“I have loved working in New Zealand! My two stints have been in very different settings. The first experience was in a small rural hospital. Well-seasoned GPs provided most of the obstetric care. They did operative vaginal deliveries and assisted at cesareans. Midwives were involved in a smaller portion of the cases. I really appreciated not having to do normal deliveries, but only being involved in complicated OB cases, or cesareans. There was a reasonable flow of GYN surgery. The GPs do routine Paps and provide contraception. They refer “interesting” cases to you, the specialist. This system had obvious advantages and disadvantages.
This time, I am in a setting with a higher volume of patients. It is a district hospital. The pathology is stimulating (two cases of malignant pleural effusions and a couple of ectopics this week. And a leiomyosarcoma last month). I also love teaching the new “house officers.” Their training is very different from the ob/g residents at home. Most of them will become GPs, not OB/GYNs. This system is much more closely aligned with British practice than with American traditions. As a result, I have learned many new approaches to O&G. There is an enormous cross cultural to medicine, not only to life and times in NZ.
I have worked in both urban private/ academic and rural/non-academic settings in the States. There is a greater difference in practice patterns within the States than there is from the US to NZ. Some differences are frustrating, while others are joyous.