Otago beyond Otago

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1920s, 1930s, 1960s, 1970s, 1980s, 1990s, 2000s, Auckland, Christchurch, clinical education, executive programme, Invercargill, medicine, public health, radiation therapy, teacher education, university extension, Wellington

In the late twentieth century changing government education policies allowed universities to become very entrepreneurial and expand into the territories of other institutions. Massey University opened a new campus in Albany, not far from the University of Auckland, in 1993 and merged with Wellington Polytechnic, not far from Victoria University of Wellington, in 1999. Otago’s first expansion into other territories came decades earlier, when New Zealand’s universities were under much stricter central control and direct competition was discouraged. The expansion resulted from a desire to provide improved clinical education for senior medical students, at a time when Otago had New Zealand’s only medical school.

In 1923 the undergraduate medical degree was expanded from five years to six, with the last year to concentrate entirely on clinical work. Finding sufficient clinical experience in Dunedin for the lengthened course proved difficult. Dunedin was New Zealand’s largest urban centre when the medical school began teaching in 1875, but by the 1920s Auckland, Wellington and Christchurch were all home to larger populations. The medical school began sending some of its sixth-year students to hospitals in the other main centres and in 1938 these were formally established as the Auckland, Wellington and Christchurch Branch Faculties of the Otago Faculty of Medicine. The Auckland Branch closed in 1972, as the first students of the new University of Auckland Medical School reached senior level (the Auckland course began in 1968).

An aerial view of Wellington Hospital in 1971, soon before its Branch Faculty of the Otago School of Medicine became a full Clinical School. Image courtesy of the Alexander Turnbull Library, negatives of the Evening Post newspaper, reference EP/1971/0946-F.

Meanwhile, big changes were afoot in Wellington and Christchurch. A major 1968 review of the Otago Medical School, undertaken by Professor Ronald Christie (Medical Dean at McGill University, Montreal), recommended big changes to the Otago programme. Noting the inadequate experience then available in Dunedin, Christie advised that, unless the medical school was to be downsized, it needed to expand its Christchurch or Wellington facilities into full clinical schools. After considerable political negotiation (with considerable resistance from advocates for the alternative of the University of Canterbury or Victoria University of Wellington opening their own medical schools) both Christchurch and Wellington became full clinical schools of the University of Otago, in 1971 and 1973 respectively. After the first three years of education, medical classes were divided into three groups, destined to spend the final three years of their education in either Dunedin, Christchurch or Wellington.

Since the 1970s the Christchurch and Wellington campuses, originally known as the Christchurch/Wellington Clinical Schools, have had name changes which reflect their expansion beyond the teaching of undergraduate medical students into other courses, and their significant roles in research and postgraduate education. In 1984 they were renamed the Christchurch/Wellington Schools of Medicine and in 2007 the University of Otago, Christchurch/Wellington. The Wellington campus now has nine academic departments, including radiation therapy, for which it is the sole national provider of undergraduate and postgraduate education. Its Department of Public Health also provides an undergraduate Certificate in Health Promotion by distance education. Wellington researchers, especially public health professors Philippa Howden-Chapman and Michael Baker, frequently appear in the national news. The Christchurch campus today has eleven academic departments, together with a Centre for Postgraduate Nursing Studies and Maori Indigenous Health Unit. Its postgraduate students have outnumbered its undergraduate medical students since the late 1980s.

The University of Otago’s activities beyond Dunedin have not been confined to the health sciences. In the late 1990s it moved into the competitive Auckland education market, offering an executive MBA and opening its Auckland Centre. That centre evolved into an information and liaison facility for Otago in the north, but still offers some Summer School papers and postgraduate distance courses. Closer to home, the university has run numerous courses around Otago and Southland over the years as part of the former Department of University Extension. Its adult education programme was very active in Invercargill and the Faculty of Commerce, among others, also offered various distance papers there for its degrees. The university opened an administrative centre in Invercargill in the 1970s, located in the Southland Polytechnic grounds – a sign of the cooperation between the two institutions in that period. The merger with the Dunedin College of Education in 2007 brought a new relationship between the University of Otago and Invercargill, because the college also had a Southland campus. The university now offers various teacher education programmes in Invercargill, including a degree specialising in primary bilingual education.

When people think of the University of Otago they often think of its iconic Dunedin campus, but it is clearly much more than that! Do you have any stories to share of the northern, and southern, campuses?

How to teach doctors

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1870s, 1880s, 1890s, clinical education, hospitals, medicine

Millen Coughtrey (1848-1908), the first professor of Otago’s Medical School. Photograph courtesy of Hocken Collections, University of Otago, S06-092.

Otago’s first medical professor, Millen Coughtrey, was not short of an opinion or two. Lancashire-born and Edinburgh-educated, he was appointed to the chair of anatomy and physiology in 1874, but resigned two years later after a disagreement with the university over his right to continue in private medical practice. Coughtrey stayed on in Dunedin and was a respected physician and participant in numerous community activities; he opened a private hospital at St Clair in the 1890s.

Two major published speeches by Coughtrey suggest he was an entertaining presenter. “I love plain speaking, wherever it is desirable, and I shall, therefore, not hesitate to point out whatever may seem to me to be defects and errors in the present means and methods of conducting the practice of medicine, and of preparation for that practice.” So he declared early in his Introductory address in the Faculty of Medicine of Otago University, given in May 1875 at the gathering “to cut the first sod of medical education in this Colony”. Twelve years later, the university invited Coughtrey back to deliver the graduation address; William Christie was awarded Otago’s first medical degree at this historic event, and it was also the occasion when Frederick Fitchett was awarded New Zealand’s first LL.D.

As well as more general discussion of university education, in his 1887 speech Coughtrey reflected on the history of the Otago Medical School and made suggestions for improvement. These ranged from the division of the heavy workload of anatomy and physiology into two professorial chairs (that finally happened in 1905) to the fostering of original research. Some of his most intriguing comments related to clinical education. More needed to be done, he said, in the way of “systematic instruction by the bedside in the hospital”; he was concerned that the public did not really understand this. “The presence of medical students in the hospital does not necessarily involve that the patients should be tortured, that the unfortunate sufferers should be percussed out of one disease into another.” On the contrary, claimed Coughtrey, medical students made the hospital a better place: they provided a “wholesome check” on senior staff, who did not want to perform badly under their gaze; under careful supervision they contributed to medical care, promoting “the early recovery of every ailing inmate”; and they lessened the workload of the nursing staff “by doing the practical dressing of patients’ wounds.” Coughtrey’s opinion of nurses of this period was scathing: “With some exceptions the nursing in New Zealand hospitals is simply execrable”.

Arranging adequate clinical experience for medical students is a perennial challenge, but it was probably never more difficult at Otago than in the nineteenth century. Medical students may have been few, but hospitals were also small and training opportunities there limited. Public hospitals were yet to become centres of technology, open to all; instead they were the last resort of the ailing poor, with admission severely means tested. Most people paid to receive private healthcare – including surgery – in their own homes. Dunedin Hospital had particular problems, and an 1890 Royal Commission thoroughly condemned conditions there.

Thankfully things have moved on considerably since the 1890s, in part due to the advocacy of Otago Medical School staff like Coughtrey who campaigned for improved hospital services for the public and better clinical education opportunities for their students. If you are asked to consent to the involvement of a medical student in your care, remember you are not only helping with their education, but may also be contributing to the betterment of health services!