical practice. MCNZ will be actively
promoting the Treaty of Waitangi principles of partnership,
participation and protection.
Awards Presented at the ASC
Congratulations to fellows presented with their awards, by
Professor David Watters, then RACS President:
Professor Peter Gilling – awarded the RACS Surgical
Research Award in recognition of his significant
contributions to surgical research.
Peter Gilling
Mr Chris Dawe – awarded the ERS Hughes Medal for
distinguished contributions to surgery
Professor Andrew Hill - awarded the Māori Health Medal
for his contribution to Māori health advocacy
and health outcomes
Chris Dawe
Andrew Hill
Convocation Time at the ASC
Amit Reddy with his parents CK and Reet
L-R Lord Tangi and John Windsor
L – R Michelle Locke, Bevan Jenkins, Ian Bissett
L-R Adrian Secker, Birgit Dijkstra, Murray Ogg, Philippa Mercer, Sarah
Abbott, Ros Pochin
Cutting Edge | Issue No 59. June 2016
11
ACTIVITIES OF THE NZ NATIONAL BOARD
T
he New Zealand National Board (NZNB), its
representatives and the NZ National Office are
involved in promoting high standards of surgical practice
and advocating on matters of importance to surgery
on behalf of Fellows, Trainees and IMGS in the MOPS
programme. Some of these activities since the previous
Cutting Edge are identified below:
Submissions
In the last three months the NZNB has provided written
comments on a number of discussion documents including:
• Medical Council of New Zealand’s (MCNZ) revised
statement on telehealth.
• MCNZ’s consultation on proposed changes to
registration policies.
• MCNZ’s consultation on use of testimonials
in advertising.
• Perioperative Mortality Review Committee’s
recommendations regarding consideration of nonoperative treatment for patients with ASA 5 status
and communication with patients on risk of dying
perioperatively where an “operation with significant risk”
is being contemplated.
• Sale and Supply of Alcohol (Display of Low-alcohol
Beverages and Other Remedial Matters) Amendment Bill.
Three Ministry of Health (MOH) documents are currently
under consideration (submissions all close 29 July):
• Strategic priorities for health research in NZ for the
next 10 years.
• Consultation on draft regulations for Smoke Free
Environment (Tobacco Plain Packaging) Amendment Bill.
• Consultation on initial proposals within a wider
strategy to increase deceased organ donation and
transplantation in NZ.
In addition, the MCNZ is consulting on its review of its
Statement on Providing Care to yourself and those close
to you. NZNB is reviewing this documentation also and
submissions are due 16 August.
Recent Meetings
College representatives have attended a number of meetings
with external groups including the following:
National Prioritisation Criteria Working Groups: College
representatives continue to be involved in MOH surgical
specialty working groups for the development and trialling
of agreed national Clinical Prioritisation Access Criteria for
elective surgery.
Perioperative Mortality Review Committee’s (POMRC) Annual
Forum: This was preceded by the release of POMRC’s Annual
Report for 2015/2016. The results included recognition of
increased mortality when a procedure was performed on a
Saturday or Sunday with elective having a higher rate than
emergency. Reasons for this are unknown and POMRC
will be asking hospitals to review deaths associated with
weekend surgery to gain an understanding of the causes.
Māori patients have higher mortality rates (regardless of the
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Cutting Edge | Issue No 59. June 2016
operative day) and POMRCs Māori Caucus has suggested use
of a co-morbidity tool to gather information on this.
Choosing Wisely New Zealand – Clinician’s Launch: This
programme is being coordinated by the Council of Medical
Colleges (CMC). It has input from the Colleges along with
regulatory authorities, other health professional groups and
statutory health organisations, and has strong consumer
representation. This launch was to introduce clinician groups
to the work being undertaken and to the planned community
information programme.
Omics-based Technologies Workshop: Run by the MOH, this
was one of three workshops aimed at understanding the
issues and opportunities omics-based technologies might
present for the health sector.
Promoting Surgery as a Career
RACS was represented at the NZ Medical Students
Association (NZMSA) annual conference by Richard Lander
(EDSA (NZ)) at the College stand. In addition, Fellows and
staff have assisted at careers events for RMOs in three
District Health Boards (DHBs). At all events, information on
the various specialty training programmes was discussed and
the JDocs initiative promoted.
