Preparing for the health professions

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1870s, 1880s, 1900s, 1940s, 1960s, 1970s, 1980s, 1990s, 2000s, anthropology, biochemistry, biology, chemistry, dentistry, English, mathematics, medical laboratory science, medicine, pharmacy, physics, physiotherapy

A familiar sight to HSFY students of recent years – popular teacher Tony Zaharic of the biochemistry department. Image courtesy of University of Otago Marketing and Communications.

Health Sciences First Year (HSFY) is a term very familiar to anybody who has been around the university over the past couple of decades. Students aiming to enter one of Otago’s undergraduate health science degrees – dentistry, medical laboratory science, medicine, pharmacy and physiotherapy – complete this shared course in their first year of university study. Entry to the professional degrees is also available to some graduates, but most come via the HSFY course, which brings a large number of students to Otago. The course has undergone a few changes since it first appeared under this guise in 1998 and it was built on a much older tradition of the ‘intermediate’ year; I thought it would be interesting to look back over the long history of first year health science courses.

When the medical school started out in the 1870s it could only offer the first two years of a medical course and students headed overseas – most often to Edinburgh – to complete their training. Prospective doctors had to register as medical students, which required them to pass a ‘preliminary examination in general education’. Once registered, medical students started out on their two-year course in chemistry, biology, anatomy, physiology, surgery and clinical instruction at the hospital. From 1885 students could complete their entire medical course at Otago. To obtain a New Zealand medical degree, they needed to pass an intermediate exam, followed by three professional exams. The intermediate exam covered a general university science prospectus of biology, physics and chemistry.

The dental school opened in 1907, offering a four-year degree, later extended to five years. Students had to formally register for the course and this required passing the same preliminary exam as medical students. Also like medical students, they took the standard first-year courses in physics and chemistry, but added to the biology requirement was a course in dental anatomy. There was little rest for dental and medical students, for as soon as their first-year exams were over they commenced their specialist courses with a ‘summer term’. For many years there was, however, no competition for places: anybody who could pay the fees, complete the courses and pass the exams could qualify as a doctor or dentist.

In 1941, faced with rising student numbers and significant overcrowding, the Otago medical school for the first time limited entry to its second-year classes, initially to 100 students. Some places were reserved for graduates and people repeating second year, but for most students entry came through obtaining the best exam marks in the intermediate course. No intermediate medical student could afford to rest on their laurels now: competition for entry to medical school varied from year to year but was generally tough. Some of those who did not gain entry to the medical course instead enrolled for dentistry. From 1945 the specialist dental course disappeared from first year and prospective dentists took exactly the same intermediate course as prospective doctors, that is, first-year chemistry, physics and biology (zoology and botany). Unsurprisingly, the dental course then became crowded, exacerbated by an influx of returned servicemen to university. From 1947 entry to second-year classes in the dental school was also limited, initially to 50 places.

Dental students working in the prosthetics lab in 1949. Before reaching this stage they had to overcome the hurdle of a competitive intermediate year. From left: Brian Arkinstall, Jim Armour, Reece Baker, Clive Bayley, Rod Beattie and Nick Bebich. Image courtesy of Elaine Donaldson.

The medical school began offering a Bachelor of Pharmacy degree in the 1960s, though most New Zealand pharmacists trained through a technical institute diploma course until 1991, when Otago’s newly independent school of pharmacy became the country’s sole training programme for pharmacists. The intermediate year for pharmacy was the same as that for medicine or dentistry – chemistry, biology and physics.

