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Medical student teaching in Paediatrics in Wellington – early days

From 1924 onwards sixth-year medical students were attached to the main centre hospitals in Auckland, Wellington and Christchurch, in addition to Dunedin. This arrangement for clinical teaching was formalised in 1938 with the setting up of "Branch Faculties" of the Otago School in the three northern centres.  Teaching of Paediatrics for final year students was limited but Dr Jim Watt working at the Hutt hospital at the time became a stimulating focus. Dr Richard Bush and Dr Jeff Weston were appointed to the Hutt in 1960. Dr Athol Arthur (from 1967) in Wellington was also an important student and junior staff role model as was Dr Archie Kerr at the Hutt from 1976.

 

Department of Paediatrics & Child Health, University of Otago, Wellington

The Wellington Branch Faculties were absorbed into the Otago "Wellington Clinical School" when this opened in 1977. Dr Mark Hoby was appointed tutor specialist in Paediatrics as the first Academic appointment in 1973. Interestingly he now works in Adelaide, Australia in adult medicine. HJ Weston was appointed to the first Wellington Paediatric Chair in 1975.  Other early academic appointees as Senior Lecturers were Dr Russell Franklin (1977-1991), Dr Margaret Lewis (1978-1999) and Dr Thorsten Stanley (1980- current).  

 

Professors of Paediatrics and Child Health, University of Otago, Wellington

Professor Jeffray Weston – 1975-1991

Professor Weston had been a resident at Wellington Hospital in 1950. He then trained in England at the Hammersmith hospital, the Brompton Hospital and the Hospital for Sick Children at Great Ormond St where he was a Resident Assistant Physician (4). Jeff Weston was a tireless advocate for children. He particularly championed the interests of children subject to abuse. His other particular clinical interest was in paediatric cardiology. At this time the Professor of Paediatrics was also the clinical lead of the hospital children’s services. In this role Prof Weston was instrumental in overseeing the building of the Children’s Hospital wing at Wellington Hospital that is still standing today. Jeff Weston’s retirement in 1991 left a gap that was not filled for a number of years. After retirement Jeff Weston was awarded Emeritus Professor status and he also continued his service to the University by taking an interim role as HOD for the Dept of Obstetrics & Gynaecology. He received the inaugural Dean’s Medal for distinguished service to the School in 2000. He remained actively interested in the Dept of Paediatrics & Child Health up to the time of his death in 2010. He was an excellent recorder of history and much of the information contained in this section is based on information recorded by him.

Interim Period 1991-1997

During this period Dr Margaret Lewis and Dr Thorsten Stanley both had periods as acting HOD.

Professor Keith Grimwood – 1997- 2007

Professor Keith Grimwood was appointed in 1997. He was also a New Zealand graduate and commenced his paediatric training in Christchurch and then completed postgraduate training in Canada. Keith Grimwood was recruited from an academic position at the Royal Children’s Hospital in Melbourne and had clinical and research expertise in Paediatric Infectious Disease. Under his leadership the research output of the department increased considerably. At this time the length of the 5th year teaching attachment in Paediatrics also increased from 5 to 10 weeks. 

Interim Period 2007 to 2010

During this period Dr Thorsten Stanley was acting HOD. An external appointment was made to the HOD role but the applicant did not complete the process and take up the position.

Professor Marie Johannesson -2010-2011

Professor Marie Johannesson was a Swedish graduate who had undertaken specialist training in the USA. Her main research interest was Cystic Fibrosis.  Professor Johannesson greatly increased our awareness of the differences in the availability of services for children in New Zealand compared with Sweden. She returned to Sweden after nearly 2 years in the position.

Interim period 2011 to 2013

During this period Dr Thorsten Stanley and then Assoc-Prof Dawn Elder were acting HOD.

Professor Dawn Elder 2013 – to current

Professor Dawn Elder is a graduate of the University of Otago and trained in Paediatrics in Dunedin, Australia and England. Her research interests are in cardiorespiratory stability of preterm infants at discharge, Sudden Infant Death syndrome and sleep issues in childhood. Under Dawn Elder’s leadership there has been ongoing development of the research capacity of the department with the appointment of post-doctoral fellows and further PhD students.

Other Professors associated with Child Health

Professor Kevin Pringle

Professor Kevin Pringle was appointed as an academic Paediatric Surgeon in 1987 and promoted to Professor in 2000. He was initially based in the Academic Dept of Surgery and Anaesthesia having a role as Acting HOD in that Department at one stage. In September 2000 he was appointed Head of Department of Obstetrics and Gynaecology. Professor Kevin Pringle worked clinically as a Paediatric Surgeon for the Child Health Service as part of his joint clinical – academic role.  He retired from clinical service and teaching in 2015 but continues with a research role.

Clinical Professor Ken Dawson

Professor Ken Dawson was appointed as a Clinical Professor based in Blenheim (supervising students on their community placements) from 2001 to 2007. He had previously been an academic staff member of the Dept of Paediatrics in Christchurch.

Honorary Professor Mark Stringer

Professor Mark Stringer was appointed in 2015 to a full time clinical role as a Paediatric Surgeon at Capital and Coast DHB. Professor Stringer has a distinguished academic record and was previously a member of the Dept of Anatomy in the Otago School of Medical Sciences.

Academic staff in the Department of Paediatrics & Child Health

As noted above, early academic appointees as Senior Lecturers were Dr Russell Franklin (1976-1991), Dr Margaret Lewis (1978-1999) and Dr Thorsten Stanley (1980- current).  

