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From the Flight Deck

I don’t know how many of you subscribe to the daily Curt Lewis’ Flight Safety Information Newsletter which catalogues the accidents, incidents and events that have flight safety implications around the world. The record is reassuring: in flight smoke or odour in the cabin or cockpit, a cracked windshield, minor engine problems and rarely a pilot incapacitation.

The common theme though is that each event is recovered safely without death or injury. Airline aviation has a safety record that just keeps getting better. We need to ask ourselves why health care does not have the same enviable record of safe operations, all the time. In most countries, deaths from medical misadventure are comparable with the numbers who die in motor vehicle accidents.

What is the difference? A focus on Non-Technical Skills, loosely analogous to Crew Resource Management, adherence to safety procedures, working effectively as teams, and a culture of safety.

In the same way that passengers put their trust in their pilots and the operations that support them, health professionals literally have their patients’ “lives in their hands” and are trusted to make our best efforts to preserve life, health, safety and dignity. In my work, I see instances where that fiduciary responsibility has been breached, and patients have suffered. As professionals who traverse both worlds, we have an important role to play in promoting systematic approaches to safety in health care.

I am sure that, like me, when people ask you at social functions “so what do you do?”, your audience is amazed at the complexity of our field, in aviation, air ambulance operations and in the workplace. It never occurs to them that the fitness of our pilots and air traffic controllers, and the sophistication of care in the air, is supported by dedicated professionals who step outside of reactive medicine practice to provide a healthy and safe environment in a challenging and potentially hazardous operations. I think we can be proud of what we do!

The challenge is staying current in advancing best practice. Studying with Occupational & Aviation Medicine is just the start of learning what clinical best practice means in your particular field. I hope that being associated with us means that you seek to learn something new every day, and we strive to be the best that we can be for those people whose care we are responsible for. I hope that regular contact with us means that the hunger to be the best of the best rubs off. If we can help you enhance that, please let me know.

Travel safe, wherever you are.
Per ardua ad astra!
Rob
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Student Profile: Michael Tombros

I trained in the UK initially, first completing an undergraduate degree in Pharmacology at UCL (1999) and then in Medicine at Southampton (2003). I initially started training as a surgeon but then changed my mind and completed GP training in London in 2010. After that I moved to Australia where I worked for nearly four years before moving to New Zealand in 2014 (my wife is from NZ). I worked in General Practice for a few years, but decided to specialise in Occupational Medicine about a year ago. I currently work at the Accident Compensation Corporation (ACC) as a Medical Advisor and one day a week at Australis Medical Ltd. as an Occupational Medicine Registrar.
 
My decision to specialise in Occupational Medicine stemmed from my interest in aviation medicine. I initially wanted to work as a GP and conduct pilot medicals, primarily out of a general interest in aviation that I have always had. My hobbies as a child included making Airfix models. At one point I nearly joined the RAF and I gained a PPL(A) in the UK in 2010. When looking for a course in Aviation Medicine, the Otago University modules seemed ideal and could easily fit amongst my other work/life commitments. I spoke to Rob Griffiths at the time as I had just arrived in NZ. He suggested I do some Occupational Medicine modules first as the Aviation Medicine ones were not available that year. I did, and I enjoyed those so much that I decided to retrain as an Occupational Physician!
 
My study has made quite a big change in my professional life so far. In addition to being able to do pilot medicals as a CAA Examiner, I am now on a pathway to a new career as an Occupational Medicine Specialist. I am learning new things all the time, I have met lots of interesting people, my income has increased and I am generally very optimistic about my future career prospects.
 
I would recommend Otago University's Occupational and Aviation Medicine courses to anybody interested in Aviation Medicine and/or Occupational Medicine, particularly GPs. The Occupational Medicine component is very relevant to GPs as it is not something that in my view is taught well (if at all) either at medical school or GP training programmes. This is unfortunate as GPs do a great deal of work fitness certification (including medicals) particularly in NZ with the widely-used ACC system. Additionally, I would recommend these courses to any GPs considering a potential career change, as the RACP pathway into a career in Occupational Medicine recognises prior GP training to a significant degree. Junior doctors considering their career options are also likely to find these courses interesting and useful, as they provide exposure to a speciality that most doctors are unlikely to have received a lot of information about or training in as students.
PVP 2018 in Taiwan

Some of you are very familiar with the Professional Visits Program (PVP). However for some of you this will be your first opportunity to join in this unique experience. For me personally the PVPs were where I developed my passion for Aviation Medicine, and where I developed connections with the other Av Med professionals I interact with on a regular basis. I have just recently employed someone whom I first met on a PVP 16 years ago!