The intermediate health science courses remained essentially unchanged for many years, though there were of course some changes to the content of the basic science courses, reflecting new scientific developments. Over time, though, questions arose about the suitability of the criteria for entry to health science courses: did New Zealanders want their doctors and dentists selected purely through their ability to obtain top marks in science exams? Academic ability and scientific understanding were clearly important, but the best health professionals also needed some sympathetic understanding of the human condition and good communication skills. Extensive changes to the medical curriculum in the 1970s included modifications to the long-standing biology/chemistry/physics requirement of the intermediate course. From 1973 students took four subjects in their intermediate year: chemistry, biology and any two subjects of their choice from the arts or sciences (those who hadn’t got 50% or more in either maths or physics at bursary level had to include one of those among the two options). While some students stuck with the sciences, others branched out, with anthropology a popular choice. From 1981 students without an arts background were forced to think more laterally, as those without 50% or more in an arts subject at bursary level had to include an arts paper in their medical intermediate programme. The dentistry intermediate also added a fourth subject, taken in any of the arts and sciences, in 1980. Pharmacy retained a more scientific focus for longer. It added a statistics paper to its biology, chemistry and physics intermediate year from 1975. It was not until 1988 that pharmacy intermediates had a wider choice: they could then choose between physics and statistics, freeing them up to take their fourth course from any within the science, arts or commerce offerings.

Concerns remained about the communication skills of the medical profession. In 1993 the English department introduced a new paper primarily designed for health science students (though also open to others): ‘language, style and communication’, an ‘introduction to the fundamentals of effective speaking and writing’. This became a compulsory part of the intermediate years for medicine and pharmacy, unless a student had a good pass in bursary English; dental students were also advised to take an approved English paper from 1995.

1998 brought the biggest change yet to intermediate courses, with a completely revamped programme named Health Sciences First Year. Controversially, the course had to be taken in Dunedin; previously students had been able to complete their intermediate year at any university. Cynics noted that this increased Otago’s student numbers and thereby its funding. This was undoubtedly true, but there were also sound academic reasons behind the change. First, it was difficult to make fair comparisons between applicants who had obtained their grades in intermediate subjects at a variety of institutions. Second, and more important, Otago could now tailor its Stage 1 courses more closely to the needs of the health sciences and transfer some of the overcrowded specialist curriculum into first year. The course included two brand new compulsory papers – foundations of biochemistry, and chemistry: molecular reactivity – together with the biology of cells and biology for health sciences. Students without exemptions also needed to complete introductory physics, introductory biostatistics and the English language, style and communication paper. Students needed a total of 8 papers, leaving them to choose between 1 and 4 other subjects. This course became the common intermediate year for medicine, dentistry, pharmacy, medical laboratory science and physiotherapy degrees. The change was most radical for physiotherapy, which previously had a tightly-structured first year programme with papers specifically designed for the profession (the Bachelor of Physiotherapy degree was jointly taught by the university and Otago Polytechnic from 1991, with the university taking sole responsibility from 1996).

HSFY was modified over the years to cater for changing health priorities and learning needs. Biostatistics morphed into epidemiology, a specialist biological physics paper was added, the compulsory English paper was dropped (except for those who failed a diagnostic test) and in 2007 a new acronym – HUBS – entered the Otago lexicon. ‘Human body systems’ replaced the former biology papers; it was a significant modification aimed at improving students’ self-directed learning skills. Throughout, the HSFY course attracted many enrolments and competition for entry to second-year classes in the professional degrees remained intense. Debate continued – and will probably never end – over selection methods. Grades remain the number one criterion, but some courses now also require prospective students to pass a psychometric test, the Undergraduate Medicine and Health Sciences Admission Test (UMAT), a widely-used tool devised in Australia. At Otago UMAT became part of the admission process for medicine in 2003, for dentistry in 2005 and for medical laboratory science in 2007; the dental school also interviewed prospective students from 2005. For some decades a number of places have been reserved for the best Maori and Pasifika applicants, because New Zealand needs more Pacific Island and Maori health professionals, while more recently the medical and dental programmes have also targeted students from rural backgrounds with a commitment to rural practice, to help overcome serious shortages of rural health practitioners.

Are you a survivor of HSFY or one of the older intermediate courses? Do you have any memories to share?

Heading to the hills

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1920s, 1930s, 1940s, climbing, recreation, sports, tramping

The 1100 or so students at Otago in the 1920s were an energetic bunch and a number of sports thrived, notably athletics, rugby, tennis, netball (then called basketball), hockey and boxing. The 1920s also witnessed the birth of one of the most enduringly popular clubs on campus: the Otago University Tramping Club. Tramping was just taking off in New Zealand in the 1920s. Walking for recreation had been popular for many years and climbing also had its devotees, but tramping, involving more energetic walks, often in the wilderness, was something new. Wellington’s Tararua Tramping Club was the country’s first, founded in 1919, and eight more clubs emerged during the 1920s, including the Otago Tramping Club in 1923 and the Otago University Tramping Club in 1927.

