After qualifying as a GP in 2009, I wanted to do something to broaden my experience, as a doctor and a person, but also consolidate my skills as a GP.
I heard about a job working part-time as a GP and part-time as a doctor on the ski slopes in New Zealand and decided this was for me.
I moved to Wanaka on the South Island of New Zealand, where I worked part of the week at a commercial ski resort called Treble Cone and the rest at Aspiring Medical Centre, one of two GP surgeries in Wanaka.
A day on the slopes
The clinic opens at 9am and the day begins with a perilous journey winding up the road to Treble Cone ski field. At the beginning of the season it can be treacherous due to snow and ice. Snow chains need to be carried, and occasionally fitted, which can be very entertaining.
The mornings are normally quiet. This is a good time for the nurse and I to check the stock and have a cup of tea. The clinic consists of three beds in one room and a one-bed trauma room.
In the trauma room we keep a supply of medications, oxygen and nitrous oxide, emergency airway equipment and an automated external defibrillator.
As the morning is the quiet time, the nurse and I can take it in turns to ski or snowboard, wearing a radio so that you can be kept informed if the clinic is filling up. On a typical day, I manage around 90 minutes of skiing but this can range from nothing if the clinic is busy, to three hours if the clinic is quiet.
The afternoons are busier with accidents on the slopes. On an average day I see around 10 patients with conditions ranging from simple sprains to spinal trauma.
Any patient who is too injured to ski to the clinic is brought down by ski patrol, who are all trained in first aid. At the clinic we assess and stabilise patients.
Anyone needing an X-ray or further management is transported off the mountain by their own car, ambulance or helicopter depending on their needs.
The day ends at 4.30pm when ski patrol confirms that there is no-one left on the slopes and we are safe to go home.
A Rural GP
General practice in New Zealand is a little different from the UK. There is a large transient population of tourists with the ski season and summer visitors.
My GP role includes what I do as a GP in England but there is more accident and emergency work with fracture diagnosis and management.
We have an X-ray machine in the practice with a daily radio graphy session in the afternoon.
As there are few older people there is much less chronic disease management and fewer home visits. It costs patients more for a home visit so if they can get to the surgery they will.
I participate in the on-call rota looking after the out-of-hours needs of the patients. The nearest rural hospital is 90 minutes away by car and the nearest hospital with ICU, paediatrics and surgery is five hours away by ambulance. This plays a role in decision making. At times a helicopter is needed to ensure quicker access to the hospital.
Improving my skills
Working as a ski slope doctor and rural GP in New Zealand has given me the opportunity to improve both my emergency care skills for trauma patients and my skills as an out-of-hours doctor, as well as improving my skiing.
However, working in a country with a private health care system has also made me appreciate the NHS more.
- Dr Carter is now a locum GP in West Yorkshire and East Lancashire
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