So why should you come to a PVP? Firstly because it is fun. You get to spend a week hanging out with like-minded colleagues with a passion for aviation. Second, you will make connections with students, staff and industry that will stay with you for the rest of your life. And last, but not least, you will learn things by seeing and doing, that you will never be able to learn by reading books or articles.

The Taiwan PVP is an especially unique opportunity. This is the first PVP in Taiwan and it is unlikely we will be back there within the next ten years. We are going to get a taste of just about everything that aviation and aviation medicine has to offer in Taiwan, from commercial airlines, to military Av Med, to commercial and military aeromedical retrieval. The program outline has been circulated to you previously.
Taipei is also a wonderful city to visit. It is cheap, easy to get around and there are a number of interesting things to see and do within easy reach of our hotel. So don't miss out, book now to reserve your place!

I look forward to seeing you there. 
Ben Johnston
Read our Facebook feature about Dr Calum Young's takeaways from the 2017 PVP here.
Student Profile: Dr Hardeep S Hundal

I am a bit of a Jack of all Trades and Master of None (or perhaps one!!). I am also a Global Nomad: originally from Malaysia, I grew up in Europe and completed my education in the UK/Ireland. I am now a Kiwi and currently live in Auckland with my lovely wife Amrit and two young kids Harneel (7) and Harik (4). In Auckland, I have been working as a medical officer for Air New Zealand for almost three years.  
 
After completing my chemical engineering degree in the UK and medicine in Ireland, I came to New Zealand some 11 years ago. Initially I worked in the various surgical specialties. Then I decided to do emergency medicine and slowly branched out into General Practice. It was there where I met Rob Griffiths and he introduced me to the University of Otago programmes. Initially I did a Postgraduate Diploma in Occupational Medicine. It worked out very well and I have now completed the Master of Aviation Medicine.

Anyone who knows me well knows I am a “stickler” for aeroplane models. I have over 500 of them and YES, I am still collecting them. My wife thinks I am a professional hoarder and have an addiction problem. Believe me, I have asked several addiction specialists in town and they do not think I have an addiction problem! It’s just a hobby and everyone should have one. After all, it was my hobby that led to my interest in the job at Air New Zealand.
 
The role of a medical officer for an airline is an interesting one! It is a job with many hats: a combination of a general practitioner, occupational physician, aviation medicine specialist, addiction specialist, psychiatrist, counsellor, travel medicine specialist and emergency specialist. I believe my unique background in engineering and my exposure to the different specialties have prepared me well for this job. I do 60% of pilot medicals and enjoy communicating with fellow pilots. I am also a gate keeper and strike a fine balance between the regulators CAA NZ/CASA and the pilots.
 I see myself progressing to the role of Aviation Medical Specialist in the next 3-5 years. And in the next 10 years, hopefully to the role of Chief Medical Officer of a reputable airline. God willing!

The Master of Aviation Medicine is a four year distance learning course at Otago. I did consider alternatives, but the distance programme fits well with my work,  lifestyle and study time frame. Time really flies when you are enjoying your learning. I particularly enjoyed the Professional Visits Programme (PVP). I also enjoyed the networking with course participants (who are airline medical officers, air force medical officers, regulators, etc.). I also enjoyed the online quizzes and the essays we had to write.

I would definitely recommend this course to anyone with an interest in Aviation Medicine. This is one course you will enjoy and will not regret taking. Two of the most important aspects of this course are the networking and connections you make as well as the visits to various cities during the PVP (e.g., Dubai, Auckland, Calgary, Sydney, Kuala Lumpur, Phoenix, Lisbon).
 
Thank you Rob, David Powell, Ben Johnston and David Fitzgerald for all the kind encouragement you have given me! I wish you all the best.
Hardeep
Distance Learning Review

The University of Otago is conducting an independent review of distance learning across the university from a quality improvement perspective. Rob Griffiths is on the internal review team preparing materials for the external review, having been part of the team that developed the Distance Education Strategy for the University a number of years ago.