A group of energetic 1920s students with the summit of Mt Park in the background. From the Otago University Review, September 1925.

Groups of Otago students had already been out exploring the southern wilderness before the club began. The Grave Talbot Pass in the Darran Mountains is named in honour of two Otago graduates, William Grave and Arthur Talbot, who pioneered this link from Lake Wakatipu to Milford Sound in the 1910s. The pass would prove too strenuous for most tourists, but the valleys leading up to it on both sides were made more accessible by groups of students who formed the tracks, working over the summers between 1914 and 1925. An article in the September 1925 Review recounts their adventures of the last two summers, including life in campsites, on the track, and scaling mountains. They named a lake after George Thompson (French lecturer and chair of the professorial board) and a mountain after James Park (head of the School of Mines). Another mountain became Students Peak. An ascent of Mt Christina took four days, with the day they reached the summit fuelled by ‘an excellent breakfast of cocoa, porridge, and cold boiled kea’. Many will relate to their ‘perpetual war with the innumerable army of sandflies’! A newspaper article names those who scaled Mt Christina and Mt Park that summer as Kenneth Roberts, William Grave, George Moir, RSM Sinclair and Henry Slater, all former Otago students. Those who worked on the track in 1920 are named in another newspaper article as Merville Harris, David Jennings and Stewart Crawford, all medical students, and dental student Joseph Tanner.

These were strictly all-male adventures, but one of the joys of the tramping club was its accessibility to both men and women, with romance sometimes flourishing in the great outdoors or at the club’s social gatherings. The earliest reports I’ve found of the club are from 1929, when it was in its third season. The new committee elected late that year included Mr W.M. Stothart (the president, who sadly died over the summer), Miss E. Labes, Miss W. Fairbairn, Miss B. Dash, Mr B.C. Bellhouse and Mr Russell. That year ‘every holiday has seen happy parties of enthusiastic walkers out in the open country, which so fortunately forms the environment of Dunedin’. Some students might find mountaineering too much but could, as the 1930 report noted, ‘appreciate the joy of a brisk tramp, with its accompaniments of wood-fires and billy-teas’. Among the ‘scenic resorts’ explored by university trampers in 1930 were Harbour Cone, the Spit, Red Hut, Mount Charles, Tomahawk Creek and Chain Hills Tarn. Many of these were day outings, but some trips went further afield. In 1938 the club had ‘over thirty enthusiastic members’ who took part in day trips, two weekend trips (Mt Misery and Silver Peaks via Evansdale) plus a five-day excursion ‘to the various places of interest about Lake Wakatipu’.

Numbers waxed and waned, with some years finding more dedicated trampers than others; the club was always keen to recruit new members. ‘A good outing, providing both exercise and glorious scenery is assured’, stated a report in Critic in 1931. The club’s aims were stated in the front of its trip diary, started in 1940. It wanted to ‘foster tramping activities’ and ‘break down the barrier of interfaculty isolation’. It was also keen to ‘inculcate in members the canons of good tramping’. These included ‘a love of natural beauty and the outdoors; a respect for private property; a scrupulous care regarding fires; an idea of what is adequate in the matter of equipment and food; a sense of obedience to one and only one leader; and a realisation that a party must always keep together’.

A 1929 Critic notice provided advice for beginners on how to ‘dress for the occasion’. A ‘haversack is far preferable to a young suit case. On the longer trips women will find skirts rather a hindrance and are strongly advised to wear “strides”. Then again boots or shoes should be stout, comfortable and nailed; and of course do not wear a collar and tie, because it simply is not done in the best circles’. Clearly practicality was important, and the trip diary for the first tramp of the year in 1940 comments that over lunch there was ‘some amusement … at the President’s expense – in connection with his bootiful hat – a blue velvet beret’.

