Australian Medical Association South Australia Inc. Level 7, 431 King William St, Adelaide SA 5000 PO Box 685, Fullarton SA 5063
Telephone: (08) 8361 0100
Email: medicsa@amasa.org.au www.ama.com.au/sa
Membership: membership@amasa.org.au
EXECUTIVE CONTACTS
President Dr John Williams: president@amasa.org.au
CEO Nicole Sykes: nsykes@amasa.org.au
medicSA
Editorial
Medical Editor: Dr Roger Sexton editor@amasa.org.au
Advertising medicsa@amasa.org.au
ISSN 1447-9255 (Print) ISSN 2209-0096 (Digital)
DISCLAIMER: Neither the Australian Medical Association South Australia Inc. nor any of its servants and agents will have any liability in any way arising from information or advice that is contained in medicSA. The statements or opinions that are expressed in the magazine reflect the views of the authors and do not represent the official policy of the Australian Medical Association South Australia unless this is so stated. Although all accepted advertising material is expected to conform to ethical standards, such acceptance does not imply endorsement by the magazine. All matter in the magazine is covered by copyright, and must not be reproduced, stored in a retrieval system, or transmitted in any form by electronic or mechanical means, photocopying, or recording, without written permission. Images are reproduced with permission under limited license.
COUNCIL & BOARD
AMA SA Council
President: Dr John Williams
Vice President: A/Prof Peter Subramaniam
Immediate Past President: Dr Michelle Atchison
Chair: Dr Karen Koh
Ordinary Members
Dr Vikas Jasoria
Dr Emily Kirkpatrick
Dr Bridget Sawyer
Dr Krishnaswamy Sundararajan
Dr Hannah Szewczyk
A/Prof William Tam
Dr Isaac Tennant
Specialty Group Representatives
Anaesthetists: Dr Louis Papilion
Dermatologists: Dr Karen Koh
Doctors in Training Representative: Dr Hayden Cain
Emergency Medicine: Dr Cathrin Parsch
General Practitioners: Dr Chris Moy
Intensive Care: Dr Raj Ramadoss
Ophthalmologists: A/Prof Michael Goggin
Orthopaedic Surgeons: Prof Edward (Ted) Mah
Pathologists: Dr Shriram Nath
Physicians: Dr Andrew Russell
Psychiatrists: Prof Tarun Bastiampillai
Surgeons: Dr Christopher Dobbins
Regional representatives
Southern: Dr Jerida Keane
Northern: Dr Alice Fitzpatrick
Public Hospital Doctors Representative: Dr Clair Pridmore
AMA SA Board
Dr John Williams (Chair)
A/Prof Peter Subramaniam
Dr Shriram Nath
Dr Bridget Sawyer
Prof Tarun Bastiampillai
Prof Edward (Ted) Mah
Ms Megan Webster
PRESIDENT President’s Report
It was noted by a friend from medical school with whom I graduated that I would probably have been voted as the most likely in my year to become AMA SA president. Not particularly political in nature. Certainly not interested in media and public speaking. So how did I get here? As I approach the end of my term as president I’ve been pondering that question.
I joined the AMA in 1996 as I saw it as a respected and relevant organisation. But I didn’t particularly understand the AMA’s inner workings.
I remained a member as my life and career continued. Paediatrics, obstetrics, ED and then into general practice where I - as do mostencountered the immensely frustrating daily barriers to patient care delivery.
I managed this with regular rants with colleagues in the tearoom. Enjoying the collegiate support and camaraderie but ultimately facing fatigue and burnout as I struggled against the feelings of ineffectiveness.
I would now be able to attach better words to what I experienced then. The moral insult of being tasked with patient care without the required and often basic resources to deal with patients in front of us. The difficulty of advocating for our patients in an increasingly fragmented and confusing system.
Seemingly out of the blue in the late ‘90s, I was invited by AMA SA to go with GPs from all over Australia to Canberra to meet personally with the Health Minister, our local members of parliament and other people in power.
Dr John Williams
I have little clear memory of what happened in that whirlwind visit. But I do clearly remember the feeling that I can only equate to ‘having the curtains drawn back’. Or, in The Matrix terms - I took the ‘red pill’.
We would all like to believe that sensible and informed ideas have the most traction. But the reality is there are many competing forces. It’s commonly called politics.
The AMA’s role is to take those informed, evidence-based and sensible ideas to those who have the power to promote them and, through listening and discussion, find ways to advance those ideas. It’s commonly called advocacy or lobbying. The AMA is consistently voted one of Australia’s most ethical and effective lobby groups.
It did my mental health and wellbeing a world of good to be involved with the AMA. It has been a privilege to serve my fellow rural GPs in helping negotiate the most significant and innovative rural GP contract. It has been amazing to work with our junior doctors to advocate for a safe workplace.
On a daily basis I make a difference. What an honour and privilege.
Thanks to all those AMA SA Board, Council and committee members who have my back. And thanks to those members who continually feed me the information I need.
I hope I have been your voice. I hope I’ve helped advance AMA SA so we can continue to be your voice now and into the future.
CEO
Nicole Sykes
As we embrace 2025 with renewed energy and purpose, we extend a warm welcome to both our existing and newest members. This year already promises significant opportunities to influence positive change with key initiatives underway. Together, we will continue to champion the highest standards of medical practice and advocacy, ensuring our commitment to healthcare excellence remains steadfast.
Firstly, our move into new offices on the corner of King William Street and South Terrace provides modern facilities enhancing and modernising our membership services. The enthusiasm of our team is at an all-time high, and we are ready to deliver what promises to be a productive and effective year with a shared focus on delivering value to our members.
We hit the ground running welcoming South Australia’s interns in January. Looking ahead, our calendar is packed with events designed to empower, inspire, and connect the medical community in South Australia. We’re particularly excited about our speed mentoring sessions focussed on finance. It’s a vital area of knowledge for our members navigating the complexities of financial management across their professional journey. We’re also proud to announce the upcoming Medical Women in Leadership Breakfast, set to inspire and elevate the conversation around female leadership in the medical field, featuring prominent thought leaders.
The pinnacle of our social calendar will undoubtedly be the AMA SA Gala. This event promises to be a memorable evening of
celebration and reflection, as we acknowledge the inspirational contributions of our outgoing president, Dr John Williams and warmly welcome new leadership.
I hope you have seen the advertising for the critical roles of President and Vice President of AMA SA. Aligned with our mission to lead and advocate effectively, these key positions are instrumental in shaping the future of healthcare advocacy. We encourage all passionate members to consider registering their interest in these pivotal roles. Stay tuned for more details.
Finally, we look forward to introducing our corporate subscription for business support, tailored to enhance the operational capabilities of our members’ practices. Further information will be shared through our normal communication channels very soon about what this entails.
As we embark on this exciting year, your active participation and engagement will be key to our collective success. I encourage you to contact our team if you’re interested in further information about services or our advocacy.
AMA SA’s new office on King William Street
AMA SA Gala 2025
Saturday 28 June
SkyCity Ballroom
Click here for more details
Medical Editor
From the Dr Roger Sexton
Over the past four years, we have seen here and overseas ongoing scepticism about research evidence and the advice of experts. These two things go to the heart of what we do as a profession and how we develop the evidence for our treatments.
The rapid development of the COVID-19 vaccines was quite miraculous, bringing new and accelerated processes of vaccine development to the forefront. Suspicion was aroused, however, as adverse events affecting patients in the community from vaccines produced in this way were broadcast for all to see.
Population groups became tired of restrictive advice, medical missives and statistics, and less trusting of scientific and medical evidence. Some choose to ‘do their own research’ and exercise their right to refuse and question the evidence.
At a time when governments did not know what they were dealing with, politicians regularly stood beside chief medical officers stating to an increasingly tired and doubtful public that they were acting on the ‘best medical advice and evidence’. In doing so, the trust in us and the science we rely upon was tainted. The stress placed upon the network of chief medical officers across the country was profound.
Here we are in 2025, and the perception of risk posed by COVID has faded. But the threats remain. In the post-COVID setting and with the rise of artificial intelligence and factual distortion, trust has never been more important.
In terms of patient care and public health, our own adherence to medical science and evidence-based care remains paramount, but defending it now will take more effort. Allowing others to gradually devalue, erode or try to borrow our professional skills must be resisted.
In the end, when trust in so many things is being lost, we must stand tall and earn it. Patients deserve to spend time with a skilled doctor who is a truthful and caring communicator. Time, talent, trust and TLC. These are the ‘four Ts’ that patients need.
We must solve problems to remain relevant. Some take longer to solve than others. An appendicectomy has an immediate clinical and statistical impact. Preventing a stroke is a different matter. What matters is the adherence to the science and art of our profession while solving the problems of the health system.
Loss of trust is now pervasive across society. Think fake news, photographs, AI. We must actively work to preserve trust in our profession by celebrating our expertise and our precious skillset and adhering to providing the ‘four Ts’ at every opportunity. A return to spending more time with patients and care through face-to-face medicine, underpinned by professionalism and authenticity is worth the effort.
Enjoy this edition of medicSA and see what your colleagues and AMA are doing to solve problems. As always, I welcome your feedback and comments. roger.sexton@bigpond.com
Are you our next President or Vice President?
Your leadership can make a difference
This is a rare opportunity to drive AMA SA’s advocacy, lead growth in our organisation and support other doctors to successfully practise medicine.
Doctors of all ages and career stages are eligible. Being a member is the only requirement. We prioritise diversity, equity and the advancement of women in healthcare leadership.
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FUTUREPROOFING
HEALTHCARE
Australia’s two major political parties have promised to spend billions of dollars to strengthen Medicare with more bulk-billing and more doctors. The AMA has welcomed the historic investment but says its ‘Modernise Medicare’ plan sets out a vision for the kind of generational reform Australia needs.
AMA President Dr Danielle McMullen explains the AMA’s plan to overhaul Medicare rebates and expand the GP workforce.
Both major political parties have already made it clear healthcare will be a major theme of this year’s federal election campaign.
Before the starting gun for the campaign had even been fired, both parties announced a historic funding commitment for general practice and Medicare.
Labor came out first, committing $8.5 billion in funding – the largest funding announcement since the advent of Medicare in the 1980s.
The Coalition swiftly matched this pledge, effectively guaranteeing this investment regardless of the outcome of this year’s poll.
This bipartisan recognition of the need for significant investment in primary care is a tremendous step forward for our healthcare system and follows years of campaigning by the AMA and, most recently, our ‘Modernise Medicare’ campaign.
It shows both sides of politics understand the funding shortfall that needs to be reversed to overcome decades of underinvestment and improve the sustainability and affordability of general practice.
The federal government initially tripled the bulkbilling incentive for concession card holders and families with children in 2023. Labor, and now the Coalition, have promised to extend this incentive to all Australians from 1 November, with an additional incentive for practices that bulk bill all their patients.
We know patients have been delaying care due to cost, and that saddens me. We urgently need investment and reform to turn that around.
The announcements from Labor and the Coalition this February will do part of that – improving the sustainability of our most vulnerable practices, and perhaps allowing some practices that have recently commenced charging a private fee to return to bulk billing.
But it won’t improve things for everyone, and many patients will still face out-of-pocket fees. For many practices even the additional incentive won’t meet their costs.
With increasing rates of chronic disease, mental illness, and an ageing population, Australians need
more time with their GPs. Therefore, we must push for a Medicare that better funds longer consultations for everyone. That is the key ask in our ‘Modernise Medicare’ campaign
Our campaign proposes long-overdue reforms to Medicare to ensure it can meet the needs of Australian patients now and into the future.
We have developed a model that proposes a new seven-tier standard consultation item structure that will support patients to spend more time with their doctors, by significantly increasing funding for the longer consultations that today’s patients need.
Our modelling was developed over more than 18 months and was based on consultation with our members, analysis of available GP consultation time data, detailed economic modelling, consideration of the impact of different assumptions and scenarios, and testing against real appointment and billing data provided by members.
Our campaign also includes several calls for significant investment in the GP workforce. I am
pleased to say the packages announced by Labor and the Coalition go a long way towards directly addressing these calls, including 400 additional GP training places per year by 2028, more than $200 million to fund salary incentives for early-career doctors to specialise in general practice, and $43.9 million for paid parental leave and study leave for GP registrars.
These funding pledges will open new doors for junior doctors who otherwise may not have considered a career as general practice specialists due to the disparity in employment conditions with hospitalbased colleagues. This would not have been possible without the sustained advocacy of the AMA, which is a leader in calling for GP workforce reform.
In short, we welcome the considerable Medicare funding commitment from both major parties, but we know there is more work to be done.
Dr Danielle McMullen at the launch of the AMA’s ‘Modernise Medicare’ campaign on 3 February
It’s been a trying year for South Australians hoping to access care within the state’s healthcare system and the doctors who work to help them. Record ramping levels and an 11-week shutdown of essential planned surgeries are only two of the challenges.
Almost three months into 2025, the chronic bed block underpinning ambulance ramping and surgery delays persists. Despite South Australian Government efforts to build capacity in the system, the dial doesn’t seem to be shifting – at least, not far enough.
The AMA’s Public Hospital Report Card, released in February, indicates our emergency departments (EDs) are performing at the worst levels in recent history. Just 38% of category-three patients were seen within the recommended 30-minute time frame during 2023-24, compared with 65% 10 years previously. Only 50% of ED presentations were completed within the recommended timeframe of four hours or less.
The most vulnerable members of our community, including the elderly and those with poor mental health, bear the brunt of the health-system failures.
AMA’s Public Hospital Report Card: Mental Health Edition, published in October, shows South Australians suffering from severe mental health problems are spending longer in overcrowded emergency departments than anywhere else in mainland Australia. During 2022-23 the average wait before receiving a bed was 10 hours – two hours longer than the national average.
