An interest in medical administration is predicated on a desire to
make a difference to the way the health system is run. It can be
extremely rewarding to establish new organisational systems and to
make decisions that improve the operation of health services.
You also gain insight into vastly different perspectives as you
observe and encounter the attitudes and stances that non-clinicians
have towards the health service. The best part is that you can have
more of an impact on the community than in an individual situation.
The specialty requires you to act as a link between non-clinician
management and doctors, so you need to be aware of the similarities
and differences in their respective approaches. This requires
comprehensive insight into political pressures, economic constraints
and a broad range of other considerations. It is also helpful to
possess an understanding of the ways in which organisations
function. The workload in this area of specialty is often heavy so
you should be able to prioritise and work efficiently. Good
interpersonal skills are essential: you will need to negotiate,
build relationships and encourage people to work well together, and
you must be able to remain calm and composed in heated situations.
There are occasions when you have to make tough decisions, so
confidence is important. You need to be able to combine both your
clinical expertise with knowledge about running a business.
A typical day would involve a significant amount of office-based
work. You would expect to attend numerous meetings and to liaise
with staff members, external agencies and the media. There is
minimal or no patient contact.
Since late 2001, medical administration has been recognised as a
separate specialty by the New Zealand Medical Council for the
purpose of vocational registration. While the Fellowship of the
Royal Australian (now Australasian) College of Medical
Administrators (FRACMA) has been recognised as a specialist
qualification in Australia since 1980, it is still relatively new in
this country. The training programme has been well established in
Australia and is now being progressively adapted to suit New Zealand
conditions and needs.
The College requires you to have spent a minimum of three years
working in a clinical setting so that you have a level of
understanding of clinical perspectives. If you move into medical
administration it would be worthwhile maintaining your clinical
skills, perhaps by working one day each week as a clinician. A
number of New Zealand, universities offer complying Masters
programmes. It is important that you contact the Chair of the
College’s New Zealand Board of Studies (Dr David Rankin) to discuss
a proposed course of training. You will also need to enrol as a
candidate with the College formally if you wish to work towards
Fellowship.
Medical administration is a new and growing discipline so the
outlook is encouraging. New Zealand is still some way behind
Australia and the United States in terms of the status of the field,
but is rapidly catching up.
It can be frustrating to experience conflict between management and
medical roles, and to be unable to exercise clinical skills acquired
through years of medical training.
As one of the pioneers in the training programme in New
Zealand, you will have the opportunity to work with the College to
steer the New Zealand training programme in the right direction.
You also gain insight into vastly different perspectives as you observe and encounter the attitudes and stances that non-clinicians have towards the health service. The best part is that you can have more of an impact on the community than in an individual situation.