Sir Robin Irvine, a previous University of Otago vice-chancellor, noted his opposite numbers with medical schools under their control were identifiable by furrowed brows and haunted looks.
Are those responsible for the launch of the proposed Waikato Medical School aware of the many challenges accompanying that task?
Contentious comments by leading economists and academics, as well as the demonstrably flawed business case for the venture, does not suggest a sound financial foundation. Figures initially proposed were reduced significantly, so the oily rag remaining will hardly smell of roses.
Current political winds blow in their favour, but future changes in force and direction are inevitable.
Being a postgraduate course, they will benefit greatly by having "spade ready" students keen to fulfill a life ambition.
It will be intriguing to learn whether their curriculum will follow the modern problem-based format, integrating clinical experience with the learning of basic medical disciplines (e.g. anatomy, physiology, pathology, microbiology). This is best conducted in small groups which is costly in staff, time and resources.
Appropriately trained and motivated teaching staff are vital for adequate training of medical students. Clinical students demand attentive staff time. Modern doctors learn from multiple sources, especially the internet and modern lab facilities.
However, essential learning interactions come from patients. Sir William Osler, a famous medical educator, stated doctors who learned their profession without exposure to patients were like sailors who had never been to sea.
Waikato training being based in rural practice, GPs will presumably be the main student mentors.
GP appointments are already difficult to secure, and teaching is time-consuming. Patients will need to adapt to having their GP time shared with students.
GP facilities will need to provide accommodation for patient-student interactions. Auckland and Otago already have well-established rural GP-based student training programmes.
Specialties cannot be ignored in the curriculum.
Medical specialists and academics are currently scarce in New Zealand. The recent government move to offer 10-year contracts for specialists to work in private facilities at higher remuneration will restrict teaching time and numbers even further.
Salaries offered by Health NZ are not competitive on the international market, and the current state of our hospitals is hardly attractive to overseas applicants.
Many of the public hospital facilities in the Waikato area are currently being used as teaching bases by the Auckland Medical School. Despite some available facility advantages, the total number of learning opportunities will have to be increased still further.
It could be questioned whether this has been included in the calculation of cost.
Student assessment is a vital part of the course. It needs to ensure that graduates behave appropriately and are competent and safe to treat any patient. While theoretic knowledge is assessed relatively easily, clinical skills present complex challenges; personal attitudes, cultural, ethical and social issues, and the integration of medical art and science by the budding doctor need judgement.
This has challenged medical educators for years, and the modern world of AI includes many more levels of complexity.
It needs to be fair, but also equitable, as modern society is very quick to challenge any questionable decisions.
Research is important in medical education. Our future doctors need to be aware of what is necessary for the profession and the public to provide for future needs.
Medical knowledge has expanded dramatically over the past decades, and students need to be part of an environment with a research ethos of future continual development. Modern technology needs to be applied to solving problems in modern settings. Research-based mentors are invaluable in medical education.
Medical school education has been described appropriately as a three-legged stool, each leg representing teaching or clinical care or research. Remove one leg and it collapses.
Assuming the project goes ahead, the ultimate test will come when the Waikato course applies for accreditation with the Australasian authorities. This is required if graduates wish to apply for registration with the Medical Councils of Australia or New Zealand.
It is also vital for international recognition of its graduates, and the reputation of New Zealand’s medical education. Accreditation is a stringent process, taken very seriously by all concerned.
Waikato will have to meet this challenging high standard if its graduates wish to share the distinguished reputation of their New Zealand peers.
• Gil Barbezat is an emeritus professor of medicine.