The AMA has repeatedly highlighted how the bedblock crisis has been exacerbated by decades of underinvestment in aged care. South Australian Government figures demonstrate that in February, 253 patients were stuck in public hospitals waiting to be placed into aged care. The latest Productivity Commission report shows the average wait time for a federally funded aged care bed in South Australia is 253 days. That’s the longest wait-time in the nation and almost double the national average wait-time of 136 days.
Solving the sticky issues
AMA SA President Dr John Williams reflects on the big problems facing healthcare in South Australia and explains how the AMA is taking real steps for change.
Finding a way forward
It is imperative that we doctors do not become resigned to the failures of the system. There is no easy or one-stop fix. But as we consistently remind the federal and state governments, better support for primary care is key. General practice is the most effective and crucially the most cost-efficient way to keep our patients well and out of hospital.
The AMA has welcomed the multi-billion-dollar funding commitments from both major political parties. But the money must be spent wisely. Increasing bulk billing incentives is only part of the picture. We need genuine reform to ensure GPs are supported to provide care that is not just affordable but of the highest quality.
Medicare is biased towards short consultations. It penalises doctors who spend longer with their patients. The AMA’s ‘Modernise Medicare’ plan calls for a model which supports longer GP consultations so doctors have time to better manage increasing rates of chronic and complex conditions.
Closing workforce gaps
South Australia, and indeed the whole of the country, is experiencing a GP shortage that will almost certainly worsen without urgent intervention. The Department of Health and Aged Care’s GP workforce report, released in August, shows South Australia has a shortage of 376 fulltime equivalent (FTE) GPs. According to the data, that shortfall is expected to rise to 584 FTE GPs by 2033.
The GP shortage is amplified in regional, rural and remote areas where patients typically experience poorer medical access and poorer health outcomes. According to AMA research there are only 66 GPs per 100,000 people in very remote areas, compared to 122 FTE GPs per 100,000 people in major cities.
The AMA has been calling on the Australian Government to increase the number of GP training
AMA SA President Dr John Williams
places, and to equalise salary and leave conditions for GP registrars at the same levels as other specialist trainees, so doctors leaving the hospital system and entering the GP training program don’t have to take pay cuts or lose leave conditions. It’s fantastic that both sides of politics have promised to expand the GP workforce significantly if elected.
But training is only part of the solution. We also must ensure GPs are supported to work in the regional areas where they’re so sorely needed.
In South Australia, our advocacy in this area is having an impact. In collaboration with the Rural Doctors’ Association of South Australia, we negotiated the rural GP agreement that has improved conditions for more than 330 rural GPs and GP registrars. AMA SA has also championed the single employer model of training that allows GPs to be hired by SA Health as salaried employees for up to four years during their training, providing continual access to entitlements such as annual leave and sick leave. We know that the longer junior doctors stay in a community and establish roots, the greater the chance they will stay on.
AMA SA also wants to make South Australia a destination of choice for overseas trained doctors who play a vital role in the sustainability of our workforce. This year we’ve launched a new International Medical Graduate (IMG) Committee to help eliminate administrative and bureaucratic barriers to entry and establish support systems for IMGs entering and practising in South Australia. We rely on these workers to bolster our workforce, and we must do what we can to help them thrive in their careers and their personal lives.
A united effort
There are no simple solutions to the big problems in our health system. Finding short-term and lasting solutions demands the collective effort of policymakers, healthcare professionals, community leaders and patients. Our universities also have a role to play. In the following pages, the medical deans of the University of Adelaide and Flinders University explain what they’re doing to increase students’ exposure to general practice and rural medicine.
With the support of our members, and by working collaboratively with a broad range of health stakeholders, AMA SA has the power to influence decision-making and drive genuine change. With a federal election fast approaching, and a South Australian election to follow next year, we have an opportunity now to use this influence and rebuild primary care for the benefit of patients and clinicians for generations to come.
A MEETING OF MINDS
AMA SA is bringing together South Australia’s healthcare leaders to address the systemic pain points which compromise patient care and load additional pressure on hospitals and GPs.
The organisation is staging the ‘AMA SA Access to Care Round Table’ on 9 May. Leaders from across the health sector will examine practical ways to streamline clinical handover, reduce unnecessary hospital admissions and ease the burden on doctors.
AMA SA President Dr John Williams says he expects the forum will initiate both immediate relief and lasting change.
‘AMA SA wants to stop the blame game and spearhead solutions,’ Dr Williams says.
‘We work hard for our members to build and maintain relationships with a range of health stakeholders. We’re uniquely placed to bring together the decisionmakers, innovators and advocates who can make a difference.’
The round table has the support of South Australia’s Health Minister Chris Picton and will include representatives from groups including SA Health, the Australian Private Hospitals Association, the South Australia Ambulance Service (SAAS), the South Australian Salaried Medical Officers Association (SASMOA) and RACGP.
AMA SA will be represented by President Dr John Williams, Vice President Associate Professor Peter Subramaniam, Council chair Dr Karen Koh, and the co-chairs of the AMA SA Committee of General Practice Dr Bridget Sawyer and Dr Alex Main.
Dr Williams says the round table will discuss how to improve connectivity in the system to streamline patient care.
‘Healthcare is too fragmented. Different parts of the system operate in silos. They don’t talk to each other effectively.
‘This makes it harder for doctors to do their jobs. Without effective communication and data sharing between GPs, specialists, public hospital doctors and other health professionals, we can’t guarantee comprehensive and timely care for our patients.
‘This of course leads to poorer outcomes for patients. Delayed or interrupted access to primary care means many will get sicker and end up in overcrowded hospitals, adding to the pressure on the system.’
TEACHING AGILITY
The University of Adelaide has appointed Professor Josephine Thomas as its new Dean of Medicine. Speaking to medicSA, Prof Thomas explains what the university is doing to expose students to general practice, why she advocates for interprofessional education, and what the merger with the University of South Australia will mean for medical students.
Preparing the doctors of tomorrow for the challenges of the real world is no easy task.
Prof Josephine Thomas says graduates need agility if they’re going to succeed.
‘Medicine is a very dynamic field. The pace of increase in medical knowledge is massive,’ she says.
‘We must prepare our graduates to be nimble problem solvers – to use all the resources at their disposal to get the best outcomes for their patients.
‘We can never fill their heads with every fact they need to know, but we need to give them the skills to seek what they need.’
Teaching that agility has been a focus for Prof Thomas throughout her career as a medical educator.
Prior to becoming Dean of Medicine at the University of Adelaide, she taught, coordinated and developed several medical school courses, including the successful and highly popular Transition to Internship course.
It aims to get students ‘work-ready’ through a mixture of lectures, interactive small group workshops, simulation sessions and online modules.
‘Our program of simulation means students get to practise skills in a clinical environment before they have to try them on real patients,’ Prof Thomas says.
‘There are lots of opportunities to rehearse and get it right. They can ask the questions they need to ask to feel confident in the role.’
Prof Thomas also helped write the university’s new medical program. This year marks year four of the framework’s implementation.
‘What we’re launching is a modern program that helps students with their clinical reasoning and fulfills those important Australian Medical Council (AMC) domains of professionalism, leadership, health, advocacy and health and society,’ she says.
‘Becoming the Dean at this point in the rollout is an absolute delight for me. It’s great to see many years of work - by me and lots of other people – come to fruition.’
Exposure to primary care
The program places significant emphasis on primary care.
General practice placements are an integral part of year-three clinical experience. Every student attends a general practice one day per week for the entire year.
‘Health continues to deliver great challenges, even in a wealthy country like Australia,’ Prof Thomas says.
University of Adelaide Medical Dean, Professor Josephine Thomas
‘Increasingly, we need to show our students the benefits of general practice and we need to be able to introduce them in a way that gives them the “best of the best” models to work with.
‘Our third-year placement program gives them the opportunity to experience the full gamut of what general practice has to offer, including interaction with nursing and other healthcare staff.’
In years four to six, students can apply for rural and remote clinical placements.
The programs are based in rural hospitals, communitybased clinics and general practices across rural South Australia and in Broken Hill in New South Wales.
‘Students who avail themselves of our rural program generally perform better academically than their peers,’ Prof Thomas says.
‘That’s a testament to the personal, up-close experience you get in rural settings and the quality of our rural educators.’
Prof Thomas says the University of Adelaide’s merger with the University of South Australia will boost its capacity to offer rural and general practice placements.
‘The merger is a great opportunity. For starters, we’re going to be acquiring more sites – more rural sites, more community sites,’ she says.
‘We’ve already started to build those stronger links with UniSA in those clinics.’
Interprofessional education
Prof Thomas says the merger will also increase the scope for interprofessional education.
‘We’re bringing a lot of different health programs into one school, including, for the first time, medicine and pharmacy,’ Prof Thomas says.
‘These two programs are very aligned in the complex world of modern medicine.’
Prof Thomas calls this one of her ‘pet areas’. Her PhD in medical education focussed on interprofessional education research.
‘We will be increasing our interprofessional learning in the program to ensure that our students are good collaborators,’ she says.
‘There is good evidence that someone who can collaborate well with other professionals gets better patient outcomes.’
Prof Thomas rebuffs suggestions that a greater focus on multidisciplinary teaching could dilute training for medical students or distract them from time they could spend with dedicated clinical educators.
‘I won’t disagree with the fact that there are competing priorities, but I think it’s important to teach people how to collaborate – it’s an essential skill.
‘You can’t function alone in the complex world of health, so this is time well spent.’
Keeping it local
Prof Thomas says medical schools – along with government and health decision makers – all have roles to play in ensuring that the future workforce meets the medical needs of the country.
She says the University of Adelaide takes in a certain proportion of South Australian students, to ensure local demand is met.
‘We tend to be a homegrown bunch here. People who are from here and who train here will likely stay here to work.
‘A good intake of South Australian students, rural students and Indigenous students, will ensure that our medical school and our community flourishes.’
University of Adelaide student performing a simulated procedure
DEMAND AND SUPPLYBUILDING THE RURAL WORKFORCE
Flinders University is rolling out a ‘bold new initiative’ to tackle the critical shortage of doctors in rural and regional areas. The University’s Dean of Medicine and Public Health, Professor Jonathan Craig, says it’s the biggest development in South Australian medical education in decades.
Professor Jonathan Craig is acutely aware of the role Australia’s medical schools must play in producing graduate doctors who meet the medical needs of the public.
As he sees it, those needs are not being met.
‘Medical schools don’t produce enough graduates. We know that because hospitals increasingly find there is a gap between the number of interns they require and the number of graduates,’ Prof Craig says.
‘We also have systemic maldistribution – communities with the greatest need are the ones with the fewest doctors.
‘That’s particularly the case in rural and remote Australia. The two jurisdictions most affected are the Northern Territory and South Australia.’
Prof Craig says Flinders University has ‘answered the call’ from the Australian Government to help address those challenges.
After successfully securing an additional 20 Commonwealth Supported Places, this year it has introduced the South Australia Rural Medical (SARM) Program. It allows Doctor of Medicine students to undertake their entire four-year training in rural South Australia.
Initially, 60 students – roughly a third of Flinders University’s first-year cohort – have started in the program in 2025.
They’ll be based in Mount Gambier and the Riverland for the first two years, and distributed across the Limestone Coast, Riverland Mallee Coorong and Barossa Hills Fleurieu health districts for their third and fourth years.
It’s a significant step up from the university’s previous model, which offered about 40 third-year students a year-long placement in regional South Australia.
‘This probably reflects the biggest event in medical education in South Australia for the last 20 or 30 years,’ Prof Craig says.
‘We’ve had an absolute inundation of students wanting to pursue opportunities in rural South Australia. The program is full this year.’
Prof Craig says there’s clear evidence that if students train in rural settings, they are more likely to provide long-term care in those communities.
‘About 30% of past students who spent their third year in rural settings went on to work in rural locations, with around two-thirds of these graduates practising as GPs,’ he says.
Flinders University medical students performing a simulated procedure at the Barossa campus
Flinders University’s Dean of Medicine and Public Health, Professor Jonathan Craig
‘RURAL
COMMUNITIES ARE INCREDIBLY INVESTED IN STUDENTS.’
‘Rural communities are incredibly invested in students as individuals. They understand the criticality of the local GP, not only for medical care but also as an essential element of the community’s vibrancy and life.
‘Students also receive more personalised support from deeply committed clinicians.’
Flinders University also offers a Northern Territory medical program internationally recognised for its focus on Indigenous and rural health.
Prof Craig says an increasing number of South Australian medical students choose to spend years three and four of their degrees at Flinders’ campuses in Darwin, Nhulunbuy, Katherine, Tennant Creek and Alice Springs.
‘The Northern Territory medical program has been the exemplar for the new type of medical school, delivering the future medical workforce,’ Prof Craig says.
‘Students who go there have a great time and they realise there are real opportunities for a fabulous career as a primary healthcare physician.’
Flinders students who opt to stay in Adelaide have less exposure to primary care. GP placements are limited to a standard six-week period.
Prof Craig says general practices are increasingly challenged to take on the complex task of training students because this has costs to both service delivery and practice income that are not fully compensated.
According to the Australian Government, the Professional Incentive Payment (PIP) awarded to teaching practices is $200 per half-day session, regardless of how many students are in that session.
A rural loading is added if the practice is in a rural or remote area.
‘It’s my understanding that the PIP is about the same as it was 10 years ago,’ Prof Craig says.
‘It’s unfortunate that at the same time there is a need for greater exposure by medical students to general practice, some GPs are unable to accommodate those opportunities because of the commercial pressures they’re facing.’
