Browsing by Author "Thomas-Maude J"

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Critically understaffed and with Omicron looming, why isn’t NZ employing more of its foreign-trained doctors?
(The Conversation Media Group Ltd, 2022-02-04) Thomas-Maude J; McLennan S
Health system resilience in the Pacific: A scoping review of Fiji’s COVID-19 response
(Elsevier Ltd, 2025-12-01) Thomas-Maude J; McLennan S
In mid-2021, Fiji recorded one of the highest rates of COVID-19-related deaths in the world, amidst a rapidly disintegrating health care system. This scoping review examines Fijian health system responses to the COVID-19 pandemic, exploring both the vulnerabilities and adaptive strategies that emerged during the crisis. Using a systematic search strategy to identify studies relating to how the Fijian health system responded to the COVID-19 pandemic, and what insights could be drawn about adaptive practices and resilience in this context, 71 papers were included. The findings demonstrate that while Fiji experienced significant workforce shortages, infrastructure constraints, and disruptions to routine healthcare, the pandemic response was also characterised by rapid policy adaptations, innovative use of some digital technologies, and strong community-led initiatives. However, challenges with public trust and culturally inclusive governance remain key areas for consideration. By applying a health system resilience framework that explores the tangible and intangible dimensions of health systems, this review offers insights relevant both for Fiji and the region. Strengthening local capacity, investing in sustainable infrastructure, and embedding Indigenous and other local knowledge in public health strategies are crucial steps toward building resilient Pacific health systems and preparing for future crises.
Mobility justice, capabilities, and medical migration: Medical licensing pathways for overseas-trained doctors in Aotearoa New Zealand
(Taylor and Francis Group on behalf of the Geographical Society of New South Wales Inc, 2023-08-19) Thomas-Maude J
The field of medicine is traditionally associated with opportunities for training and knowledge sharing through movement and travel. Nevertheless, the contemporary migration of doctors may have negative impacts on lower-income countries. Some scholars argue for active restrictions on South to North migration of medical doctors, while others consider such suggestions as an unjustified infringement on individual rights to migrate. This paper draws on mobility justice and the capabilities approach, to conceptualise the complex dynamics of international medical migration through the example of Aotearoa New Zealand. In this context, a ‘brain drain’ of New Zealand-trained medical doctors is partially mitigated by a ‘brain gain’, with more than 40% of the medical workforce having trained overseas. However, overseas-trained medical doctors follow pathways to licensing determined by the public health indicators of their countries of training. Despite an overall ‘brain gain’, doctors who trained in the Global South experience significantly greater barriers to registration than those who trained in Global North countries. Many are unable to work as doctors, resulting in a ‘brain waste’ of their knowledge, experience, and capabilities. This may relate to (post)colonial legacies and discourses of medical competencies that underscore the hegemony of the Global North, warranting further exploration.