The NZNB has committed to providing an article for each
NZMSA quarterly publication. The first article published was
titled “JDocs and Surgery as a Career”, co-authored by Jacky
Heath, Stephen Tobin and Richard Lander. The most recent is
titled “Diversity in Surgery” and covers the RACS position and
progress on increasing ethnic and gender diversity and how
this can create a vibrant workforce. This was co-authored by
Cathy Ferguson, Richard Lander, Jonathan Koea, Kelvin Kong
and Calum Barrett.
Building Respect, Improving Patient Safety
RACS has recently held discussions with two DHBs on
working together on these issues. Several DHBs have also
already initiated internal programmes. Most NZ employers
and unions are seeing this as an all of medicine (and even
all of health workforce) issue; and the challenge for RACS is
to have its priorities incorporated within these to ensure the
culture change being sought is achieved. The former Vice
President has presented on the RACS initiatives to the NZ
Private Surgical Hospitals Association’s annual conference.
The RACS initiatives have also been discussed with Executive
staff in the MCNZ.
RACS’ Complaints Manager and In-House Counsel linked in
to the recent NZNB meeting. This was an opportunity for
members to be informed of the development of the
complaints processes; and to ask questions on issues
around confidentiality and natural justice. It is vital that
Fellows and trainees understand the processes (once these
are finalised) and issues such as these if the system is to be
appropriately utilised.
Two Foundation Skills for Surgical Educators (FSSE) courses
were held recently in New Zealand, one in Auckland and
one in Wellington, with good attendances. Along with other
College boards and committees, the NZNB is actively
promoting attendance at FSSE courses.
Continued on Page 10
Obituaries
T
THOMAS WILLIAM MILLIKEN
PLASTIC & RECONSTRUCTIVE SURGEON
23 JANUARY 1925 – 18 NOVEMBER 2015
om Milliken was born in Christchurch in 1925 to
Thomas, a solicitor, and Winifred Kate. He had two
younger sisters, Dawn and Betty. Tom commenced
school at Fendalton Open Air School in 1930 and moved
to Julius House at Christ’s College in 1938. At the age of
16, and as a result of the death of his father, killed at Sid
Rezegh in North Africa in 1941, Tom largely assumed the
responsibility of looking out for his sisters. At Christ’s Tom
represented College at athletics and rugby and was both
a house and school prefect. Rugby was his passion and he
was destined to take this to a national level.
Tom attended Canterbury University in 1943
completing basic sciences papers. Gaining
entry to Otago Medical School in Dunedin
he resided at Selwyn College. He continued
to play rugby, representing Otago University
1944-46 and gaining his University Blue. He
played for the Otago provincial rugby team
1946-47 and was selected for the New
Zealand Universities XV in 1946.
and Alexander. Tom obtained his FRACS in 1961. Throughout
much of Tom’s career the Burwood Plastic Surgery Unit had
just three surgeons resulting in a continuing requirement to
ensure cover for acute presentations – both traumatic and
burns - for an extended regional population. He was a very
competent surgeon who excelled in surgery of the cleft lip
and palate. In this area of practice he developed a very close
working relationship with the oral surgeons and so created
a very well run multidisciplinary cleft clinic. Tom retained his
appointment at Burwood Hospital until his retirement in 1989,
serving as Head of the Plastic Surgical Unit for
much of this time.
Tom served on the Committees of the
Canterbury branch of the New Zealand
Medical Association and the Part-Time
Medical Officers Association. He became an
RACS Examiner in Plastic Surgery.
Activities outside medicine formed an
important part of Tom’s life. The outdoors
and especially tramping was a true passion.