Despite the challenges exposing students to general practice, Prof Craig says he’s certain that medical students who graduate from Flinders University have the skillset to succeed as interns.
‘The Australian Medical Council provides a number of standards outlining what they expect from all medical schools,’ he says.
‘These standards include things like interprofessional education, culturally safe learning, professionalism and an understanding of the basic biology, function and structure of the human body.
‘We can be very confident that students who graduate from the Flinders program will provide fabulous care to everyone they treat.’
Kael Thomas, Desi Jordan, Nick Carrodus and Heena Bhardwaj at Flinders University’s Mount Gambier campus
Photography: Georgia Paige Photography
Nurturing the next generation of GPs
In a former life, Dr Geeta Trehan practised as a surgeon in India. It wasn’t until she moved to Australia in 2004 that she realised her true calling.
‘I love general practice. I wouldn’t change my specialty for anything,’ she says.
‘Every day when you go to work, you can help somebody. Every day you learn something new.
‘I think it’s the speciality where you make the biggest difference to people’s lives.’
It’s fitting that someone so passionate about the job is now training the GPs of tomorrow. Dr Trehan was one of the first doctors to join a University of Adelaide pilot program aimed at integrating third-year medical students into general practice settings.
Last year, she mentored two students who attended her Campbelltown practice every Wednesday for a year.
‘This intensive training over a 12-month period helped them understand what general practice is really about and how vast it is,’ Dr Trehan says.
‘For me the most important thing is the contact with patients and the longevity of that relationship.
‘I think they pick up on the empathy and respect you have for your patients, and the job satisfaction that comes with that.’
Dr Trehan says a concerted effort is needed to encourage more student doctors to consider a career in general practice.
She says all medical schools should follow the University of Adelaide’s lead and make GP placements a mandatory part of student training.
‘For some reason, general practice has not been promoted. It’s not being promoted by the government, the medical colleges or the hospitals,’ she says.
‘GP placements should be an essential part of the student rotation program.’
Dr Trehan is also calling for additional federal government investment to encourage more GPs to become mentors.
Right now, metropolitan practices can claim $200 for each half-day teaching session.
‘The remuneration is not great. A lot of GPs aren’t willing to take on the extra burden of teaching for what they get in return,’ Dr Trehan says.
‘The future of general practice is not sustainable unless the government starts putting more money into it.’
Despite poor compensation, Dr Trehan says becoming a mentor is deeply satisfying in other ways.
‘I enjoy teaching medical students. It’s rewarding watching them learn and grow,’ she says.
‘One of my students sent me a little card on his last day. He said he felt absolutely inspired and thanked me for showing him the kind of doctor and the kind of person he wants to become.
‘As a general practitioner, you’re constantly teaching your patients about their illnesses, treatments and living a healthy lifestyle. It’s what we do every day.
‘You foster relationships with your patients, and you foster relationships with the students as well.’
Dr Geeta Trehan with students Angus and Youssef
in ADVOCACY ACTION
Safety first
Healthcare workers confront an elevated risk of workplace violence. AMA’s Council of Public Hospital Doctors chair Dr Katherine Tan explains how the organisation is taking a leadership role in addressing the risk.
It is a sad reality for many frontline doctors that they may become victims of violence and aggression at any moment.
We often care for patients and their families at stressful and traumatic points in their lives. Feelings of frustration, confusion and anger are understandably common reactions to life-and-death situations.
However, when this frustration leads to violence and aggression, it places the lives of patients, healthcare workers and non-clinical staff at risk.
We are seeing violence become more prevalent in public hospitals, as widespread ambulance ramping, bed block and delays caused by the logjam crisis deepen.
The World Health Organization estimates that as many as 38% of medical professionals will suffer from physical violence at some point in their careers. Safe Work Australia regards healthcare as an industry with an elevated risk of workplace violence, with some estimates predicting that 95% of Australian healthcare professionals have experienced the effects of physical violence and/or verbal abuse.
Responding to the rising threats of violence against doctors, we have developed a new position statement, ‘Managing and responding to violence in the medical workplace’.
While the AMA has several position statements relating to safe work environments, this is the first to offer a comprehensive approach to violence in the medical workplace, particularly public hospitals.
Doctors and healthcare staff who fall victim to workplace violence risk serious physical injury and profound psychological impacts such as anxiety and decreased job satisfaction. It is also proven to have negative impacts on patient outcomes.
It is in everyone’s best interest to eliminate violence in medical workplaces.
This is why the AMA is going on the front foot, taking a leadership role in addressing this crisis.
The AMA’s new position statement offers practical measures hospitals and other medical workplaces can implement to reduce the risk of violence. Some measures will be obvious and familiar to health practitioners, such as providing educational material for patients, informing them of no-tolerance policies, and making physical adjustments to include unimpeded exit points and video surveillance.
Crucially, though, the position statement advocates for a shift in culture and management processes.
It endorses recent changes to state legislation in South Australia and Queensland that place the responsibility of staff psychosocial wellbeing on the
boards of hospitals. We encourage this change across all jurisdictions; while everyone has a role to play in ensuring safety, this change encourages a top-down, systems-based approach guided by those in medical leadership positions.
The position statement also stresses the importance of post-incident support – both immediately and longer term – and the benefits of risk audits in assessing the level of risk in a workplace and the appropriateness of mitigation measures.
Violence in medical workplaces remains underreported and poorly studied, in part due to perceptions that it is an inherent part of the job. But violence is always unacceptable, and everyone deserves to be safe at work. A change of mindset is needed, whereby a culture and system of reporting, monitoring and evaluation of incidents is embedded.
Don’t get me wrong. Governments have a huge role to play, and we call for all state and territory governments to better protect all medical professionals. Our position statement calls on governments to invest in continuous monitoring and evaluation mechanisms to enable medical workplaces to report incidents with confidence.
There are major benefits in deidentified data being made available to state and federal authorities, encouraging collaboration on research relating to
violence in medical workplaces and pursuing evidence-based solutions.
While our latest position statement is primarily focussed on hospital settings, the principles are also applicable to other medical workplaces, such as private practices, general practice clinics and other community settings.
It is our hope the document sparks long-overdue, serious discussions about violence in medical workplaces. I encourage you all to read it, and consider how you can be part of the solution.
‘It is in everyone’s best interest to eliminate violence in medical workplaces.’
Mental health ‘action now’
The AMA is backing an action plan to make the mental health and wellbeing of the medical profession a national priority.
The National Doctors Health and Wellbeing Leadership Alliance (NLA) has launched a blueprint to protect the mental health of doctors in the workplace. The ‘Every Doctor, Every Setting Action Plan’ was unveiled by NLA Chair and the AMA’s Immediate Past President Professor Steve Robson at a summit in Sydney on Friday 21 February.
‘Doctors and medical students face so many challenges in the workplace, including burnout, job strain, and mental health concerns, and this can impact patient care,’ Prof Robson says.
‘We need system-wide change and the implementation of policies and frameworks that support the psychosocial health and safety of medical professionals.’
One in five South Australian junior doctors who completed the 2024 Medical Training Survey said they had experienced bullying, harassment, racism and discrimination in the past 12 months. AMA SA President Dr John Williams says this should be a wake-up call.
‘I’m urging all levels of the health system to get behind this action plan,’ Dr Williams says.
‘We’re working closely with the South Australian Government and SA Health to improve workplace culture and minimise troubling behaviour.’
TELL US WHAT REALLY MATTERS TO YOU
AMA SA wants to hear from you about the issues which affect you. Our new Feedback Portal gives members a direct line of communication to the AMA SA team.
Tell us what you really think about our policies, where we should direct our advocacy and the services we offer members.
Professor Steve Robson launching the ‘Every Doctor, Every Setting Action Plan’
Staying one step ahead
The AMA’s advocacy has led to the creation of a Medicine Supply Action Group.
The AMA has been calling for a dedicated medicine shortages forum to overcome disruptions to the supply of crucial medicine since 2023.
The Therapeutic Goods Administration (TGA) has now heeded those calls. It is establishing the Medicine Supply Action Group which will include a range of stakeholders, including the AMA.
Until now, ad-hoc action groups were formed in response to specific shortages.
The AMA President Dr Danielle McMullen has welcomed the establishment of a dedicated forum which includes key groups representing medicine, pharmacy, wholesalers and sponsors.
‘We expect this action group will lead to more timely, accurate and consistent communication regarding medicine shortages for patients, doctors and pharmacists,’ Dr McMullen said.
‘Medicine shortages and other disruptions have a profound effect on the community and inadequate communication can result in additional costs for patients, for whom there is often little transparency or forewarning.
‘We appreciate the nature of medicine shortages are unpredictable, but this is about giving us the best possible chance to respond to supply disruptions, which remain prevalent in the post-COVID era.’
Keeping our roads safe: a united effort
AMA SA’s Road Safety Committee works closely with South Australia Police (SAPOL) to help make our roads safer. In recent months, the committee’s chair Dr Monika Moy has been discussing proposals for more rigorous testing of older drivers. This article, provided by SAPOL’s Road Safety Centre, explains how police identify whether a person is a fit and proper person to hold a driver’s licence.
In our duties, SAPOL members may become aware of issues regarding a person’s medical suitability to hold a driver’s licence. There are different ways that a person can be referred for examination:
• A procedure in accordance with section 80 of the Motor Vehicles Act 1959 (the Act). This is where a mental or physical impairment has been identified and an examination is recommended.
• A procedure in accordance with section 82 of the Act. If a person has breached traffic laws anywhere in Australia in a motor vehicle and there are concerns the person will cause a crash or injuries to other road users, then an examination can be recommended.
A person may have a medical referral conducted for both procedures at the same time. However, there must be sufficient information to support both processes and they must be conducted independently of each other.
Interstate drivers can also be referred for assessment pursuant to section 97A(2) of the Act.
A medical referral will be submitted by a police officer in one or more of the following circumstances:
the driver is 70 years of age or older and is at fault in a collision
a medical episode or other medical condition may have caused or contributed to a collision or breach of driving laws
• a person is impaired from a permanent or longterm injury or illness
The SAPOL Road Safety Section is responsible for auditing all medical referrals from police officers and forwarding them to the Licence Regulation Manager (LRM) of the Department for Infrastructure and Transport (DIT).
The LRM is responsible for assessing all medical referrals and may request that a medical review be undertaken with a general practitioner. This would usually involve the GP filling out a ‘fitness to drive’ form.
When a medical referral needs to be processed urgently, the SAPOL member will email the Road Safety Section advising of the urgency.
The medical referral information will be reviewed and forwarded on to the LRM. All medical referrals are kept on record.
Information regarding a medical referral may be accepted from any person, including a relative, friend or health professional.
After consideration of the medical referral, the person may be required to undergo medical tests to ensure they are able to safely operate a motor vehicle. Their driver’s licence may be cancelled or they may be issued with conditions or restrictions, such as a curfew or restrictions on where they are able to drive. The driver may appeal the decision.
GPs have a responsibility to notify the LRM if they become aware of a driver’s medical condition that would place the public in danger if the individual continued to drive.
SAPOL’s Road Safety Centre is a leader in road safety education, playing a vital role in reducing road trauma through enhancing the awareness, knowledge and skills of all road users through lifelong learning.
For more information on SAPOL’s range of programs visit www.police.sa.gov.au/your-safety/road-safety
To book a FREE road safety session email SAPOL.RoadSafetySection@police.sa.gov.au
Andrew van den Berg from the Centre for Automotive Safety Research discusses car safety with AMA SA’s Road Safety Committee
AMA SA Council News AMA SA’s calls for change
AMA SA’s Road Safety Committee chair Dr Monika Moy is advocating for more rigorous testing of older drivers, to ensure the safety of all road users. She’s been collaborating with SAPOL, DIT and representatives from Optometry Australia about possible updates to the ‘fitness to drive’ form.
‘We’re concerned the current testing process is very subjective,’ Dr Moy says.
‘It’s in the interests of all road users to ensure thorough medical assessments are carried out.’
Dr Moy is considering two significant updates to the ‘fitness to drive’ form.
1. Requiring optometrists or ophthalmologists to complete the eyesight component of the certificate
2. Including an objective cognitive test as part of the baseline testing.
‘The proposed changes will assist GPs who conduct the assessments, especially in borderline cases,’ Dr Moy says.
‘By establishing a formal pathway, medical assessors will be better able to decline a medical assessment until further opinion has been sought.’
Dr Moy has also suggested introducing mandatory medical tests for drivers over 70, but says any changes must be ‘worthwhile and evidence-based’. She notes that 91 people were killed on South Australian roads last year. Analysis published by the RAA found that almost half of those killed were aged 60 or over.
‘The fact that so many older drivers lost their lives last year is cause for worry, but it’s wrong to assume older drivers are at fault because of their age alone,’ she says.
‘It’s important that all road users have the ability and cognitive capacity to drive, regardless of how old they are.
‘We’ll continue to work with SAPOL, DIT and other road safety groups to help make South Australian roads safer for us all.’
February 2025
Associate Professor Krishnaswamy Sundararajan, Ordinary Member
The AMA SA Council meeting on 13 February covered many themes pertinent to the medical community in South Australia. Councillors discussed AMA SA’s plan to convene a primary care round table. We also received reports from the Doctors in Training Committee, the Road Safety Committee and the Committee of General Practice, along with an update on AMA SA’s work with ReturnToWorkSA.
Council discussed its strategy to collaborate with the AMA SA Board to establish a roadmap for promoting the interests of doctors in South Australia. We unanimously agreed that a united front of generalists and specialists is necessary to manage the challenges that lie ahead. There was also consensus that Council’s role is to formulate policy and advocacy while finetuning organisational procedures. We agreed that clearly defined terms of reference would help Council become more comprehensive and draw in new members, particularly from craft groups that have not been directly represented. Attraction and retention of members remain top priorities for Council in 2025 and AMA SA is examining novel ways to accomplish that goal by creating a value proposition for its members.