A club outing at Mihiwaka, 1946. Image courtesy of the Hocken Collections, from an Otago University Tramping Club album, 96-063-36, S15-592b.

In appealing to potential members, the club had a few prejudices to overcome. A 1947 report emphasised that it was not all about extreme fitness: ‘We are convinced that the only thing which keeps our membership below the 100-mark is the popular illusion that a tramper is one who steams round the landscape at a steady 20 miles per hour, bowed to earth by a Bergan of the size and shape of a young bungalow. This is false – such a figure is only to be met with in the vulgar and more pushing clubs, such as the Tararuas. We prefer to stroll gently along with fitting dignity, stopping for the regulation ten minutes in every half-hour. Of course we have a large number of young “keen types” in our membership, but many of us are completely decrepit.’

Over the years many people have been introduced to the joys of tramping and to the beauties of the natural world around Dunedin and further afield through the Otago University Tramping Club. There has been the occasional tragedy along the way, but for most it has been a positive experience. This post has concentrated on its early years – to anybody wanting to learn of its later history I recommend the highly entertaining book 45 Years of Antics: Adventures and Escapades of the Otago University Tramping Club, published by the club in 2006. This is a compilation of articles from its magazine, produced annually (with a few gaps) from 1960; editor Kevin Lloyd also tracked down a club trip diary from 1934 to include.

Among the brightest and the best

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1900s, 1920s, 1930s, 1940s, 1950s, 1960s, 1970s, 1980s, 1990s, 2000s, 2010s, anthropology, botany, economics, geology, law, medicine, physics, Rhodes, scholarships, sports, vice-chancellors, women

James Allan Thomson, New Zealand’s first Rhodes Scholar, as he appeared in the Auckland Weekly News, 7 July 1904. Image courtesy of Sir George Grey Special Collections, Auckland Libraries, AWNS-19040707-7-2.

The Rhodes Scholarship – one of the most prestigious academic awards in the world – has shaped the lives of some of Otago’s most gifted graduates. The scholarship, which provides for study at Oxford University, has been awarded since 1902 thanks to a generous bequest from Cecil Rhodes. Rhodes, an English clergyman’s son and Oxford alumnus, made his fortune as a mining magnate in southern Africa. He was an ardent promoter of the British Empire and played a large hand in African politics as Prime Minister of Cape Colony in the 1890s. His business ethics and racial views seem highly suspect today, but the purpose of the scholarship he founded – to promote peace and civic leadership by bringing together young people from the British colonies, Germany and the USA to further their education – remains admirable. The scholarships provide tuition and living costs for two or three years of study at Oxford; they are awarded to young people who demonstrate a combination of intellect, moral character, leadership, physical vigour, and an unselfishness which will lead to a commitment to public service.

There have now been 219 Rhodes Scholars from New Zealand. This country was generally allocated one scholarship per year from 1904, with two per year from 1926 until 1993, when the allocation was increased to three. Otago has a proud record of producing 61 of New Zealand’s Rhodes Scholars, and for some years now has been neck-and-neck with the much larger University of Auckland for first place honours. Rhodes Scholars are, by definition, outstanding people. All have interesting stories and it is not possible to recount them all here. Some feature in items produced to celebrate the centenary of the scholarship, including an Otago Magazine article and an exhibition at the University of Otago Library Special Collections.

Otago’s – and New Zealand’s – first Rhodes Scholar was a geologist, Allan Thomson. He taught at Oxford and worked in Australia before returning to New Zealand, where he was a palaeontologist with the Geological Survey before becoming director of the Dominion Museum. He made major contributions to the organisation of science in this country before his life was sadly cut short by tuberculosis (his initial diagnosis prevented him from taking up a position on Robert Falcon Scott’s Terra Nova expedition to Antarctica).

A considerable number of Otago Rhodes Scholars continued their careers beyond these shores. For example, there were several from the 1930s – when there were fewer scholarly opportunities in New Zealand – who became well known: doctor and Olympic champion Jack Lovelock (1931), journalist and war correspondent Geoffrey Cox (1932), Oxford English professor Norman Davis (1934), and writer and publisher Dan Davin (1936). Quite a few, like Davis, continued their academic careers at Oxford and other overseas universities.