The key messages are that the University of the future will enable postgraduate students to learn in place, and be able to directly link their learning to their personal and professional development. Learning should be linked to the competencies that students need to achieve their work goals. Occupational & Aviation Medicine provides a good case study of how that can be achieved.

Other universities are thinking the same way (see EY's report on The University of the Future). There is a need for Universities to change (see NZ Productivity Commission's report on New Models of Tertiary Education), and we believe that Occupational & Aviation Medicine is leading the charge.
Report from the research desk (July 2018)
 
2018 was an audit year for the Performance Based Research Funding model under which NZ Universities such as Otago are funded (based on the research performance of their academic staff members). Rob Griffiths and Julie Myers were the NZ-based OAMU staff required to participate in the audit, which required preparation of a relatively detailed ‘portfolio’ of all their research related activity. The aim of the PBRF funding model is to encourage and reward research in the tertiary education sector; not by funding research directly but by supporting the research and post-graduate teaching. So while the success of Rob and Julie in terms of their research-related performance does not directly benefit the OAMU it is a vital aspect of ensuring funding streams for our post-graduate education activities are maintained.

From the Aviation Medicine desk, Hardeep Hundal and Ben Johnston have been involved in evaluating pilots’ opinion and attitudes regarding health promotion during their regular aero-medical certification exam, while Nic Emslie is developing a research plan to examine UVA exposures within the cockpit of flying aircraft. In other research news, Graham Denyer, from our Aeromedical Retrieval teaching team, is undertaking some work around determining the key competencies required in Aeromedical Assistance practice; Julie is due to submit her PhD thesis (examining the impact of fatigue on the non-technical skills of critical care transport clinicians) by the end of the year; and we are hopeful of getting a new PhD student project up and running in early 2019 (examining non-technical skills in the obstetric flight setting) in collaboration with the Department of Obstetrics, Gynaecology and Women’s Health.

In the Occupational Medicine programme Mark Newson-Smith and Rob Griffiths have previously developed a Virtual Reality (VR) site-visit platform and this has now been incorporated into the teaching programme. They are working on formally evaluating the impact of this on various aspects of learning (such as clinical decision making and communication). During the past 12 months Mark has given presentations at the Society of Petroleum Engineers International Conference (Health, Safety, Security, Environment, and Social Responsibility in Abu Dhabi) and participated in a panel presentation and discussion (Sustainable Health and Well being in the Oil and Gas sector: focusing on Human Capital inside and outside the fence). He has also given presentations about the emergence of Nanoparticles as an emerging occupational health challenge at the 5th Public Health Forum, Arab Health, in Dubai and at the 5th Etihad Aviation Health Conference in Abu Dhabi. Occupational Medicine PhD projects in fatigue-risk management and opioid use in the elderly are still in the pipeline, but as always their progression is dependent on many factors including funding.



Publications

Ady Wirawan, I. M., Griffiths, R. F., & Larsen, P. D. (2018). Cardiovascular tests for risk assessment in asymptomatic adults and implications for pilots. Aerospace Medicine & Human Performance89(7), 648-656. doi: 10.3357/amhp.5065.2018

Loke, S.-K. (2018). Explaining how students can learn the dispositional components of physical world actions by performing virtual world actions (Doctoral thesis, University of Otago, Dunedin, New Zealand). Retrieved from http://hdl.handle.net/10523/7974

Vuorio, A., Budowle, B., Sajantila, A., Laukkala, T., Junttila, I., Kravik, S. E., & Griffiths, R. (2018). Duty of notification and aviation safety: A study of fatal aviation accidents in the United States in 2015. International Journal of Environmental Research & Public Health15(6), 1258. doi: 10.3390/ijerph15061258

Myers, J. A., Powell, D. M. C., Aldington, S., Sim, D., Psirides, A., Hathaway, K., & Haney, M. F. (2017). The impact of fatigue on the non-technical skills performance of critical care air ambulance clinicians. Acta Anaesthesiologica Scandinavica61(10), 1305-1313. doi: 10.1111/aas.12994
New staff

In this issue of AvGas, we warmly welcome our new staff to the OAMU team.