Finally, considering the significant challenges confronting healthcare in South Australia, Council agreed that AMA SA will continue to actively monitor the building, operations and management of the new Women’s and Children’s Hospital while continuing to advocate for the wellbeing of all South Australians.
A/Prof Krishnaswamy Sundararajan is an AMA SA Councillor and Director of the Royal Adelaide Hospital’s Intensive Care Unit.
SAPOL Road Safety Educator Senior Constable Michael Krawczyk & AMA SA Road Safety Committee chair Dr Monika Moy
VAD: an update for doctors
South Australia’s law to provide access to voluntary assisted dying (VAD) came into effect in January 2023. Two years on, VAD Review Board Presiding Member Associate
Professor Melanie Turner provides an update on how the scheme is operating.
Q+A
The VAD legislation came into effect two years ago. How are things going?
It has been a busy two years safely introducing VAD as a new end-of-life choice in South Australia. We are incredibly grateful for all the dedicated people who have supported its operation over the past two years, including our dedicated VAD-trained doctors. Since commencement of VAD on 31 January 2023, there has been a continued upward trend in VAD activity, which is in keeping with patterns of activity reported by other states.
Meeting monthly, the Review Board undertakes a detailed review of each individual patient’s VAD pathway, completing approximately 650 individual reviews since the commencement of VAD in this state. We are touched by the individual stories of patients and the efforts of medical practitioners and support staff in supporting people at their end of life. The Review Board is pleased to note the high degree of compliance with the legislation, a testament to the systems, processes and people involved in VAD on a day-to-day basis.
How
many doctors are participating
in VAD?
As of 31 December 2024 82 medical practitioners have completed their mandatory training, becoming eligible to support access to VAD in South Australia. When we first reported two years ago in medicSA, we had 40 doctors who were full trained for VAD –
as doctors are vital to the success of VAD, we are pleased to see this significant increase.
We continue to encourage interested medical practitioners to undertake the mandatory practitioner training to support patients on the VAD pathway, with mandatory training now registered as a continuing professional development activity with the RACGP and ACRRM.
How
many people have requested access to VAD in South Australia?
As of 31 December 2024, a total of 794 people have made a first request for VAD to a participating doctor. In the same period, there were 516 VAD permits issued by SA Health, and 326 deaths recorded from administration of the VAD substance.
The Review Board regularly shares up-to-date information and data on VAD with the South Australian community through publication of quarterly and annual reports on VAD available on the SA Health webpage.
Has there been feedback from patients and families?
The Review Board welcomes feedback to support its role in continuous improvement of VAD in South Australia. Since the commencement of VAD, we have received and read over 200 individual pieces
of feedback from patients, families, medical practitioners and the community. This helps us understand how well VAD is meeting the needs of the community and what can be done to improve. We continue to encourage patients, their families, medical practitioners and others in the community to provide us with feedback.
What support is there for doctors?
Doctors play a critical role in VAD as the only clinicians who can assess eligibility for, and facilitate access to, VAD. The Department for Health and Wellbeing offers online and face-to-face training to support doctors to be registered and eligible to support VAD.
A community of practice for VAD practitioners has been created. Meeting regularly, and led by VAD Clinical Advisors Dr Peter Allcroft and Dr Chloe Furst, the community of practice provides a safe place to share concerns and learnings with peers. It also offers the opportunity to take time to reflect on this important work and build relationships between medical practitioners and staff of VAD support services.
In addition, SA Health maintains a centralised online resource hub of up-to-date information, practical tools and templates to help doctors deliver compassionate VAD services. Doctors are also supported by two experienced and dedicated VAD Clinical Advisors who are available to provide peer support, clinical advice and assistance to navigate more complex scenarios or ethical considerations related to VAD. VAD Clinical Advisors work alongside SA Health’s other wrap-around services supporting individuals through the VAD pathway, including VAD Care Navigator Service, VAD LHN Liaison and SA VAD Pharmacy.
What is on the horizon?
We have established a VAD Research Framework that underpins the work of a new VAD Research
Subcommittee. This is an important step in increasing our understanding of VAD, by bringing together a group of people dedicated to supporting thoughtful and coordinated research on VAD in South Australia.
With other jurisdictions, the VAD Review Board is continuing to advocate for changes to the Commonwealth Criminal Code Carriage Laws to allow for the expanded use of telehealth for VAD.
After a successful visit to Port Lincoln in September 2024 to meet with local health services and clinicians, the Review Board is planning a regional visit in 2025 as part of community and stakeholder engagement in VAD. In addition, and following a recent suggestion from the AMA SA, we are working on establishing a rural contact for general practitioners who are interested in learning more about providing VAD services.
Acknowledgement
The VAD Review Board sincerely thanks all participating medical practitioners and health professionals for their dedication and hard work in supporting access to VAD as an end-of-life choice in South Australia.
For information about participating in VAD as a medical practitioner go to the SA Health webpage or contact Helen Chalmers, Executive Director, Health Services Programs, Department for Health and Wellbeing on 0488 548 021 or Helen.Chalmers@ sa.gov.au.
A/Prof Melanie Turner is South Australia’s VAD Review Board Presiding Member.
New Advanced Care Directive Kit available for free statewide
New Advanced Care Directive documents were published on 1 March 2024. The new ACD Kit includes a new contemporary look and feel, is clearer and easier to understand, and provides an updated step-by-step ‘do-it-yourself’ guide. If your clinic would like to become a collection point for ACD kits, contact the Department for Health and Wellbeing at Health.AdvanceCarePlanning@sa.gov.au For more information visit www.advancecaredirectives.sa.gov.au
Into the disaster zone
Australian Medical Assistance Team (AUSMAT) member and Kangaroo Island GP Dr James Doube navigated powerful aftershocks to provide medical support after the deadly earthquake that struck Vanuatu in December.
Locals and tourists heard it before they felt it –a deep, roaring rumble like a jet taking off. Then came the screams of panic.
The 7.3 magnitude earthquake struck near Vanuatu’s capital Port Vila in the early afternoon of 17 December 2024. Bridges buckled. Buildings came crashing down. Landslides blocked roads and buried a bus.
According to official tallies, 14 people were killed and more than 250 others were injured. Thousands of homes were damaged or destroyed.
Six days later, Kangaroo Island GP Dr James Doube was on a plane bound for the disaster zone. He was part of AUSMAT’s health emergency response, leading Team Bravo – the second AUSMAT team to arrive in Vanuatu.
Dr Doube is no stranger to working in austere conditions. His first mission with AUSMAT was to the Philippines in 2013, in response to Typhoon Haiyan. Haiyan was one of the most powerful and deadly tropical storms recorded in the region, killing more than 6,000 people.
Since then, Dr Doube has been deployed to Fiji and Vanuatu several times. He was in Vanuatu during the COVID-19 pandemic and again in 2023 when the archipelago was hit by cyclones Judy and Kevin in quick succession. But Dr Doube says December’s earthquake was different.
Dr James Doube in theatre
‘Vanuatu is one of the most natural disaster-prone places in the world, but with cyclones and volcanic eruptions, there’s typically some warning,’ he says.
‘You don’t get that with an earthquake. There was no warning – just a rumble and then 15 or 20 seconds of sustained, violent shaking.
‘That lack of ability to prepare affected people both physically and psychologically.’
As mission team lead, Dr Doube managed a group of surgeons, emergency and infectious disease doctors, nurses and allied health workers. It was his responsibility to coordinate the clinical response with Port Vila’s health network.
Dr Doube’s team responded to complex orthopaedic traumas that under other circumstances would have led patients to be evacuated for treatment. That wasn’t an option.
To add to the complexity of their job, a lot of hospital equipment had been damaged during the earthquake.
‘I’D BRACE MYSELF ANYTIME I HEARD A RUMBLE.’
‘We were working with local staff to treat patients while offering mentoring, teaching and training,’ he says.
‘We were also providing a degree of reassurance that we had faith in the hospital buildings which had been deemed safe by Australian engineers.’
Dr Doube says there was anxiety among local staff, especially because of the frequency of earthquake aftershocks.
‘People were hypervigilant. They’d come running out of buildings when we felt those tremors,’ he says.
‘Even when I returned home, I’d brace myself anytime I heard a rumble. I’d expect the ground to start shaking.’
‘Fortunately, we had a biomedical engineer who in many ways was the biggest star of the show,’ Dr Doube recalls.
‘He tested, recalibrated, and repaired things to help get the equipment back up and running as much as possible.
‘I was working with an inspiring bunch of people. All of us were doing our best in difficult circumstances.’
It doesn’t come without a personal cost. Dr Doube was away from his young family for two weeks. He missed the entire festive season.
He says it was probably harder on his loved ones than on him, but they understand why he does it.
‘Medical aid work allows you to make a very big difference in people’s lives. That’s why many of us get into healthcare in the first place,’ Dr Doube says.
‘There was a definite sense of reward providing that care in Vanuatu. You feel quite honoured being able to help.’
Dr Doube (front, second from right) with his Team Bravo colleagues
Doctors making a difference
AMA SA members Professor Stephen McDonald and Dr Samantha Pillay were recognised in the 2025 Australia Day Honours list for their crucial roles in advancing the health and wellbeing of the community.
HONOURS AUSTRALIA DAY
2 025
PROFESSOR STEPHEN McDONALD
Member of the Order of Australia for significant service to kidney medicine as an administrator, researcher and clinician
Profesor Stephen McDonald’s entrance into the world of nephrology was no accident. He chose to pursue a career in kidney medicine because it offered meaningful contact with patients.
‘Patients will typically see their nephrologist for many years. We know each other pretty well by the end of that journey,’ he says.
‘That’s one of the things that I’ve found very rewarding about my job. I’m with my patients throughout the ups and downs – across all the “shades of life”.’
Prof McDonald wears many hats. He’s the director of the recently formed Adelaide EpiCentre (a collaboration of the University of Adelaide Medical School, CALHN and SAHMRI) and a senior staff nephrologist at the Central Northern Renal and Transplantation Service based at the Royal Adelaide Hospital.
He’s also the clinical lead of renal services for the Rural Support Service of SA Health. However, he says his core role is seeing patients, including regular clinics in regional and remote communities.
It’s something he’s done throughout his career.
‘It goes way back to last century when I was a registrar at the Queen Elizabeth Hospital,’ Prof McDonald recalls.
‘I was sitting down with a group of Indigenous people, just listening to their stories, and I realised there’s a big world far beyond the hospital.
‘If you’ve got patients from remote areas with long-term or chronic conditions, we need to allow them to get home.
‘If patients have severe kidney disease, and need dialysis or a kidney transplant, the ability to bring that care to them is a marker of success.’
Prof McDonald’s inclusion in the 2025 Australia Day Honours list is recognition of the work he’s done identifying and addressing barriers to care.
Over the past two decades, he’s played a pivotal role in developing the Australian New Zealand Dialysis and Transplant (ANZDATA) Registry.
This clinical quality registry collects and produces a wide range of statistics relating to the outcomes of treatment of those with end-stage kidney failure.
Prof McDonald says findings from the ANZDATA Registry led to the creation of the National Indigenous Kidney Transplant Task Force and improved access to dialysis and kidney transplantation in remote areas.
‘One of the things we’ve tried to do is make sure that the data is interpreted properly and that, where needed, action can be taken,’ Prof McDonald says.
‘There’s still a long way to go, but the provision of dialysis facilities outside major capital cities has substantially improved across Australia compared to 20 years ago.
‘An honour like this is very much recognition of the team I have around me and I’ve certainly been blessed in that regard.’
DR SAMANTHA PILLAY Medal of the Order of Australia for services to urology
Dr Samantha Pillay isn’t afraid to break new ground. She was the first woman to complete surgical training in adult urology in South Australia.
Now a leader in her field, she offers specialised services to improve incontinence treatment for men and women and works tirelessly to combat stigma around the condition.
‘For whatever reason, we know 60% of people who suffer with incontinence don’t speak to their doctor,’ Dr Pillay says.
‘It’s a quality-of-life issue. A lot of people really struggle to acknowledge the impact their incontinence has on their lives and what they’re giving up regarding their relationships, travel, the clothes they wear, where they live, what job they do.’
Dr Pillay has developed a number of creative ways to lift the veil of silence around incontinence.
She directed and produced an award-winning film titled An Incontinent Truth which uses AI-generated voices and images to share personal stories.
She also lays claim to perhaps the world’s only dance track about incontinence. Break the Silence is available on Spotify.
‘It really is a grassroots movement using any modality I can, to get people recognising the impact that incontinence has on their lives,’ she says.
‘Ending that stigma and embarrassment can motivate people to seek what can be life-changing treatment.’
Dr Pillay’s expertise spans beyond the fields of medicine and film and music production.
She’s also a motivational speaker, entrepreneur and children’s author.
Her picture book series Inspirational Careers for Kids seeks to break down gender stereotypes.
‘As the first female to do surgical training in adult urology in South Australia, there were a lot of barriers that I had to overcome. I was also a single mum while working as a consultant,’ she says.
‘By overcoming those challenges, it gives you the inspiration to want to make the journey easier for other people.
‘I’ve achieved more than I ever thought that possible. And by highlighting that pathway, hopefully it gives other people the strength and vision to follow their dreams and not be held back by stereotypes.’
Professor Stephen McDonald
Dr Samantha Pillay
RESEARCH BRIEFS
Antibiotic use high among more affluent Australians
University of Queensland research has found antimicrobial usage is significantly higher in affluent communities in Australia.
