Former University of Otago student and staff member Dr Pat Farry devoted nearly 40 years to providing rural health services and was intimately involved in rural health education for most of that time.

The late Dr Pat Farry: “I came to realise that, in the rural environment, we are always ‘the loss of one GP’ away from a crisis.”

Born and raised in Gore in a proud Lebanese family, Farry graduated from Otago with a medical degree in 1967. Following an initial interest in surgery, he went to Queenstown as a locum GP in 1971 and stayed. After five years, he opened the Queenstown Medical Centre, at the time only the second facility of its kind in New Zealand. His wife Sue, a physiotherapist, worked next door. Farry also served two terms on the Southland District Heath Board in the 1970s.

Farry’s experience as a Queenstown GP – with clinics in Glenorchy and Kingston at the far ends of Lake Wakatipu – fed his passion for rural medicine. He noted that outsiders found it funny that Queenstown was classed as rural, but it was two-and-a-half hours from specialist care and GPs had to deal with emergencies: the couple’s Combi van served as an ambulance, in high demand during the ski season.

“An evaluation of the [rural medical immersion] programme after 10 years confirms that it is particularly effective in influencing students with urban backgrounds towards working in rural or provincial centres.”

Farry renewed his association with the University in 1980, when he began lecturing in what became the Department of General Practice and Rural Health within the Dunedin School of Medicine. He subsequently held various positions within the department while continuing as a GP in Queenstown. He reckoned that he travelled between Queenstown and Dunedin about 1,600 times during his career.

Farry later reflected: “I came to realise that, in the rural environment, we are always ‘the loss of one GP’ away from a crisis.” Noting that most student doctors trained almost exclusively at universities and teaching hospitals, he felt that rural communities would continue to struggle to attract doctors if medical students had little or no exposure to life in rural general practice.

He responded in 2000 by initiating the seven-week rural health attachment for all fifth-year medical students, to try to encourage more doctors into rural practice. He later described how the initially resistant students went out in groups of three to rural teaching centres and came back saying that it was the best teaching and learning they had experienced.

Dr Martyn Williamson, an Alexandra GP who helped set up and now runs the rural health attachment programme, says that surveys have since confirmed its positive impact on recruitment and, for example, in giving students a greater understanding when they later work in hospitals and deal with rural practitioners.

Farry wanted to go further and set up a three-year programme for fourth-, fifth- and sixth-year medical students to immerse themselves in rural general practice, but the proposal foundered in a sea of health and education ministry bureaucracy.

After much lobbying by Farry, the government finally approved a one-year rural medical immersion programme, which began in 2007 as a pilot, with Farry as the programme director. While most fifth-year students spent the year in teaching hospitals, six students immersed themselves for the year in two rural centres: Queenstown, where Farry was based, and Greymouth.

Farry later recalled: “They had all expressed an interest in rural health as a career, had shown flexibility and resilience as students, had a track record of self-directed learning and an acceptable academic record. We were very lucky to get such good students: adventurous and willing.”

The number of students quickly increased to 12 and then to 20 under the innovative and successful scheme, and the number of teaching centres to six – Balclutha, Blenheim, Dannevirke, Greymouth, Masterton and Queenstown – linked by a videoconference tele-medicine network.

Dr Branko Sijnja, a long-serving Balclutha GP and director of the rural medical immersion programme, says that an evaluation of the programme after 10 years confirms that it is particularly effective in influencing students with urban backgrounds towards working in rural or provincial centres.

Farry also established a rural postgraduate programme in 2003 that now provides targeted postgraduate training for doctors working in remote general practice and rural hospitals across New Zealand and parts of the Pacific, in collaboration with the New Zealand College of General Practitioners.

Farry’s interest in rural health research impinged on his extensive overseas holidays, during which he gained insights into how rural doctors were educated and how they operated: observations he adapted to New Zealand conditions.

Researchers such as senior research fellow in rural health, Dr Fiona Doolan-Noble, are today building on that work, exemplified by a proposed study of the psychosocial impact on rural communities of the cattle disease mycoplasma bovis.

Among his other enduring contributions to the University, Farry founded the student-run Matagouri Club, which organises educational and social events for undergraduate students interested in rural medicine.

“There was always this warm, positive vibe about him,” Williamson recalls of Farry, “and an open-mindedness to ideas and determination to see things through.”

Farry received many accolades during his lifetime, culminating in being invested with a New Zealand Order of Merit in September 2009 for services to rural medicine. He died suddenly the following month while undertaking a short GP locum in Twizel, aged 65.

The Pat Farry Rural Health Education Trust was established following his death to continue his work through fundraising to provide grants and scholarships for continuing education or research in rural health, notably in providing travelling scholarships to sixth-year medical students to pursue rural health educational experiences overseas. Since 2011, 26 medical students have benefited from the trust’s scholarship programme, with the amount in grants and scholarships awarded now reaching $100,000.

The University’s various rural health initiatives are being brought together under a new Section of Rural Health, headed by Dr Garry Nixon, a rural hospital generalist at Dunstan Hospital in Clyde who has led the rural postgraduate programme since 2013.

“It will be an outward looking unit, the beginnings of a virtual campus, with about 30, mainly part-time, faculty dispersed across rural New Zealand,” Nixon explains.

Fittingly, it will embrace many of the programmes Farry established and be based on a model he developed.

Article published in the University of Otago 150th Magazine 2018