Dr Ryan Deedo
Ryan has been an attending emergency medicine physician since 2009 within the Calgary Health region of hospitals in Alberta, Canada. He also started work as a transport physician for STARS air ambulance in 2009. His current roles include remaining on the transport physician roster but also of an assistant medical director for the STARS Calgary base and as the physician support for the Emergency Link Centre (dispatch for STARS). He is a clinical lecturer for the University of Calgary Department of Emergency Medicine. Prior to medical school he also worked as a basic life support paramedic.
 
Academically he obtained his medical doctorate from the University of Alberta. Then did his Royal College Fellowship in Emergency Medicine from the University of British Columbia in Vancouver. He has also completed a Diploma in Aeromedical Retrieval and Transport and a Masters in Aviation Medicine from the University of Otago.
 
Ryan lives in the city of Calgary in Canada with his wife, son, and two french bulldogs. He spends his free time fly fishing, hiking, and skiing in the Rocky mountains when he can.

Dr Annette Forrest
I am an intensive care consultant at Waikato Hospital in Hamilton New Zealand but dual trained in emergency medicine. I am the Medical Director for the Hauora Tairāwhiti Flight Nurse Team, Gisborne New Zealand and the Intensive Care team at Waikato Hospital. I have been in retrieval medicine for 20 years in prehospital, interhospitral and international in New Zealand, Australia and overseas.

I have a Masters in Aviation Medicine, Postgraduate Diploma in Aeroretrieval Medicine, Postgraduate Diploma in Occupational Medicine from Otago University and a Postgraduate Diploma in Toxicology from Cardiff University.

I live in Hamilton New Zealand, married with one son and a Rhodesian Ridgeback Puppy (see photo). I enjoy snorkeling in the Ningaloo Marine park in Western Australia when I can.

 
Dr Julian Eason
Julian is a Consultant Neonatologist and University Lecturer currently practising in the UK as an intensivist and Transport Consultant for the Peninsula Transport Service in the Southwest of England.

 
He is UK Paediatric and Neonatally trained in London with a Canadian Fellowship in Neonatology, also gaining a Masters degree at the University of British Columbia in Healthcare and Epidemiology. His interests in Neonatology are many but Neonatal Transport and Ventilation are a particular area of expertise. Starting out in the 1980’s he has undertaken Neonatal road, fixed wing and rotary transfers in the UK, Canada, and Europe and has recently set up and run courses in Neonatal Transport in a number of countries in the Middle East.

He was the British Association of Perinatal Medicine representative for the South of England from 2010-2012 and has been involved at committee level producing the UK Department of Health Neonatal Toolkit in 2009 and the NICE Standards for Neonatal Care in 2010. Having held a rotary PPL he has maintained an interest in aviation and medical evacuation throughout his career.

Spare time is usually spent rowing and racing Cornish Pilot Gigs from picturesque villages in Devon and Cornwall.

 
Julian Eason BSc, MBBS, DCH, MRCP, FRCPC, FRCPCH, MHSc, FHEA, Cert Aero RT

Maggie McConville
Maggie comes to us from the world of American higher education. After receiving her Bachelor’s in English from the University of Illinois at Urbana-Champaign, she went on to pursue a Master’s degree in Student Affairs Administration from University of Wisconsin-La Crosse.

As her time as an undergraduate advisor at the University of Illinois at Chicago came to a close, Maggie decided to trade one windy city for another and made the permanent move to Wellington earlier this year. She’s trying to get used to the fact that winter here doesn’t mean negative temperatures and snow days.

Dr Kin Loke
Kin has been supporting teachers in using educational technologies at the Ministry of Education (Singapore), the Nanyang Technological University (Singapore), the Otago Polytechnic, and the University of Otago. He has also researched the use of educational technologies. At OAMU, Kin's responsibilities include refining the online learning environment and supporting teaching staff. He is overjoyed that Maggie (see above) has taken over as the new OAMU programme manager.

Like Rabio the Octopus, Kin accurately predicted in May 2018 that France was going to win this year's FIFA World Cup. Other hobbies include annoying his teenage son by attempting to play the clarinet. 
 
Copyright © 2018 Occupational & Aviation Medicine Unit, University of Otago, Wellington. All rights reserved.
 
Contact us at:
23A Mein Street, Newtown, Wellington
PO Box 7343, Wellington South 6242
New Zealand
oamu@otago.ac.nz