Arthur Porritt in 1923, the year he was awarded a Rhodes Scholarship. Image courtesy of the Alexander Turnbull Library, S P Andrew Ltd :Portrait negatives. Ref: 1/1-018584-F.

Other scholars brought their overseas experience back to New Zealand. Where leadership is concerned, the best known is Arthur Porritt (1923).  At Oxford he completed the medical studies begun at Otago and went on to a stellar surgical career in England, becoming president of the Royal College of Surgeons and British Medical Association. He was also a stellar athlete; his bronze-medal win at the 1924 Paris Olympics was represented by the fictional Tom Watson in the film Chariots of Fire. From 1967 to 1972 Porritt returned to New Zealand and served as the first locally-born Governor General.

Sir Arthur and Lady Porritt in vice-regal splendour for the opening of parliament in 1968. Image courtesy of the Alexander Turnbull Library, Further negatives of the Evening Post newspaper. Ref: EP/1968/2679/6A-F.

Some Otago Rhodes Scholars returned to their alma mater and took up significant leadership roles. Hubert Ryburn (1921) was a mathematics scholar and Presbyterian minister; he sat on the University Council from 1946 and served as Chancellor from 1955 to 1970. Otago managed to entice another former Rhodes Scholar, Robert Aitken (1924), back to New Zealand to serve as its first full-time administrative head in 1948. Aitken left his position as Regius Professor of Medicine at the University of Aberdeen to become Otago’s vice-chancellor; he left in 1953 for a position as vice-chancellor at Birmingham. A more recent vice-chancellor, David Skegg, was also a Rhodes Scholar (1972). Skegg, who graduated top of his class at the Otago Medical School, relished the opportunity to study at Oxford with distinguished medical epidemiologist Richard Doll. In 1980, at just 32 years, Skegg returned to Otago as Professor of Preventive and Social Medicine, skilfully leading that department until 2004, when he became a popular vice-chancellor. He left that role in 2011, but continues as a highly respected research professor to this day.

David Skegg outside the Bodleian Library at the time of his graduation with an Oxford D Phil. Image courtesy of David Skegg.

Others also returned to Otago, sometimes briefly, and sometimes to make a career. A couple of recent examples are Jesse Wall (2008), now on the law faculty staff, and bioethicist Tom Douglas (2003), who remains at Oxford but visited last year to foster research links with Otago staff.

Athletes Porritt and Lovelock weren’t the only famous sportsmen on Otago’s Rhodes list, which also features two All Black captains, Chris Laidlaw (1968) and David Kirk (1985). For Kirk, like some others, the scholarship provided an opportunity to branch out from his original field of study. He was a medical graduate, but studied PPE (politics, philosophy, economics) at Oxford, returning to a career in politics, then business, in New Zealand and Australia. For Kirk, Oxford also provided a welcome respite from his celebrity status in New Zealand as Rugby World Cup-winning captain.

Cecil Rhodes’s will limited the scholarship to men. By the 1960s this had become a sore point, and from 1968 to 2000 Rhodes Visiting Fellowships were awarded so women who had already embarked on academic careers could also benefit from time at Oxford. Only 32 of these fellowships were awarded, so it is remarkable that 11 went to New Zealand women, two of them from Otago: archaeologist Helen Leach (1980) and lawyer Mindy Chen-Wishart (1992). In 1977 an Act of Parliament overturned the gender restriction and made the original scholarships open to women. Otago’s first woman Rhodes Scholar was law student Christine French (1981); since then women have accounted for just over half of the Otago recipients. The Rhodes Project, established by one of the first American women Rhodes Scholars to promote public understanding of female achievement, provides information about some of the Rhodes Scholar women and their subsequent careers.

Though Otago’s first Rhodes Scholar was a scientist, the list is dominated by arts, law and medical students; the most recent Otago science student to win a Rhodes was Jane Larkindale (1996), who majored in plant biotechnology and physics and is now a research scientist in the USA. Commerce students are even rarer, though Louis Chambers (2013) was a student of economics as well as law. Talented commerce and science students of today might like to consider this a challenge!