UQ’s Queensland Alliance for Environmental Health Sciences screened samples from 50 wastewater treatment plants servicing about 11.3 million people across Australia for about 100 antimicrobial compounds and compared the findings with the residents’ socioeconomic factors, including income, education, occupation and housing.
UQ’s Dr Jake O’Brien said antibiotics such as cephalexin, ciprofloxacin, and sulfamethoxazole were detected in 100% of samples, which he said suggested widespread use across Australian communities.
‘The five most-used antimicrobials or breakdown products were amoxicilloic acid, cephalexin, ciprofloxacin, sulfapyridine, and sulfamethoxazole – and each was detected in more than 90% of samples,’ he said.
Dr O’Brien said Australia has one of the highest per capita rates of antimicrobial usage among high-income countries.
‘Extensive use may pose a risk for the development of antimicrobial resistance, which is a critical global health challenge projected to cause up to 10 million deaths annually by 2050,’ he said.
‘National survey of the occurrence of antimicrobial agents in Australian wastewater and their socioeconomic correlates’ (Nature Water, December 2024)
Five-day brain stimulation may prevent future pain
Researchers from NeuRA and UNSW have found that a five-day brain stimulation treatment has promise in preventing future pain.
Chronic pain affects over 1.5 billion people worldwide and costs the Australian economy an estimated $139 billion annually due to lost productivity and healthcare expenses.
NeuRA Research Fellow and Head of Neurostimulation at the NeuroRescovery Research Hub at UNSW, Dr Nahian Chowdhury, led the research that found a five-day course of repetitive transcranial magnetic stimulation (rTMS) before pain onset could significantly reduce future pain intensity and improve brain activity associated with pain resilience.
rTMS is a non-invasive procedure where magnetic pulses are delivered through a coil worn on the scalp to stimulate specific brain regions.
The research involved 41 healthy participants in a blinded, randomised, sham-controlled trial over 26 days. Participants attended five sessions during which they received either active or sham rTMS. Key brain activity measures such as Peak Alpha Frequency (PAF) and corticomotor excitability (CME) were assessed on days zero and four.
At the end of day four, participants received an injection into their cheeks to induce prolonged pain. For days 5-25, the trial participants completed twice-daily electronic diaries measuring pain and function.
‘Regardless of whether people received the active treatment or sham, our analysis showed that those with faster PAF and higher CME on Day 4 had lower intensity future pain,’ Dr Chowdhury said, suggesting that brain activity metrics in future can be used to predict pain resilience.
‘This research shows in some situations – such as for people undergoing a surgery known to be painful or often leading to chronic pain – there is promise from preventative treatments that may be able to stop chronic pain before it begins.’
‘A 5-day course of repetitive transcranial magnetic stimulation before pain onset ameliorates future pain and increases sensorimotor peak alpha frequency’ (PAIN, December 2024)
New test identifies specific whooping cough strains
Researchers at UNSW Sydney and the University of Technology Sydney (UTS) have developed a genomic test that can identify specific strains of whooping cough (bacterium Bordetella pertussis).
The new technology has provided insights into two previous epidemics of whooping cough in Australia and overseas.
In 2024, all states and territories reported a rise in whooping cough cases compared to previous years, with more than 10 times the number of cases than in 2023. Children aged nine to 12 accounted for nearly 40% of all notified cases by early December.
UNSW’s Professor Ruiting Lan and Dr Laurence Luu from UTS and UNSW hope to use the genomic test to pinpoint the strain responsible for the 2024 outbreak. Detailed information on the strain could help manage the outbreak and develop future vaccines.
While the vaccine is effective, the team’s earlier research suggests that whooping cough may be evolving under vaccine pressure, much like COVID-19. Historical data shows that despite the widespread use of the vaccine, whooping cough cases tend to spike every four to five years.
For many years, whooping cough was diagnosed by growing the causative bacteria, before a switch was made over to PCR testing that no longer requires growing the live bacteria.
‘The method we’ve developed, known as mPCR sequencing assay, can directly sequence the residual whooping cough DNA leftover from a PCR test and needs as few as four copies of the bacterial DNA to work effectively,’ Dr Luu said. ‘It doesn’t require us to grow the bacteria.’
The team tested their assay on 178 leftover diagnostic DNA samples from across Australia from two previous outbreaks, with the samples collected between 2010-2012 and 2019. Analysis of the results provided unprecedented detail on the evolution of the whooping cough strains that had been circulating in Australia prior to the pandemic.
‘Deciphering Bordetella pertussis epidemiology through culture-independent multiplex amplicon and metagenomic sequencing’ (Journal of Clinical Microbiology, November 2024)
Women at risk of depression more likely to develop heart
disease
Women who have a high genetic risk of depression are more likely to develop heart disease, University of Queensland researchers have found.
During a study that analysed genetic and health data from more than 300,000 people, Dr Sonia Shah and Dr Clara Jiang from UQ’s Institute for Molecular Bioscience found women who had a high genetic risk of developing depression also had a high risk of developing heart disease, even in the absence of a depression diagnosis.
Dr Shah said these results exposed a difference in the risk for women compared to men.
She said the link between the genetic risk of depression and developing a cardiovascular disease was seen even among women who had never been diagnosed with depression or taken any psychiatric medications.
However, she said, the link was not observed in men, despite an overall greater proportion of men developing heart disease. The variation between men and women could also not be explained by differences in traditional risk factors such as BMI, smoking, high blood pressure or high cholesterol.
Dr Jiang said that despite heart disease being the leading cause of death for women globally, they have historically been underrepresented in cardiovascular research and clinical trials.
‘This has led to a bias towards men in our knowledge and approach to cardiovascular health, and as a result women are going underdiagnosed and under-treated,’ Dr Jiang said.
Dr Shah said the study highlighted that women who have depression should be assessed for heart disease risk, regardless of their menopausal stage.
‘Sex-specific association between genetic risk of psychiatric disorders and cardiovascular diseases’ (Circulation: Genomic and Precision Medicine, November 2024)
Sights set on science
An Adelaide ophthalmologist whose research is saving thousands from irreversible vision loss has been named South Australia’s Scientist of the Year.
Professor Jamie Craig from Flinders University and the South Adelaide Local Health Network, along with his team, has developed a powerful new screening tool to assess and triage glaucoma patients.
‘Glaucoma is the most common cause of irreversible blindness and is influenced by family genetics,’ Prof Craig says.
‘Our research team at Flinders is ensuring thousands of treatable cases don’t go undetected and people are treated before damage and vision loss are irreversible.’
Prof Craig’s test is the first of its kind. It enables more accurate and earlier diagnoses of glaucoma to prevent vision loss in high-risk individuals.
Prof Craig received the prestigious prize at the 2024 SA Science Excellence and Innovation Awards held at the Adelaide Entertainment Centre in November. ‘This award is an acknowledgement of the tireless work our research team is undertaking to improve people’s lives,’ Prof Craig says.
‘It provides inspiration to continue our pursuit of effectively detecting and treating causes of blindness.’
Glaucoma affects an estimated 80 million people globally, including 300,000 Australians over the age of 40.
‘People are treated before damage and vision loss are irreversible.’
Professor Jamie Craig with his screening tool (above) and at the 2024 SA Science Excellence and Innovation Awards (below)
&BUSINESS TECHNOLOGY
From
handwritten to high-tech: What you need to know about AI in medical note-taking
The integration of artificial intelligence (AI) into note-taking processes in medical practices is rapidly gaining momentum. But how do these emerging tools work? And what factors should you consider before implementing them in your practice?
any medical practitioners are often overwhelmed with administrative pressures, including creating comprehensive and precise clinical notes. Traditional methods of medical note-taking involve manual data entry and the transcription of patient interactions, which can be time-consuming.
AI note-taking tools offer assistance for medical practitioners, balancing the demands of a busy practice. They can streamline documentation processes and allow medical practitioners to focus more on the provision of patient care. This shift could improve both efficiency and the overall quality of medical documentation.
How AI note-taking works
AI note-taking tools operate by recording the dialogue between the medical practitioner and the patient during a consultation. Using advanced technologies, these tools extract relevant information and generate coherent clinical notes. Over time, AI systems learn to mirror the user’s tone and style, ensuring that the AI-generated notes resemble those created manually by the medical practitioner.
Medical practitioners can review and amend AIgenerated notes before finalising them. This allows
Patient consent is essential
‘AI tools facilitate more efficient and patientcentred healthcare.’
seeking and recording patient consent every time AI
said and observed during a consultation and correct
AI-generated notes may not always include essential patient identifiers, leading to potential issues during
practices should implement robust processes and provide training to staff involved in handling AI-generated documentation.
More efficient care
There is no obligation to use AI in medical note-taking. However, practices and medical practitioners who use AI or are thinking of purchasing and implementing an AI note-taking tool in their practice should ensure the selected tool:
• meets clinical needs
• enhances the delivery of quality patient care
• complies with legal and professional obligations.
It is recommended that practices and medical practitioners consult with an IT expert, their cybersecurity provider and their medical defence organisation when implementing an AI note-taking tool.
Careful attention to patient consent, data privacy and the accuracy of records is essential.
As AI technology continues to evolve, it may further transform medical documentation, making the integration of these tools a promising step towards more efficient and patient-centred healthcare.
This article was written by AMA NSW’s workplace relations advisors Anastasia Livanova and Dominique Egan and first published in NSW Doctor’s Spring 2024 edition.
3D solutions to clinical problems
Australian researchers are revolutionising surgical planning with 3D-printed models. The life-like tools are enhancing patient care and surgical precision.
Biomedical engineers at the University of New South Wales (UNSW) are pioneering the development of anatomically accurate, 3D-printed models that mimic the feel and movement of human body parts.
The models allow doctors to better plan for surgery and determine if certain procedures can be conducted safely.
Researchers from UNSW’s Tyree Foundation Institute of Health Engineering (IHealthE) recently created a 3D model of a young child’s skull, helping surgeons to successfully remove a life-threatening tumour.
They also produced a replica of a patient’s trachea to evaluate the safety of a surgical procedure.
Dr Keng-Yin Lai is a postdoctoral research fellow at UNSW who helped create the models.
‘What we have been doing is making patientspecific 3D-printed models so clinicians can practise specific surgery techniques unique to their patient,’ Dr Lai says.
‘They are geometrically and anatomically accurate which is really useful.’
Saving Isaac
The first project involved creating a model of the skull of eight-year-old Issac Lee, who had a complex brain tumour.
The model had to show the precise size, shape and location of his tumour, and other critical structures such as optic nerves.
Dr Catherine Banks from Sydney Children’s Hospital says the model helped save Isaac’s life, by allowing surgeons to plan a successful but less invasive procedure.
‘These 3D-printed anatomical models allow us as surgeons to think about different trajectories for procedures,’ Dr Banks says.
‘(They) allow us to really plan our angles of attack, and consider all the instrumentation that we will need, so they are invaluable for providing us with more information than we’d get just from MRI or CT scans.
‘I think that as health professionals we have a role to constantly try to push the envelope of what we can offer our patients.’
Dr Catherine Banks holding a segment of a 3D-printed skull
Educating patients
Dr Banks says the 3D-printed models are also an important tool to educate patients and their families about the procedure that is being planned, to help them evaluate the risks and give consent.
‘Even medical professionals can have some difficulty looking at two-dimensional CT or MRI scans and understanding the three-dimensional relationship between critical structures,’ she says.
‘You can imagine how hard it is for someone with no medical knowledge to be shown scans and try to figure out how it all comes together.
‘The 3D models are fantastic in demonstrating the spatial relationships between all the vital structures and we can show patients and their family what we are trying to achieve and help them understand the procedure and consider the risks before they give consent.’
‘We have a role to constantly try to push the envelope.’
Into the future
Researchers are now experimenting with different printing materials that recreate the complex way body parts feel and move.
IHealthE senior technical engineer Gabriel Graterol Nisi says ‘bio-mimicking’ materials imitate the texture, hardness and flexibility of the tissues or bone structure.
‘The bio-mimicking materials can be created, for example, by depositing the resin in complex patterns that recreate porous bone structures, fibrotic tissues and ligaments,’ he says.
‘Using that would allow us the ability to replicate musculoskeletal models that match bone density characteristics and behave like native bone when force is applied such as discectomy, drilling, reaming or sawing.
‘That is the next step in future developments and I think it will only enhance the possibilities of surgical planning.’
Gabo Graterol Nisi cleans the 3D-printed skull
Death, taxes and insurance
Hood Sweeney’s Cooper McRae says there may be ways to lower the cost of life insurance without compromising on your cover.
The financial strain of the cost-of-living crisis has led many of us to scrutinise our expenses. But insurance may be overlooked because it is perceived as a fixed cost.
Lately, though, insurers have been actively competing for new business, particularly in the death and total and permanent disability (TPD) space. This has resulted in attractive premiums being offered to new clients while loyal customers watch their premiums increase.
‘Ensuring you are not overpaying for essential coverage is a step towards improving your financial health.’
This recent activity has created opportunities for our clients to shop around for significant premium savings from alternative insurers to protect them in the event of premature death, or total and permanent disablement.
Death and TPD cover can provide a safety net for you and your family in the unfortunate event of death or a condition that leads to total and permanent disablement. They can cover
expenses such as medical bills and mortgages and provide an ongoing income stream for your family.
This financial support is invaluable if the unthinkable happens and you are unable to provide for your family.
Consumers who haven’t had their personal risk insurances reviewed by a financial planner with expertise in this area may find they are under-insured or don’t have death and TPD insurances structured to ensure optimum tax effectiveness and certainty at claim time.
There are other factors that could contribute to cost reductions in your death and TPD insurance.