In 1948 Tom returned to Christchurch to
He and Ray purchased a property in
complete his 6th year of training and secure
Queenstown in the early 70s spending a lot
his MBChB. He remained there for the next
of time tramping and skiing in that area. They
two years as a house surgeon and then,
loved the peacefulness and serenity of the
following three months undertaking general
country at the head of Lake Wakatipu, one of
practice locums in Christchurch and Kaikoura,
their favourite tramping locations, and their
Thomas Milliken
Tom sailed for England arriving in May 1951.
wish is to have their ashes scattered in the
Prior to leaving for England he attended a
Rees Valley. In Christchurch they joined the
ball at the Christchurch Winter Gardens where he met Ray
over 40s tramping club and spent many days exploring the
Brownlee, a secretary, noting her to be the “most lovely
Port Hills above Christchurch. With this club they travelled
person” he had ever met. At that time Ray was about to sail to
overseas to places like Canada and Italy.
England with her father, JJ Brownlee, a Christchurch plastic
Tom and Ray were members of St Mary’s Church in Merivale
surgeon. Tom’s version of events is that they met again quite
and strongly supported the Christchurch Cathedral,
by accident in London and the rest is history.
where for many years prior to the earthquake Tom was
He initially lived at London House in Guilford St while
in attendance for several hours each week providing
attending a course for the Primary FRCS examination.
information and guiding visitors. He served as a committee
Casualty and Resident Surgical posts were obtained until
member of the Cathedral Grammar Board of Governors,
he successfully completed the Primary examination in July
the Canterbury Winter Sports Club and the Canterbury
1952. During 1952-53 he obtained general surgery posts at
Automobile Association becoming its President for four
Whittington Hospital Archway, and West Middlesex Hospital
years. Tom continued his love of sport with regular and
followed by orthopaedic posts at West Middlesex and Fulham
enthusiastic participation in tennis, golf, skiing and tramping.
Hospitals. He then commenced plastic surgery training and
Tom was a generous and caring man. Up until the time of his
in 1955 was awarded FRCS Edinburgh and England. In 1956
death he still took great interest in all his grandchildren and
Tom worked briefly in the East Grinstead Plastic Surgery Unit
children. He remained mentally sharp and engaging until days
as Clinical assistant. In 1953 Tom and Ray were married in
before his death. He died peacefully with Ray by his side.
Chelsea. Their first child, Thomas, was born in 1954 and two
Tom is survived by children Thomas, Peter and Alexander
years later the family of three headed home to New Zealand
(Anna having died some years previously) and 11
by sea, Tom working as ship’s doctor
grandchildren. Ray died just three weeks after Tom – they
On his return to Christchurch, Tom was appointed Part-Time
had shared 62 years of married life.
Visiting Plastic Surgeon at Burwood Hospital, where he joined
This obituary was prepared by Thomas Milliken and family
his father-in-law, JJ Brownlee, and he commenced part
with assistance from Sally Langley FRACS
time private practice, initially having consulting rooms in the
Victoria Mansions building and subsequently in Colombo
St. The family increased to four with the birth of Peter, Anna
Cutting Edge | Issue No 59. June 2016
13
JOHN HALL-JONES OBE FRACS
OTOLARYNGOLOGY HEAD & NECK SURGEON
14 SEPTEMBER 1927 – 19 NOVEMBER 2015
J
ohn Hall-Jones had a truly remarkable career. As a
surgeon he exemplified the qualities of a skilled and
dedicated doctor providing the best possible patient care
from a sole specialist practice. As an adventurer he gained
an internationally respected knowledge of New Zealand’s
remote and rugged Fiordland. As an author he was
recognised for his understanding, sensitivity and humour
in creating numerous permanent records for everyone
who wants to enjoy the challenges, beauty and history of
southern New Zealand.
Coleman. John realised that he was at the beginning of a new
era of ear surgery when he assisted Simson Hall perform
a stapedectomy. This was one of the first in the UK and
completed the morning after Simson Hall had rushed back to
Edinburgh after watching John Shea perform the operation
in London the previous day! Perhaps even more exciting
for John’s future was his renewal of an acquaintance with
obstetric nursing sister, Pamela Simpson, whom he had met
briefly in Christchurch. Sharing a common love for skiing and
mountains, their relationship blossomed and they married
as John completed his time in Edinburgh. After
a skiing honeymoon in Europe they returned
separately to New Zealand by sea, John again as
the ship’s doctor.