Dr Vaughan Richardson was employed as a Senior lecturer (1986-1996) after returning from advanced training in Paediatrics in the UK. He later resigned to work fulltime for Child Health Services and concentrate on his leadership role in the Neonatal Intensive Care Unit. Dr Geoff Aitken (1992-1994), also a neonatologist, was appointed after Dr Russell Franklin’s departure. Dr Dawn Elder was appointed as Senior Lecturer in 1995 after Dr Geoff Aitken resigned. Dr Margaret Lewis sadly was unable to continue in her position after 1999 because of ill health. In 1999 Dr Lynette Sadleir was appointed as a Senior Lecturer and in 2001 Dr Esko Wiltshire.   Both had been clinical students at UOW and registrars in the clinical department before heading overseas for specialty training. From 1999-2006 Dr Peter Watson, Adolescent Physician, who had an academic appointment with Auckland University, was a visiting Senior Lecturer coming regularly to teach on the 5th year programme. Dr Russell Wills, who later served as the Commissioner for Children (2011-2016), also worked in the department as a Senior Lecturer from 1999 -2001 with a Community Paediatric focus. It was at the time of this appointment that we were able to develop a regional community child health programme.  Also involved in this programme were Dr John Eastwood, Public Health Physician and Dr Amanda D’Souza, Senior Lecturer (2010-2015).  In 2012 Dr Mary (Max) Berry was appointed as Senior Lecturer.

By far the majority of the appointments listed above were for joint clinical academics, usually working 0.5FTE for the University and 0.5-0.7FTE for the DHB depending on clinical responsibilities and on-call commitments. However along side these staff members there has been an increasing list of 30-40 Clinical Senior lecturers and Clinical Lecturers who have ably assisted with student teaching. The ongoing development of the teaching programme for 5th and 6th years and the postgraduate Diploma of Child health would not have been possible without the assistance of these clinical colleagues.

Development of Teaching in Paediatrics in Wellington over the years

Over the years the teaching programme in Wellington has developed so that there is now a 10-week programme in 5th year and a 4-week programme in sixth year.  This is probably the longest time available for teaching in Paediatrics across Australasia. Students are exposed to both community and in-patient paediatrics. The 5th year students have opportunities to go to regional paediatric services to experience community paediatrics and 6th year students can be assigned to Hutt, Palmerston North and Hastings hospitals as well as Wellington. From 2016, 6th years students have also been sent to Whanganui. 

With regards to the regional placements these started in 1999 as one week and increased to two weeks in 2002. The programme is unique among the three Otago Clinical schools. The aim of this part of the programme is for students to be able to spend time in the community seeing how children are managed outside of hospital and at home and also to understand how services work for children at DHB level.

The department is also involved in convening the clinical component of the Diploma of Child Health (Otago) and in the neonatal teaching component of the Diploma of O & G. Enrolments for the Diploma of Child Health come from all around the country despite a similar programme also being offered by the Auckland medical School.

The current Children’s hospital facility was opened in 1988. This facility had provision for rooms for student teaching but with increasing numbers of students space has become more restricted. The Department of Paediatrics & Child Health has been one of the few departments of UOW to be embedded in the DHB site.  All staff are housed in offices in the Children’s hospital annexe where they are co-located with their full time clinical colleagues.

Development of Research in Paediatrics & Child Health in Wellington over the years

At the time of the early development of the department the focus of academic staff was mostly on setting up a teaching programme in paediatrics and publication outputs were low. The first Professor of Paediatrics, HJ Weston had just 15 publications, a number that would be considered low currently. However Jeff Weston was renowned for his clinical expertise in Paediatrics and was very active in Community Service. He was highly respected nationally and internationally and during his tenure many of the international ‘big names’ in Paediatrics visited the department. As time has gone on the University has expected not only clinical expertise and community service for those working in joint clinical – academic positions but also sustained research outputs and attraction of research funding. The department has responded with increasing success in securing external research funding and dramatic increases in published research outputs. In recent years there have been around 20-25 published journal articles annually with a wide range of paediatric topics being covered including: allergy, diabetes, endothelial function, genetics and classification of epilepsy, respiratory variability, childhood sleep, SUDI and perinatal and neonatal research.

Research is carried out in many places. Members of the department have been involved in multi-centre trials as well as carrying out their own research. As well as hospital inpatients, research has been undertaken on community groups, in children’s homes and schools and even at the annual camp for children and young people with diabetes. When the Centre for Translational Physiology was developed in the school a room was decorated to be friendly and interesting for children. Staff have collaborations with other departments at UOW as well as with colleagues in the other two clinical schools and nationally and internationally.

Many members of the department have served on committees nationally and internationally related to their area of specialist research interest as well as assisting the MOH and other government departments.  This increasing expertise in research has also lead to the appointment of post-doctoral fellows, and in increase in the numbers of post-graduate and BMedSci(Hons) student being supervised from within the department.

Future of the Department of Paediatrics and Child Health

The changes over time have definitely increased the workload of staff. From the small beginnings of a department where the main focus was on teaching and clinical service, we have developed to a place where as a team we can have a strong focus on research while still maintaining excellence in teaching of the Paediatric Curriculum.  In New Zealand in 2017 we currently do not do as well as we should in the care of infants, children and adolescents. Our challenge as teachers and researchers is to provide teaching and advocacy for this heterogenous group of infants, children and adolescents in the lower age range of the lifespan and ensure that our future doctors and allied health workers have the skills to support improvements in the health and wellbeing of children of every ethnicity and type of social circumstance in Aotearoa.

 

This account of Academic Paediatrics was provided by Professor Dawn Elder

Sources:

1. Evans RG. A quest for identity, authority, and status: The development of Paediatrics Australia. Health and History 2008:10:48-72

2. A Precis of the history of Academic Paediatrics in New Zealand. Professor HJ Weston 2006.

3. The Dictionary of NZ biography

4. JH Weston, obituary. NZ Med J 2010, Vol123 No 1323

Last updated 15 September 2020.