• Financial circumstances: Your need for death and TPD cover may have changed since your insurances were last reviewed. Perhaps your debts have reduced, you are part-way through paying off school fees, and your investment assets such as superannuation have increased.
• Health and lifestyle changes: If your health has improved or your lifestyle has changed since taking out your policy, you may qualify for lower premiums. Many insurers now offer discounts for non-smokers, those with healthy BMIs, and individuals who have taken steps to reduce health risks.
• Bundling discounts: Many insurers offer discounts for bundling multiple types of coverage. If your death insurance and TPD cover are with different providers, consolidating them could yield savings.
A real-life review
Our team recently reviewed the insurance policies of a husband-and-wife client. The review aimed to:
• ensure their levels of cover were appropriate for their current financial circumstances and needs, and obtain premium savings where possible.
These clients were open to going through the insurance application process if it meant achieving savings with equivalent quality policies.
Following the review, we were able to save the husband about $4,400 in the first year alone by moving to another insurer, on a like-for-like basis, on $2 million of death and TPD cover.
For the wife, we saved just over $4,500 in the first year, on a like-for-like basis, on $2.1 million of death and TPD cover.
More premium savings were possible because the amount of cover needed had reduced for both the husband and wife since their last insurance review.
This proactive process resulted in significant savings for the clients on their personal risk insurances, while providing them with the peace of mind that they have the appropriate levels of cover for their current circumstances.
AMA SA Member Benefit
Navigating the complexities of life risk insurance policies can be daunting to tackle alone. Ensuring you are not overpaying for essential coverage is a step towards improving your financial health.
Disclaimer: The information in this article contains general information and does not constitute finance advice.
Cooper McRae is a financial planner and life insurance specialist with Hood Sweeney.
South Australia’s ‘hotspots’
Looking to invest in property this year?
James Robertson from Ouwens Casserly Real Estate gives an update on the Adelaide market and the areas to watch this year.
Property markets throughout Australia showed remarkable resilience during 2024. Despite high interest rates and increasing cost-of-living pressures, the Adelaide property market finished the year with double-digit dwelling-price growth. That strength is likely to continue in 2025.
CoreLogic executive research director Tim Lawless recently commented that the immediate outlook for the housing market is for further growth, but with a continuation of a gradual loss of momentum and increasing diversity across cities and regions due to the increase in the number of properties available for sale. He says the upside of the housing market is
improving sentiment amid a slowdown in inflation and tight labour markets. Many believe further rate cuts will give potential buyers more borrowing capacity and provide them with more money to compete for properties. On the surface, this could lead to another strong year for property prices; however, there are more factors at play than just interest rates.
Drawing on expert insights, Ouwens Casserly Real Estate has identified five of the hottest suburbs and towns to watch this year. These standout areas represent the very best of South Australia, offering exceptional potential for savvy buyers and investors looking to kick off the year with confidence.
Prospect, SA
Prospect
A suburb that seamlessly blends heritage charm with a modern, vibrant vibe, Prospect has become a hub for dining, arts, and culture. Its tree-lined streets are dotted with character homes, while its main streets offer trendy cafés, global eateries, and boutique shops. With ongoing infrastructure upgrades, Prospect continues to grow in both popularity and value.
Ideal choice for: Young professionals and families seeking a vibrant, community-focussed suburb with excellent amenities.
Mile End
Located just two km from Adelaide’s CBD, Mile End, with its mix of historic homes and modern amenities, is the epitome of convenience and lifestyle. This innerwestern suburb offers easy access to the city, beautiful beaches, and a thriving café culture.
Ideal choice for: Young families and professionals looking for a blend of city convenience and local culture.
Glenelg
Adelaide’s quintessential beachside suburb, Glenelg offers a laid-back yet vibrant lifestyle. From its sandy beaches and family-friendly attractions to its trendy cafés and boutique shops, Glenelg has something for everyone. Whether you’re strolling along Jetty Road or catching a dolphin-spotting cruise, this suburb perfectly blends coastal relaxation with modern amenities.
Ideal choice for: Beach lovers and families seeking a lively coastal lifestyle with modern conveniences.
Stirling
Tucked away in the lush Adelaide Hills, Stirling is a picture-perfect village known for its leafy streets, boutique shopping, and thriving food scene. This suburb is a perfect escape to a green, tranquil lifestyle without sacrificing urban convenience. Its strong community spirit and enchanting surroundings make it one of Adelaide’s most coveted Hills locales.
Ideal choice for: Those who value community, greenery, and a serene hills lifestyle close to the city.
Goolwa
Nestled in the heart of the Fleurieu Peninsula, Goolwa is a historic river port just 85 km south of Adelaide. This picturesque coastal town offers a serene blend of riverfront charm and beachside allure. Known as ‘The Elbow’ by early settlers, Goolwa boasts scenic surf beaches, the tranquil waters of Lake Alexandrina, and direct access to the Coorong and Murray River Mouth.
Ideal choice for: Those seeking a relaxed coastal lifestyle with a connection to nature and history.
Mile End, SA
Goolwa, SA
Glenelg, SA
WELL BEING Wellbeing
Health hurdles for doctors
Progress has been made in addressing doctors’ health issues, but significant challenges remain, writes Dr Roger Sexton.
As I look back on the health of the profession over the past few decades, it is clear there has been progress, but we still have some way to go.
The sources of good individual health include a composite of epigenetic, genetic, parental, personality, lifestyle, educational, nutritional, environmental and experiential influences.
Through our medical training, we acquire a special knowledge of the contribution these things can make to our patients’ health. It is common for others outside the profession to assume and expect that we apply this special knowledge diligently to our own health and for our enduring benefit.
In my experience, the expectation that ‘doctors shouldn’t get sick’ is common and widespread. The incredulous reaction to the death of British broadcaster Dr Michael Mosley on the Greek island of Symi was a recent example.
To make this worse, our connectivity with the health system and ability to jump the queue with our social and professional connections are regarded as unique advantages that should assist us to look after our own health. Our freedom to legally manage our own illness, self-investigate with pathology and imaging and self-prescribe add to the pervasive view that we are at a significant personal advantage compared with the general population.
These can of course, have the opposite effect through a lack of any independent medical overview and diagnostic rigour.
At the workplace level, insufficient and even dismissive regard may be given by employers, administrators and even competitive colleagues to the hazardous environment in which doctors are expected to work, practise flawless medicine and excel.
The belief that doctors should neither become ill nor need help is common.
Work practices that are illegal, unhealthy and entrenched have remained unchallenged, while they continue to take a toll. In a culture where these are accepted, they persist. Resignations, interpersonal conflict, industrial action and even illness itself, are not seen as the red flags that they really are. The good health of doctors is taken for granted and therefore not considered in these examples, and too many people remain unconcerned about the health of doctors.
Systemically, the health of doctors and patient care and errors is well-documented.
‘ THE EXPECTATION THAT DOCTORS SHOULDN’T GET SICK IS COMMON AND WIDESPREAD.’
The medical board recognises that the suboptimal health of doctors can contribute to complaints and clinical errors and can deteriorate further because of the complaints process.
With these issues in mind, it is worth knowing that solutions are being implemented.
From a personal health literacy viewpoint, our own lifestyle habits are up to us. Coming to work in good shape is everyone’s responsibility and professional obligation. I have highlighted the importance of sleep, caffeine and alcohol reduction and aboveaverage aerobic fitness previously. Others are retaining contact with non-medical friends, creative interests, having your own GP to advocate for you in the health system, undergoing preventive health checks and establishing a panel of expert advisers to call upon in time of need are some of the keys to a successful medical life.
In the workplace, advocacy for changes to harmful workplaces and work practices requires more than one voice. Small changes make a difference.
Allowing a portion of CPD allowances to help fund personal services and treatments, such as a personal trainer, nutritionist or psychologist, can improve doctors’ health. Undergoing very comprehensive health assessments prior to commencing internship and when moving through career transitions has real merit.
Creating wellbeing leadership positions in tertiary hospitals is finally happening and will hopefully alter the dismissive mindset of others towards doctors’ health and focus on ways to create an environment in which they can truly excel, but not at the expense of their own health.
System-wide endorsement of ways to embed doctors’ health in training is occurring. Accreditation of clinical rotations, regular health checks along the career continuum and support for specialist doctors’ health programs are examples.
The aim is to come to work in good shape and work in a supportive, respectful place where you can excel and where you feel safe, valued and listened to. A doctor must have confidence that the wider health system is committed to investing in doctors’ health, because it’s important to the clinician and their family and to the safety and welfare of their patients.
Dr Roger Sexton is the medical director of Doctors’ Health SA
Heart matters
The Heart Foundation’s Chief Medical Officer Professor Garry Jennings provides practical tips to help doctors improve their heart health.
‘Take my advice. I’m not using it.’ Many a true word is spoken in jest.
As doctors, we are well-versed at giving patients health advice. With cardiovascular disease still one of the most prevalent health conditions in Australia, we often emphasise to our patients how lifestyle factors can affect their risk. Much time is spent in clinical consultations providing information and guidance on lifestyle changes – such as adopting a healthy diet, increasing physical activity, avoiding smoking and excess alcohol, and maintaining a healthy weight. With our clinical knowledge, people expect that we practise what we preach.
We benefit from our own health literacy. We know the guidelines for healthy nutrition, physical activity, smoking cessation and alcohol consumption. And we do try to follow our lead, but our days can be hectic, often finding ourselves prioritising our patients and professional obligations over our own needs. Just like any other Australian, we can easily fall through the cracks and resort to habits that could impact our heart health. The new year can be a great opportunity to start anew and cultivate healthier habits – for us to improve not just our heart health but our mental wellbeing as well.
The Royal Australian College of General Practitioners and the Royal Australian College of Physicians, encourage their members to take care of their physical, mental, emotional and social wellbeing and provide resources and confidential support services, if needed. The ‘Every Doctor, Every Setting’ national framework for the mental health and wellbeing of doctors and medical students in Australia has been published. But until the action plan is implemented across all settings where medical professionals work and train, here are a few reminders of healthy habits that we can incorporate in our daily routine.
Be more physically active
Exercise is not just for your patients. If you haven’t already, find a physical activity or sport – be it walking, swimming, yoga, cycling, martial arts or any activity you like or have been putting off – and start off slowly. Increasing your physical activity from as little as 10 minutes a day to 30 to 45 minutes a day, five or more days of the week can help reduce your risk of heart disease and heart attacks.
Eat as you advise your patients to do
Follow a heart-healthy eating pattern with wholegrains, fibre and healthy fats, and which is naturally low in unhealthy fats, salt and added sugar. Preparing meals in advance and having handy options such as fruits and nuts can help with avoiding the hospital vending machines and the drivethroughs. Take a proper break for a proper meal.
Try the Heart Foundation’s heart-healthy meals: www.heartfoundation.org.au/recipes/recipe-ebooks
Create some contact boundaries
Just because you can be reached does not mean you should be available 24/7. Find ways and time to disconnect without compromising your obligations to work and family.
Don’t be lonely in a crowded day
Talk through that nagging case with colleagues before it keeps you awake at night. Rural doctors might want to reach out to professional networks online.
Don’t be your own physician
Let others decide if those symptoms are related to an underlying condition and what the best treatment options are. If you do not already have heart disease and are over the age of 45, speak to your GP about a Heart Health Check.
Professor Garry Jennings is the Heart Foundation’s Chief Medical Officer and has a distinguished career as a cardiologist in clinical practice.
Greek tuna salad jars
Ingredients
• 250 g packet microwave brown rice and ancient grains
• 1 tablespoon olive oil
• 1 tablespoon lemon juice
• 50 g soft feta, crumbled
• 185 g can tuna, drained and flaked
• 1 small red capsicum, chopped
• 1 small Lebanese cucumber, chopped
• 60 g cherry tomatoes, quartered
• 1 green shallot, thinly sliced
• 1 tablespoon sliced kalamata olives
• 2 teaspoons chopped fresh dill
• 4 cos lettuce leaves, coarsely chopped
• 2 teaspoons pine nuts, toasted
Method
• Step 1
2 serves 15 m prep 2 m cook
Heat rice blend in microwave according to packet directions. Transfer to a bowl. Cool.
• Step 2
Divide olive oil, lemon juice and feta between 2 x 450 ml capacity jars or containers. Season with pepper. Top evenly with tuna and rice blend.
• Step 3
Combine capsicum, cucumber, tomatoes, shallot, olives and dill in a bowl. Divide mixture evenly over rice layer in jars. Top with lettuce. Seal jars with lids and refrigerate until ready to serve. Divide pine nuts between 2 small containers.
• Step 4
To serve, invert salad jars onto plates or into shallow bowls and sprinkle with pine nuts.
Tips
• Salad jars can be prepared 1 day ahead. Keep refrigerated. For easy, spill-proof transport, assemble salads in jars or containers with a screw top lid.
• You can use any unflavoured wholegrain microwave rice blend. Check out the varieties available in the rice section of supermarkets, or substitute plain cooked brown rice, if preferred.
This recipe was reproduced with permission from the Heart Foundation website.
For more healthy recipes visit: www.heartfoundation.org.au/recipes.
A call to (slightly slower) action
Ever wonder why a short walk outside reduces your stress levels and helps you resolve a problem? We are so deeply connected to work, technology and daily demands that we forget the positive impact nature has on our health and wellbeing.
In the new book, The Natural Advantage (Major Street Publishing $32.99), Australian lifestyle medicine practitioner Dr Jenny Brockis provides an evidence-based guide exploring the powerful ways nature affects our lifestyle choices around nutrition, exercise and sleep to elevate our health, wellbeing and happiness.
Drawing upon four decades of experience in lifestyle medicine, Dr Brockis shows how more time in nature not only makes us feel better, but enhances our quality of life and contributes to a healthier and longer life.
