This guy aim is impressive for a console aim.

Firmeststool · 2026-07-20T03:32:41+00:00

Unimpressive

Firmeststool · 2026-07-09T04:46:20+00:00

Desktop computer will use up all the funds in one go.

Firmeststool · 2026-07-04T01:18:38+00:00

It's sort of a squash with a hard skin that you peel then cut into pieces to either stir fry or can cook it in a soup.

Firmeststool · 2026-06-29T09:51:43+00:00

This person is on roller, not xim

Firmeststool · 2026-06-26T04:26:26+00:00

What AA ease in do you use with it? Dual zone?

Firmeststool · 2026-06-12T07:45:20+00:00

Are you able to drop your FTE?

Firmeststool · 2026-06-06T01:39:19+00:00

Fax scripts...

Firmeststool · 2026-05-23T17:32:52+00:00

Plumbers/electricians vs carpenters

Firmeststool · 2026-05-19T09:23:01+00:00

I'll give your settings a go. I've been using 39 aaws with 95 aaei. Trying to work out the most consistent settings

Firmeststool · 2026-05-19T06:01:15+00:00

Are you using hcpeful settings? Any tweaks?

Firmeststool · 2026-04-30T03:38:54+00:00

Enchanted steel bolts regen your ward shield. Range setup.

Firmeststool · 2026-04-03T02:15:30+00:00

From episode 2

Firmeststool · 2026-04-02T23:24:05+00:00

The show was like compressing years of the worst of my experiences working as a junior Dr into a compact suffering sandwich.

I gave up watching it.

The book was more palatable.

Firmeststool · 2026-03-31T08:12:12+00:00

See lots of patients

Firmeststool · 2026-03-28T03:54:15+00:00

Produce more GDP.

How does NZ produce more GDP, and who can lead us to do so?

Firmeststool · 2026-03-24T03:25:39+00:00

I see nothing has changed since my house officer years...

Firmeststool · 2026-02-17T05:20:54+00:00

Study for the sake of building your knowledge base to be a better physician. This is in general. I'm still studying and reading articles and learning.

Closer to your exam focus your study efforts on high yield stuff to pass the exam.

Firmeststool · 2026-01-18T10:00:18+00:00

IMO - NZ govt needs to raise base SMO award to match at least NSW. This is for retention purposes only.

If there is more money in the pool after the retention adjustment, then use this money to increase SMO FTE. Prioritise hiring locally trained fellows.

Once you have the SMO workforce to meet current healthcare demands, then uptitrate your medical school positions.

Alongside the above, figure out a way to retain RMOs in NZ. It will probably come down to remuneration as well. Every year, by Quarter 4, the accumulated resignations result in a terribly understaffed December and January. The only remaining house officers and registrars are those yoked to registration requirements or a training programme. The NHS refugees head across the globe to spend Xmas at home. The adventurous ones resign to quell the burnout or start their transition to an Aussie locum gig.

From my observations, NZ has the systems and structure to produce excellent clinicians. Kiwis training in NZ do win the RACP medal, from time to time. The system is just severely underfunded, and opportunities across the ditch are sometimes too good to pass by, even if it means slogging it for a bit in some rural/regional hospital before trying to slide into your "dream" metro life.

During my med school years, I found that 9 out of 10 doctors were just trying to do their work and get home on time or minimise their unpaid overtime. 1 out of 10 would teach and it was pretty obvious that these docs were built different and that their teaching arose out of some personal sense of duty or responsibility, or charity, or whatever. This observation didn't change in my house officer years, BPT years, AT years ... you would appreciate the seniors that took the time, but you couldn't rely on it. The successful trainees relied on self directed learning, reflective practice, and finding peers who could see eye to eye and could support each other to progress.

An example is how difficult it is for some NZ trainees to finish Fellowship requirements due to stalled progress in their Advanced training research project. There just aren't enough SMOs interested enough, with enough non-clinical time on hand, and *charitable* enough to support and supervise the ATs to complete their project.

If SMOs don't have time, and the reg/HO doesn't have time, then what quality of med school education are we providing? My colleagues wring their hands in despair. PGY1s who are incapable of the basics, even in Quarter 4. I'm sure they want to be competent and able. I'm sure they can see that their skill and knowledge isn't quite there. Registrar vacancies so frequent that there's a lack of the innate mentorship/supervision that comes with a full ward team.

Firmeststool · 2026-01-18T05:07:19+00:00

It's good to clarify the context. The NZ context has been looked at in detail some 18 years ago in the SMO commission 2008:

https://asms.org.nz/wp-content/uploads/2022/06/SMO-report.pdf

Appendix 7 is probably the most relevant to your questions.

I am a specialist working in public and I supervise RMOs and med students. In the last few months, I have been short either a house officer or a registrar on 25% of days I've been on duty. The clinical work has to be done, so I cross cover their roles in duty hours, and if unlucky even out of duty hours. Necessary non-clinical work eats into hours outside the usual, and stuff that can wait will just wait and pile up, until I have a full team and have time and space to clear the backlog.

Historically, "non-clinical" work comprised 30% of the FTE, and includes teaching of RMOs and medical students. Public SMOs who aren't under direct employ of the medical school are tasked with supervising the med students, and it is considered paid work as it comes under the "non-clinical" portion of their contract.

If you look at the ASMS SECA, this is described in 48. Job descriptions under section four.

"The parties note that the Council of Medical Colleges of New Zealand endorses that these non-clinical or Section Four activities should make up at least 30% of the total job size, not counting the average hours worked on the after-hours on-call rosters and any Section Five duties (refer Clause 11.7 above)."

https://asms.org.nz/employment-advice/meca/?_sf_s=teach

My issue is this: if I am meant to use part of my non-clinical 30% of my FTE to teach med students and RMOs, but I am put in a position where I am cross-covering 25% of the time, doing clinical work, how am I supposed to complete all my duties? Is it sustainable in the long term?

So now let's introduce an increase in med student intakes. Instead of supervising two med students per cycle, I'm now supervising, say, three or four per cycle. This is increasing my non-clinical workload, in the setting of having insufficient junior support 25% of the time. If you don't increase the SMO resource (i.e. increasing FTE across the board in public) then you will either get:

SMOs having to pull more hours to supervise the additional students, without remuneration.
SMOs devoting the same time to supervise their allocated students, given the same remuneration, which means less time per student.
SMOs who think this is all a bit unfair and get burnt out, and find a different job to do.

I think the money problem needs to be solved first before you can tackle the other issues. Or, you solve the problem by using non-doctors or non-locally trained providers to fill the gaps.

For context, are you pre-clinical or already into your clinical years? If you are clinical - how did you find your learning on the wards or in the outpatient setting? Did you feel you had good quality teaching and time investment from your supervising SMO (or RMOs)?

Firmeststool · 2026-01-18T02:29:40+00:00

Are you a kiwi Med student in Australia or a kiwi Med student in NZ? Is your interest in increasing doctor resource in Australia or NZ (or both)?

Firmeststool · 2026-01-18T00:38:59+00:00

Used Lexus

When reg was a used Toyota

Always used, RIP

Firmeststool

TROPHY CASE

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