Transplant the focus of Heart Foundation Fellowship

Future New Zealand heart transplant patients are set to benefit from a Heart Foundation training fellowship that will see a New Zealand doctor working at a leading Canadian Hospital.

The Heart Foundation has awarded Auckland doctor Michael Stubbs an Overseas Training and Research Fellowship to work in one of Canada’s leading heart transplant centres where he will learn the latest techniques and teaching methods.

Michael will spend a year undertaking the heart failure and transplantation clinical fellowship at Toronto General Hospital, with a view to bringing the skills he learns back to New Zealand.

“It’s a heart failure and transplant centre that’s very highly regarded internationally, and they have large numbers of patients going through each year,” Michael says. “The clinical skills and experience that I gain with the world class team in Toronto, I can then bring back to our cardiology service in New Zealand. The New Zealand heart transplantation program is growing and maturing and it’s so important to get these skills from a larger, expert centre.”

In New Zealand approximately 15-20 heart transplants are performed each year, compared with the 40-50 performed annually at Toronto General Hospital.

It will also give Michael greater experience in the use of mechanical heart pumps prior to transplant.

“We’re really just kicking off our experience in New Zealand in respect to these devices, so learning from the team in Toronto will be an amazing opportunity,” Michael explains. “Although we’re doing it in New Zealand, the programme is just lifting off the ground. We’re now doing five a year or so with mechanical pumps, but I suspect that will grow.”

Using a mechanical device prior to transplant potentially increases the number of people able to benefit from the surgery.

Research to improve detection of inherited heart failure

Meanwhile, Michael will also carry out a research project in Canada which aims to improve early detection of inherited heart failure or cardiomyopathy through use of a family history tool he developed with the cardiac inherited diseases team.

“We postulated that we weren’t getting a full family history at the time of diagnosis,” Michael explains. “You’ve got someone in the clinic who has just been given a heart failure diagnosis, with a lot of new and sometimes daunting information shared. As such you can understand our patients forgetting to mention that their grandparents, for example, may have had heart failure.”

Accordingly, Michael developed a tool with questions that patients can take away and discuss with their families and bring back later.

Research undertaken to measure its value, showed that the proportion of people providing a full family history increased from 20% to 92%, when the new tool was used. Now Michael’s looking to extend that research with a larger group of patients in Canada.

“That first research piece was done in a specific heart transplant population,” he adds. “What I aim to do in Canada is to extend its use to all patients with heart failure and see if the tool needs further refinement.”

New Zealand clinical education to also benefit

Finally, he also hopes to gain valuable clinical education skills to bring back to Aotearoa on his return.

“My other passion in medicine is teaching,” he explains. “I completed a certificate of clinical education through Auckland University, and I plan to finalise that with a diploma of clinical education, which is two to three years of post-grad study. Toronto is a big teaching hospital, so learning the way they teach and the environment in which they teach and then bringing that back here is another big goal.

“I’m really grateful for the opportunity that the Heart Foundation is giving given me. I can gain skills and experience Canada that I can bring back here that I can apply to our healthcare and cardiology services.”

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