‘While medical treatments have advanced enormously, it is often the smallest and simplest of activities, such as spending time enjoying our own backyard or walking the dog, that can bring about profound positive and transformational changes to people’s lives,’ Dr Brockis says.
The book outlines proven and effective nature-based activities for home or work that enrich our lives, all backed by scientific evidence. Readers learn:
• how nature can help improve our physical, mental and emotional health through greater connection;
• simple, nature-based activities that promote wellness – no matter how much time you have or how busy you are; and
• how to develop healthier balance and get more time outdoors.
Working with business leaders, busy professionals and individuals, Dr Brockis’ aim is to educate, inform and inspire positive and transformational lifestyle change, providing practical, achievable and evidence-based solutions to mitigate, resolve and help prevent many of the modern maladies of life.
How to beat screen fatigue
Given medical professionals are required to stay in front of a computer screen for many hours a day, you’ve probably experienced eye strain. Whether you’re peering at a computer screen or smartphone, our ‘near work’ means our eyes get so used to accommodating close-distance tasks that when you look elsewhere, it takes your eyes a moment or two to adjust. Holding visual focus enhances mental focus, but it is tiring and is different from how our eyes were designed to operate all day long.
The impact on blinking
Prolonged screen time means we blink less. Usually, you’ll blink around 17 times a minute. Focussing on screens can cause that to drop to five to seven times, and that blinking is less complete. This leads to dry eyes, an issue that is compounded by exposure to air conditioning or heating. How much time do you spend in front of a screen each day? The average worldwide is seven hours a day. Yet, we typically only spend 30 minutes outside.
Once more, nature provides simple solutions. You can improve your visual range simply by getting outside for a few minutes, preferably longer, to stretch your extraocular muscles. Distance vision lowers stress, which feels good, right? You may notice you’re more relaxed and less tense. Stress causes your pupils to constrict as part of the fight, flight or freeze response. Lower stress allows your pupillary muscles to relax. Making your visual stretch routine a regular habit makes it easier to focus when required.
It’s about focus
Depending on how you work, aim to chunk your focussed work into blocks of up to 90 minutes (or whatever is practical for you) and then take a nature break for 15 to 20 minutes. This follows the ultradian rhythm, your naturally occurring body clock regulating energy. Taking a nature break restores your cognition and attention ready for the next chunk of focussed work.
Get out in natural light to allow your eyes to relax while you enjoy a visual feast of colours, light and shade.
Edited extract from The Natural Advantage by Dr
Jenny Brockis
Looking at greenery provides greater soft fascination – your brain enters the default mode, which requires far less effort and helps you relax. Natural green vegetation also helps filter out harmful UV rays and reduces glare. It makes you more creative and puts you in a better mood. Bonus! When out and about, I often find myself drawn to looking up at the trees around me, watching the branches sway in the wind, listening to the rustling leaves and scouting for the birds I can hear twittering.
Explore the greenery
Looking at a treescape has been shown to reduce stress, and the greater the tree density, the more beneficial the effect. Blue and green, the predominant colours in nature, improve emotional well-being and lower psychological stress. These colours have lower wavelengths, meaning your eyes don’t need to adjust. They are calming and promote relaxation. Don’t forget your hat and sunglasses for adequate UV protection when outdoors. The best glasses wrap around your eyes to protect your peripheral vision.
If you can’t get away, something simple you can do is to follow the 20-20-20 rule: look away from your screen every 20 minutes and focus on something that is 20 feet (6 metres) away for at least 20 seconds. The joy of having windows is that they provide the perfect way to achieve this, with the bonus that having a green outlook is particularly soothing for your eyes and brain. This also reduces dry-eye issues as your blinking rate increases. When you return to your screen, keep it at arm’s length and with the font size easy to read to reduce eyestrain.
Dr Brockis is a board-certified lifestyle medicine physician, workplace health and well-being consultant.
- This article by Martin Turner of AMA WA was originally published in Medicus magazine in October 2024.
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We provide expert advice on all aspects of wills and estate planning, asset protection, wealth management, and business succession planning. Let us help you secure your legacy with confidence.
For further information on asset planning or any other legal advice please contact one of our legal professionals.
DOCTORS NEXT-GEN
AMA SA stands with doctors throughout all career stages –from student right through to retirement.
In this section of medicSA, we introduce you to emerging medicos who are eager to make their mark on healthcare in South Australia.
AMA SA 2024 Student Medal winners
John (Jock) Duncan and Grace Mackenzie were awarded the 2024 AMA Student Medals for their determination to make the med school experience as good as it can be, to produce the best possible doctors. Speaking to medicSA they reflect on their student journey and their hopes for the future.
Dr John (Jock) Duncan Q+A
University
of Adelaide
When did you decide you wanted to be a doctor?
I’d always wanted to be a doctor, but when I left high school I went into law instead. I found the law degree very dry and by second year I realised it wasn’t for me. In 2019 I transferred into first-year medicine and the content was much more exciting.
What are you doing now?
I’m working as an intern at the Royal Adelaide Hospital in 2025. I’m starting in vascular surgery and then moving onto respiratory medicine and ED general medicine. I’m just trying to be a sponge. Hopefully I’ll be exposed to the fields I haven’t experienced as a student and try to figure out what my path is for the rest of my career.
What are your professional goals?
I would like to split my time between clinical work and teaching. I had a really good time being a tutor during one of my rotations at uni.
In terms of my bigger aspirations, I want to be a doctor who does right by their patients. I hope they feel heard and understand I’m on their side. I also want to use my degree to travel around Australia and have different professional and life experiences. I spent some time on Thursday Island in the Torres Strait, which opened my eyes to the possibilities of working in other regional and remote communities.
How did medical school prepare you for your internship?
In the first three years of my degree, the University of Adelaide gave me a really strong foundation in clinical theory work. I was also given a lot of time to practise those skills and develop clinical reasoning. They taught me how to think critically and how to come up with a diagnosis. In years four and five I got so much exposure in the hospital that I no longer feel stressed in that setting. It’s a great transition to the internship program.
What are the best and worst aspects of medical school?
The University of Adelaide had a strong emphasis on clinical interactions, including simulated interactions with actors pretending to be patients. You get used to speaking to patients. It’s really beneficial because you get to mess up somewhere safe before you’re let loose in the real world.
The other big positive is the friends you make. You start with 180 people, and you finish knowing everyone’s name and developing pretty strong friendships. I think that’s hard to replicate in other degrees.
There aren’t too many negatives. I guess the only downside is that there are no shortcuts. It takes five or six years before you’re ready to become an intern. It’s a long time and a lot of work.
How did you react to being named the winner of the AMA SA Student Medal?
It was pretty weird. I was on stage and AMA SA President Dr John Williams started reading out a list of achievements and I was like, ‘Oh! I think that’s me!’. My heart was beating fast. It was a fantastic accolade to receive.
What involvement do you plan to have with the AMA?
I’ve always been involved in advocacy during my time as a student. I look forward to continuing that during my career as a doctor with the AMA.
What advice do you have for new medical students?
Find something you enjoy outside of medicine, whether it’s a hobby or a part-time job. Medicine can be a bit of a bubble. If you have life experiences outside that bubble it will make you a better person and a better doctor. You’ll be better equipped to relate to and communicate with patients from different walks of life.
Also, don’t put yourself under too much pressure. You’re not going to be able to do the things you think you can do straight away – it comes with time. Do the work and trust that you will get better. By the end of your six years, you won’t even recognise yourself!
Flinders University
Dr Grace Mackenzie Q+A
When did you decide you wanted to be a doctor?
Initially, I wanted to be a laboratory scientist and began my university journey with a Bachelor of Science. During my first year, I took an elective in forensic science, which included a fascinating lecture on forensic pathology. This lecture was a turning point for me. I discovered that forensic pathology was a medical specialty, prompting me to switch to a Bachelor of Health and Medical Sciences. As I progressed through my studies, I realised that to pursue a career in medicine, I needed to enter via a postgraduate program. I sat the GAMSAT during my final year of undergraduate studies and successfully applied for a postgraduate medical program. While I’m still exploring my final specialty and may not end up in forensic pathology, that initial lecture was the catalyst that set me on the path to medicine.
What are your professional goals?
I’m still undecided. I’m interested in general practice and anaesthetics, possibly in a rural setting. I also have a strong interest in student advocacy and medical education. For now, I plan to focus on my internship and postpone extracurricular activities to settle into working life.
How did medical school prepare you for your internship?
Medical school, particularly at Flinders, gave us extensive placement experience. Beyond the practical learning benefits, being on placement really helps you understand team dynamics and interprofessional relationships. I had experiences on very functional teams, but some were highly dysfunctional. You get to learn how to handle those challenging work environments.
What are the best and worst aspects of medical school?
The best part is the lifelong friendships you form. I really struggled with that in my undergraduate degree because there were 300 of us doing different majors. In med school, you’re doing everything together all the time, so you get to know people really well.
I think the worst aspects of med school are the financial barriers that can shut out people who would otherwise succeed. The entrance exam to apply is $500. Once you start doing full-time placements it’s very difficult to juggle parttime work on top of that. If you don’t have a support network
How did you react to being named the winner of the AMA SA Student Medal?
59 around you, it can be very difficult. Ultimately these types of barriers make it difficult to promote diversity among the student cohort.
I was very humbled. I took a lot of pride in contributing to my college, but a lot of my work was ‘behind the curtain’ –people didn’t always see it. You don’t do it for the recognition, but it was really nice to be acknowledged.
What involvement do you plan to have with the AMA?
I am eager to learn more about the AMA’s initiatives and how they support both doctors and patients. I believe the AMA plays a crucial role in advocating for the medical profession and addressing issues that affect healthcare delivery. Once I have settled into my role as an intern and have a better understanding of my career direction, I plan to explore opportunities within the AMA to support their efforts in improving healthcare policies and practices. I see great value in contributing to the medical community through advocacy and policy work.
What advice do you have for new medical students?
Take pride in your small achievements and use them to stay motivated. It’s easy to get overwhelmed by the long journey ahead, but recognising and celebrating your progress, no matter how small, can help you stay focussed and positive.
For clinical years, my advice is more practical: make it easy for people to remember your name by wearing a name tag and a distinctive scrub cap. In a busy clinical environment where you might be rotating through different teams frequently, being easily identifiable helps you stand out and ensures you are seen as a valuable member of the team. This helps build better relationships with your team and enhances your learning experience.