John was born in Invercargill, where his
father, Frederick Hall-Jones, was a lawyer
and historian. His mother was Marjorie Camo
Thompson. He had two older brothers,
Geoffrey and Ted, and a younger brother,
John was appointed to Southland Hospital in
Gerard. Ted was killed aged 21 on active
Invercargill as its first qualified ENT surgeon.
service with the Royal Air Force. John
At an early stage, with the help of Pamela, he
attended Waihopai Primary School until age
established a private practice. Their son Iain
12 and was then sent to board at Christ’s
was born in 1960 and their daughter Janet in
College in Christchurch. There he was a
1962. Being the sole ENT surgeon in a relatively
member of the school shooting team, having
small provincial centre presented severe
gained considerable additional experience
challenges for a specialist who was determined
during holidays on the North Canterbury
to always be up to date and provide the
farms of classmates. The family bought a
best possible care for his patients while
holiday house on the foreshore of Lake Te
also indulging his passion for the outdoors.
Anau in 1932 and this was to greatly influence
John arranged to share responsibilities with
John’s life. It provided John the opportunity
colleagues in complementary specialties and
John Hall-Jones
to develop a love for this rugged part of New
with ENT surgeons in Dunedin - 200 km away.
Zealand and with his two brothers and their
This allowed him to be a regular attendee
friends the perfect environment to develop their fishing skills.
at meetings and courses in New Zealand and overseas.
When New Zealand’s first stapedectomy was carried out in
From secondary school John went to Otago University
Dunedin by visiting German surgeon, Detrich Plester, John
determined on a career in medicine, rather than law like his
was there and subsequently took Detrich to his crib in Te
father and surviving brothers. He resided in Selwyn College
Anau and to Milford Sound. John immediately ordered a
for four years starring in the Selwyn Ballet at the Capping
microscope and was soon carrying out stapedectomies in
Concert and then had 2 years in private digs. John completed
Invercargill. He subsequently visited Cologne to learn the
his sixth year in Christchurch and continued there as a
new techniques of micro-laryngoscopy and was amongst
junior doctor. This experience included working for ENT
the first to obtain the specialised equipment and carry
surgeons Mr Malcolm Robertson senior and Mr Ross Smith
out the procedure in New Zealand. However, he became
and this shaped his decision to travel to Britain to train as
best known for the innovative service he established at
an otolaryngologist, as at that time there was no training
Southland Hospital for the identification, early diagnosis and
programme in New Zealand. On completing his MB ChB
subsequent care of deaf babies.
John celebrated by tramping through the Haast Pass to the
West Coast – this preceding the building of a road. While a
In 1973 at the request of the New Zealand and Australian
junior hospital doctor in Christchurch in the summer of 1955
Otolaryngological Societies John and Pamela organised,
he became the medical member of a Canterbury Museum
in Te Anau, the Societies’ second combined international
project to map an unknown area west of Lake Te Anau
meeting. With his friend and colleague Malcolm Robertson
beyond its south Fiord. This was his first prolonged expedition
convening the academic program, John and Pamela
and the forerunner of many more.
organised a highly successful meeting highlighting the beauty
of the region and including travel for all to Milford Sound.
In common with many other aspiring surgeons at that
Such was the success of this meeting that just three years
time, John travelled to England as ship’s doctor passing
later they were persuaded to organise and host the New
via the Panama Canal to Liverpool. Following 6 months
Zealand Otolaryngological Society meeting in Queenstown.
fulltime study at the Royal National Throat, Nose and Ear
John was a powerhouse in the executive of the New Zealand
Hospital he obtained the Diploma of Laryngology and
Otolaryngological Society for 11 years including three as
Otology (along with his contemporary, Malcolm Robertson
secretary and two as its president. He was elected to
Jr) and continued there as a house surgeon for 6 months.
fellowship of the RACS in 1979.
Subsequently he worked as a registrar at the Royal Infirmary
at Stoke on Trent and then at the Edinburgh Royal Infirmary
The stress of working as a sole practitioner while attempting
as registrar to I. Simson Hall and senior registrar to Bernard
to maintain very high standards was exhausting for John.
