The Royal New Zealand College of General Practitioners

Teacher: Wayne Cunningham

Wayne was born in 1960 and went to high school in Hamilton and then on to Auckland University to study medicine. He graduated in 1984 and worked as a house surgeon in Auckland and Palmerston North, and then in various hospitals as a general surgical trainee, eventually leaving surgery to enter general practice training in 1990. He worked as a GP in Feilding for six years before shifting to Dunedin to take on part-time academic work in the Department of General Practice, Dunedin School of Medicine. Wayne remains a Senior Lecturer in the department and from 1999 has been in rural general practice in Milton, South Otago.

Wayne is a Fellow of the College and has served on various educational committees and advisory groups, and has been a PRIMEX examiner. He holds a Master of General Practice (Distinction) (Otago) degree, and a Doctor of Medicine (Auck), with his theses centering on the impact of complaints on doctors. He has published on this and other subjects both locally and internationally, and is active in the field of medical indemnity, having been an advisor to Medical Protection Society and is now a board member of Medicus Indemnity NZ.
He is married to Joanne, and has three children - Renee b.1989, Andrew b.1991 and Courtney b.1995, and lives in Dunedin, commuting most days to the Milton practice.

The Practice

Milton is a small town approximately 40 minutes drive south of Dunedin. The practice has an enrolled population of about 3000 patients and had a dedicated consulting room fully fitted out and equipped for the use of a registrar.

Milton Health Centre has four practice nurses, and is co-located with the district nursing service. The practice accommodates visiting nurse specialists and has access to counselling, physiotherapy, dental and other services.

The practice is typical of small town rural practice catering for the full range of general practice care including accident and emergency medicine work. The GPs perform minor surgery, fracture management and the like at the centre, and have most of the essential equipment such as a modern computerised ECG machine, autoclave, tympanometer, fetal heart monitor and so on. X-rays are usually requested from Clutha Health First, in Balclutha, and films can be read electronically by the Milton team.

Lab tests are catered for by Southern Community labs and a bi-daily courier service ensures rapid results. The practice is fully computerised with Med Tech 32 and all the rooms have broadband internet access. The practice hours are 9am to 5.30pm Monday to Friday with a 90 minute break at lunchtime (during which they also do rest home visits and the like). The Milton GPs contract on-call services after hours but they run Saturday and Sunday afternoon clinics at the surgery.

The Milton practice cares for a rest home with a dementia unit. There is also a fair bit of ACC-related medicine, covering a reasonably large chunk of SH1 and with several saw-mills and a thriving forestry and farming infrastructure in the area. Calder-Stewart Industries have their base in Milton, as do McLay Boats, Toko Trailers and Alliance Textile Mill.

Socio-economically, the town could be characterised as ‘low income working’, with a smattering of people on benefits and some who are extremely wealthy. A number of people commute daily to the freezing works in Balclutha or Mosgiel, or to industries in Dunedin, there is a large shearing industry with itinerant workers, and a thriving farming industry with dairy, sheep and beef.
Milton has a local hotel, cafes and several take-away outlets, Hammer Hardware, National and Westpac banks, two supermarkets, a greengrocer, Provincial Antiques (the best antique shop in the South Island apparently!), gift shops and a craft shop, a veterinary clinic, electrical retailer, hairdressers and several other small businesses including two motels.

The practice no longer provides medical services to the nearby prison (Otago Corrections Facility).

Registrar Timetable

Ideally, once settled in, they would like the registrar to work normal sessions and attend the weekend clinics according to College guidelines. Milton is developing very much into a commuter town and it is envisaged that a registrar would probably follow the trend of the GPs and many of the staff and live in Dunedin or Balclutha.

Rurality. This is a rural practice with a rural ranking of 65 points and does qualify for the rural scholarship; a registrar can apply and receive the rural scholarship tax free under the current scheme. All that is requested in return is that the registrar completes three months of work after PRIMEX in a rural setting.

The Community

With Dunedin so close there is ample opportunity to catch up with local theatre, movies and any other cultural needs. Central Otago with all its attractions is a 2 + hour drive and Lake Waihola is 15 minutes away. Milton offers plenty of sporting opportunities, bowls, golf, squash, rugby and netball to list a few. The Catlins are less than an hour away and offer some of the most beautiful beaches and walks in the South Island. Invercargill and access to Stewart Island is an easy drive.

With a well-rounded teaching experience, an easy commute to Dunedin or Balclutha, the attraction of the Rural Scholarship, a variety of patients with diverse medical conditions and a friendly and welcoming staff, Milton is a practice which offers a great deal to registrars!