Medical opportunity of special scale? The future of rural hospitals in New Zealand?

Campbell Murdoch The current issue of the Journal contains a report by Nixon et al1 on the vocational registration and the recognition of a new scope of practice in rural hospital medicine in New Zealand. These initiatives are claimed to represent an opportunity to generate the skilled generalist medical workforce which New Zealand rural hospitals need to move into the future. There are about 120 rural hospital doctors working in 36 rural hospitals in New Zealand. Defined as “facilities with no resident specialists where acutely ill patients are admitted and cared for solely by generalist doctors, ” in 1998, these contained 293 acute beds and served a population of about 340,000. Apart from a small number of specialists, surgeons, physicians, and emergency physicians, the doctors are in two broad categories—50 % are rural General Practitioners (GPs) with part-time appointments, and 50 % are doctors with the intriguing title of Medical Officers of Special Scale (MOSSs) who work under general registration