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Cutting Edge | Issue No 59. June 2016
There was a constant conflict in balancing his responsibility
for ensuring a continuing service in Invercargill with the need
to get away to conferences and workshops to refresh and
maintain his high standards. In 1987, at age 60, he decided to
retire from ear, nose and throat practice and focus entirely on
his other career as an adventurer, historian and writer.
John’s first book had been published in 1968. In the 28
years after “retirement” John travelled extensively in his
beloved Fiordland, in Central Otago and Stewart Island and
internationally including the Antarctica, and Sub-Antarctic
islands, the Himalayas, the Rockies, Patagonia, the Galapagos
and most of the Pacific Islands. He retraced his father’s
First World War adventures in Egypt and made trips back
to Europe, especially to Scotland to enjoy with Pamela her
family and home country. He continued tramping, climbing
and kayaking and only gave up skiing after having his hips
replaced. Sometimes he was accompanied by Pamela
who often preferred horse back to walking. He recorded his
adventures in a diary each night and on film and in winter
he collated them into more than 30 books. John wrote the
legend for the photographic art of others. He was honorary
historian and adviser at the Southland Museum and acted as
historian on boat tours of the southern fiords.
John was a keen Rotarian and like his father became
president of the Invercargill Rotary club. He was an inaugural
Honorary Fellow of the Hocken Library at the University of
Otago. His books received several literary awards. In 1995
John was awarded an OBE and in 2007 he received an
honorary degree of Doctor of Laws from the University of
Otago in recognition of his writing.
John is survived by his daughter Janet Menzies Malcolm,
three grandchildren and seven great-grandchildren. Pamela
died 4 years before him. Despite his grief he did as she would
have wished—he continued travelling, walking and writing until
the day of his death.
This obituary was provided by Ron Goodey FRACS
Member benefits are available to all Fellows, Trainees, IMGs and staff of the College and include a range
of cost-saving offerings selected specifically for the College.
The College encourages you to experience the unique benefits of your membership by taking full
advantage of these value-added financial and lifestyle member services.
Member Advantage has been working with the College to extend and enhance the member benefits
available for New Zealand members. Recent additions for New Zealand members are:
SPECSAVERS
PETALS FORIST NETWORK
NZ MILLENNIUM HOTELS & RESORTS
AMERICAN EXPRESS CREDIT CARDS.
Other benefits available through Member Advantage are:
KORU CLUB
INTREPID TRAVEL
FOREIGN EXCHANGE
HOTEL CLUB
AVIS CAR RENTAL
BEST WESTERN
EXPERIENCES & GIFTS
MAGAZINE SUBSCRIPTIONS
Visit www.surgeons.org/memberbenefits or call Member Advantage on 0800 453 244
Cutting Edge | Issue No 59. June 2016
15
NZ National Board,
PO Box 7451,
Wellington 6242,
New Zealand
We encourage letters to the Editor and any other contributions
Please email these to:
[email protected]
The deadline for Issue No. 60 is 5th September 2016
ROYAL AUSTRALASIAN COLLEGE OF SURGEONS NZ NATIONAL BOARD
Chair
Randall Morton Deputy Chair
David Adams
Honorary Treasurer
Nicola Hill
OFFICE OF THE NZ NATIONAL BOARD
Level 3,
8 Kent Terrace
Wellington 6011
New Zealand
Tollfree (NZ only) 0800 787 469 / 0800 SURGNZ
Phone: +64 (4) 385 8247
Fax: +64 (4) 385 8873
Email: [email protected]
NZ SECRETARIAT
NZ Manager
Justine Peterson
[email protected]
Skills Training
Jaime Winter
[email protected]
Accountant
Raji Divekar
[email protected]
Committees & Projects
Isobel McIntyre
[email protected]
IMGs(NZ) andTraining
Celia Stanyon
[email protected]
General Administration/Reception
Andrea Lobo
[email protected]
Policy & Communications Officer
Calum Barrett
[email protected]
Executive Director of Surgical Affairs - NZ
Richard Lander
[email protected]
The Cutting Edge is published 4 times a year.
VIEWS EXPRESSED BY CONTRIBUTORS ARE NOT NECESSARILY THOSE OF THE COLLEGE
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Cutting Edge | Issue No 59. June 2016