Graduates from South Australia’s medical schools in 2024 AMA SA congratulates
FLINDERS UNIVERSITY
Mohsin Ahmad
Pegah Ahmadiyan Ardestani
Ginger Akins
Darya Ali
Joshua Andrews
Kosta Antolis
Neil Arora
Philip Arundel
Svetlana Astashova
Rumsha Baig
Andrew Baldwin
Joshua Bates
Milica Beljic
Amy Booth
Chelsea Boylan
Jasmin Branford
John Brennan
Michael Briggs
Rohan Broadhead
Samantha Brookman
Shannon Capewell-Jones
Hannah Carter
Michael Catalanotto
Jonathon Cavuoto
Nishan Chahal
Isobel Chambers
Minyoung Cho
Pooja Chugh
Alex Coleman
Shaun Crouch
Aatmaj Dasondi
Jai Defranciscis
Prabjot Dhaliwal
Prabhsimran Dhillon
Kaavvya Divakaran
Natalie Edmonstone
Helen Fairhurst
Verena Fanous
Salma Sherif Mohamed Fathy
Rizal Fenwick
Carmel Ferrer
Matthew Fletcher
James Fowler
Tessa Gaynor
Tejaspreet Ghataura
Anushka Ghorpade
Matthew Giddings
Emily Gloede
Hamish Greenslade
Holly Groome
Ananya Gupta
Marina Habib
Monica Hansen
Andrew Hearl
Joe Hedger
Lucy Heil
Danny Hill
Ethan Hill
Cassandra Ho
Gahyun Hong
Jamie Hua
Simon Hurley
Anastassia Iambaeva
Gabriel Jackson
Jack Jeanes
Alexei Joukovski
Naomi Kanahala Gamage
Kavindya Kariyawasam
Jorjina Kasparian
Marjan Khorvash
Jeremy Kiew
Laalithya Konduru
Sharveena Krishnan
Minjoo Kwon
George Kypreos
Reynier Lara
Aisha Lay
Kelvin Le
Richard Le
Andrew Leat
Madeleine Lemmey
Stephanie Louey
Madison Lowe
Madison Ludwig
Michael Luppino
Eilish Macauley
Grace Mackenzie
Gowri Manesh
Thomas Mansfield
Matika Marchant
Ann McDonald
Emma McKenzie
Hamish Mckenzie
Bilal Mir
Mohsen Moghimi
Lauren Mormile
Nadiah Amalina Binte Mustafa
Agnes Wing Wa Ng
Daniel Nguyen
Irvin Ong
Megan O’Reilly
Sarah Othman
Nicholas Pavic
Giang Trung Pham
Jennifer Pham
Thuy Pham
Jonathan Phillips
Revania Pillay
Elena Popa
Alice Quigley
Mahadya Rahman
Sriram Raj
Chrishma Ravindranath
Jonathan Ries
Alison Rowley
Syeda Amel Safi
Rasul Sahingoz
Michelle Santella
Soufia Sarpeleh
Afia Schaefer
Laura Schultz
Bophavotey Seng
Emily Shaw
Gabrielle Shea
Isabella Sheehan
Loganathan Sivarajan
Lydia Smalls
Marshall Smith
Emily Squires
Marat Sverdlov
Hannah Sweaney
Jessica Rui Ping Thia
Su Mon Thin Zar
Jessica Thomas
Stephanie Thomson
Gabriel Tramaglino
Jin Nuo
Joan Tsang
Angela Vivish Vazhalanickal
Madeleine Veitch
Benjamin Voyvodic
Abigail Watson
Eleanor Watts
Benjamin Weimann
Muhammad Yahya
Claire Jiayi Yun
Alex Zahnleiter
Daniel Zaina
Mary Zhao
Emilie Zhou
Liz Abraham
Ann Abraham
Emmanuel Afari
Vinal Attanayake
Saghi Bahadori
Patrick Barnes
Jasmine Beger
Armaan Bhangu
Kseniia Bogatyreva
Rahnee Boyd
Annabel Brentnall
Rebecca Bright
Jessica Brooks
Erin Cameron
Elyssa Chan
Jose Chong
Jie Xin Germaine Chua
Taryn Coleman
Julia Cooney
William Cowling
Jasmine Crocker
Timothy Daniell
Griffin Dean
Nivida Dixit
Katherine Dumas
John Duncan
Lewis Elliott
Ching-Tzu Fang
Keira Fee
Nicole Kate Fernandez
Dylan Fisher
Xin Yi Foo
Jackson Furst
Daniel Gabriel
Tharushi Gamage
Namrata Gawde
Bishouy Amir Monir
Barsoum Ghaly
Nikolaos Glynatsis
Cicilia Gomes
Liam Halford
UNIVERSITY OF ADELAIDE
Rhys Hankinson
Samantha Hauptman
Kingjin Heng
Nipun Herath
Ranudi Hewage
Abhiram Hiwase
Yiran Hu
Allen Huang
Jack Hutton
Bora Hyoung
Suyash Jain
Anaa Jamal
Nayanika Jathin
Divyanshu Joshi
Kaviya Kalyanasundaram
Aditi Kamath
Laura Kelly
Sahil Kharwadkar
Alevia Khoo
Teck Hong Khoo
Sungmin Kim
Na Yeon Kim
Yi Xhuan Koh
Umutcan Konakci
Aleksander Kudra
Yi Xin Kwan
Nicholas Laity
Lydia Lam
Antoinette Lam
David Lau
Minh-Chau Le
Joo Yeon Lee
Christine Hui En Lee
Amos Lee
Tz-Shane Lee
Jordan Lesicar
Emily Li
Longcheng Li
Tze Ern Samuel Lieu
Sau Kiat Keith Lim
Yuxin Lin
Margarita-Chrissi Litinas
Natalie Liyanage
Sophie Ludbrook
Monica Margarit
Isobel Marshall
Piers Martin
Marni McFarlane
Cameron McGuinness
Bridgette McKinnon
Grace McMahon
Kira McMahon
Oscar Moore
Thomas Muecke
Ishmam Murshed
Quynh Nguyen
Xuan Nguyen
Simon Olaivar
Huy On
Seoan Park
Anuradha Pati
Chinmai Patil Pandappa
Mitchell Pearsons
Domenico Perrotta
William Proudman
Daniel Radesic
Bharat Raghuram
Poonam Rajput
Arya Rao
Mitali Rawat
Hugo Ricci
Sebastian Ricci
Matthew Robertson
Giuseppina Rositano
Vineeth Roy
Raneesha Saberi
Zakia Saymontee
Tegan Schellenberg-Beaver
Mike Schmid
Elly Schoff
Thomas Scroop
Alexander Seiboth
Mawathage Seneviratne
Ching Yu Shek
Arfaan Sheriff
Elizabeth Siaw
Sofija Smiljanic
Eden Smith
Danielle Smith-Sparrow
Katherine Song
Kate Spuler
Hannah Subramaniam
Mansa Sukheja
Kenneth Jun Jie Tan
Matthew Tan
Joyce Rachael Tan
Gek Min Amelia Tan
Jay Tan
Teresa Yen Mei Tan
Owen Taylor
Alison Teubner
Anthony Tew
Emma Tidemann
Joshua Tinnion
Ashley Tobias
Kathleen Tong
Elise Toyer
Son Tran
Anthony Vo
Albert Vu
Hugo Walker
Aaron Wu
Anthea Yew
Kevin Yin
Shaanan Ting Yong
Harrison Young
Stevie Young
Mufei Zhaoxu
Yu Zhou
Linyi Zhu
Janna Zwijnenburg
‘PINCH ME’ MOMENTS
The Flinders Medical Students Society (FMSS) is excited to embark on another year of student representation – except, this time it’s a bit more special. This year marks the celebration of 50 years of FMSS on all fronts – student advocacy, events and academic teaching.
This year also marks the very first year of an innovative, world-class program. Flinders University is launching the South Australia Rural Medical (SARM) Program – an end-to-end rural program based in Mount Gambier and the Riverland. We are very much looking forward to expanding our outlook to these regions (and more in the future). It’s our hope that medical students who undertake their training in rural settings will stay in rural communities, easing workforce shortages across country Australia. This program will also give opportunities to those who can’t attend medical school in a metropolitan region.
Sixty students will take part in the SARM program. We are thrilled to welcome them and the 170 other medical students who are new to the FMSS community this year.
It is certainly an honour to be elected as president at this time. I endeavour to lead our committee to grow the seeds planted over the past 50 years in all directions.
Outwards: We plan to increase our engagement with our colleagues at Adelaide Medical School, Flinders Northern Territory, the Australian Medical Association, Doctors in Training and our alumni.
Upwards: We have a renewed focus on membership, sponsorship, social media and external advocacy.
Inwards: We aim to cultivate a collegial, inclusive and supportive environment within the Flinders community – a community where compassion traverses our veins and ideas that resound off the medical library tables are conveyed in a productive manner.
It wasn’t very long ago that I was standing in the shoes of the starry-eyed students I get to speak to and advise today. Several times over the past few weeks I have had what I call ‘pinch me’ moments. I have had the privilege to work with The Smith Family in conducting outreach to children with disadvantaged backgrounds – sharing my journey into and throughout medicine.
I grew up as a country girl. I had a horse in my backyard, two migrant parents, a Pizza Hut deliveryboy family income and a dream to practise the art of healing. At that stage, I never could have imagined the prospect of seeing city lights, let alone moving interstate at 17 and becoming one of the first women in my family to achieve higher education. The prospect of travelling the world today, delivering healthcare to those who need it the most, was just unfathomable. For me, this is what the future of healthcare education looks like – opportunity.
I feel that it is up to us, as leaders of medically affiliated associations around Australia, to inspire, to educate and to provide opportunities for people to learn about the variety of health pathways; what they look like and where those paths may lead junior doctors.
As I progress towards the end of my medical school journey, I am grateful for the plethora of experiences I have had. And I’m excited. We’re the future of medicine – preparing to step out and wholeheartedly embrace what the medical world has to offer.
2025 FMSS Senior Committee
Angelina Arora FMSS President 2025
FROM SMALL BEGINNINGS
Five years ago, I walked into the Health and Medical Sciences Building (our beloved AHMS) for my very first lecture in medicine, ‘Introduction to Anatomy’. Nervous and eager, I knew I’d need something to keep me awake for what I imagined would be a mind-blowing (and slightly terrifying) dive into the human body. That’s how I found myself awkwardly standing at the Bean Bar Cafe as a coffee novice asking the barista what drink they recommended. I walked away clutching an almond flat white with two sugars (how tragic), hoping it would give me a spark of energy and a dash of confidence.
If you’d told 17-year-old me, standing there trying not to spill her first-ever coffee, that one day she’d be running the very med society she’d signed up for at O-Week, I definitely would’ve spilt the coffee. But here we are five years later in our last leg of the med school journey. And what a journey it’s been!
My 2025 graduating cohort and I are on the other end of Objective Structured Clinical Exam’s (OSCE’s) and Multiple Choice Questions (MCQ’s) and the finish line is well and truly in sight. At our first lecture of the year, we were all buzzing with excitement – excited to attend lectures simply for the sake of learning (exams are OVER!), excited about becoming our intern’s ‘right hand man’ and most importantly, excited about unlocking the ‘Holy Grail’ of med school wisdom: all the secret Sunrise shortcuts.
Being in our final year of uni comes with an undeniable pressure to answer the big question: What do I want to be when I grow up? After six years of exploring, I’ve decided my heart is set on general practice. Being from a small town in Queensland, I’m especially
drawn to the idea of working in South Australia’s small communities – exploring the hidden gems that make this state so unique while making a real difference in areas where healthcare can truly transform lives. Plus, let’s be honest, I’m not built to make decisions after 5pm.
As I reflect on this final year, I’m also incredibly proud of the work we’re doing at AMSS. This year is shaping up to be the biggest yet for AMSS. Both our committee and our events calendar are the largest we’ve had and we’ve hit the ground running in 2025. It’s so exciting for me to see such an incredible team of people who are so passionate about the roles they hold and the impact they have.
We are bringing a fresh energy to 2025 and challenging the status quo – keeping our members at the heart of our events and advocacy. Imagine a bigger and better MedBall, strong university alliances and advocacy, pivotal changes for the MD, enormous O-Week events and a huge student body presence.
I cannot be more confident that the AMSS will make 2025 a year to remember! If you would like to collaborate or work with us, please always feel free to contact me.
Sara Bilwani
A SNAPSHOT OF HUMANITY IN A BUSY WARD
CALHN intern Dr Allen Huang reflects on his first months at The Queen Elizabeth Hospital and the importance of making meaningful connections with colleagues and patients.
Warm days, early sunrises and late sunsets. The ‘summer triad’ of Adelaide has always signalled to me the ending of one year and the start of another.
Dressed in a navy-striped shirt and chinos, a young man approached the side entrance of The Queen Elizabeth Hospital on a warm January morning. A pair of black RM Williams boots and a belt tidied up his ‘uniform’. There was nothing particularly striking about this young man. He had worn the same ‘uniform’ for the past few years – only ever exchanging his navy striped shirt for a navy checked one and sometimes venturing beyond his comfort zone in burgundy.
However, this morning, there was a slight difference. A bright blue tag dangled haphazardly off his belt with the bold white letters ‘Intern’ emblazoned on it. The title marked a transition – one that came with a significant increase in responsibility, workload and excitement.
I was that man.
Having just completed a week of orientation, it was time for me to step up and into the outgoing AMU interns’ role – preparing the patient list and ward round notes, organising scripts, coordinating patient care and proactively pre-empting other tasks that needed to be completed. Being a ‘reliever’ compounded this as I found myself working across various medical and surgical units, attempting to adapt my acronym expansions and ward round notes to each team.
It was certainly fast paced, yet I felt undoubtedly thankful for the supportive staff. Doctors, nurses and allied health staff worked together to enable the hospital to function like a well-oiled machine (sometimes).
Though the media often highlights the challenges and pressures of the healthcare system, I was fortunate to find moments of clarity, meaning and hope.
‘How’re you going?’
I looked up and smiled. It was my friend from medical school. As we chaffed and chatted with one another, a sense of camaraderie bonded us. We were in the ‘trenches’ of the system, yet we had the support of each other and our fellow interns – old friends and new. Not only were the quick smiles and conversations refreshing, we were also able to work alongside colleagues who we trusted and respected.
Writing this one month into my ‘relieving’ rotation, I feel significantly more comfortable with this new role (although still less experienced than my RMO and registrar colleagues). Each of these moments in my first month – signing my first script, discharging and receiving my first handshake from a thankful patient, managing my first deteriorating patient, encouraging my first sixth-year student in taking bloods – was eagerly debriefed with my very patient wife (who is a teacher).
As I near the end of this reflection, I’d like to end on a more serious note. At its core, medicine is this strange juxtaposition between a career as a scientist, academic and researcher, and a role as a healer, advisor and servant to someone in their most vulnerable state. Often in our everyday bustle, we fall too easily into the former career while setting aside our role. We are blessed with the opportunity to take on our role as servant healer; to encourage the disheartened, help the weak and be patient with everyone.
I hope that this brief update awakens similar memories of your own early years and serves as a reminder of the camaraderie and purpose we all share.
As the days get shorter and puffer jackets begin to appear, we shall continue encouraging and supporting one another, just as we are doing now.
Dr Allen Huang is a medical intern at The Queen Elizabeth Hospital.
Dr Allen Huang snaps a ‘selfie’ with his colleagues
Dr Anthony Tew,
Dr Huy On and Dr Anaa Jamal
&Life leisure
TRI AND TRI AGAIN
A painful accident derailed Dr Hayden Cain’s first tilt at the Noosa Triathlon.
But the former chair of AMA SA’s Doctors in Training Committee wasn’t about to let an ankle reconstruction stand in the way of his goals.
It was November 2023 and Dr Hayden Cain was gearing up for his first Noosa Triathlon.
He’d been training for months. But on the day before his flight to Queensland, he accepted an ill-fated invitation to go bouldering with mates.
In hindsight, climbing rocky escarpments – without a harness – perhaps wasn’t the best idea on the eve of an Olympic distance triathlon.
‘I was going for a dynamic jump to get a difficult hold when I slipped, fell, and hurt my ankle,’ he recalls
‘That put an end to any hope of doing my first triathlon.’
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Dr Hayden Cain (R) with his friends at the Noosa Triathlon
Six months later Dr Cain still couldn’t run and was suffering significant pain and swelling in his ankle.
‘Finally, I got an MRI which showed some bone floating around in the joint,’ he says.
‘I ended up needing a reconstruction of all the ligaments on the outside of my ankle and a clean-up of the ligaments on the inside.’
The post-op recovery period was two months – a long time for a man with a compulsive drive to stay active.
Despite the setback, Dr Cain was determined that nothing would stop him from competing in the 2024 Noosa Triathlon.
By the time he was back on his feet, he had just three months to get race-ready. And so began a grueling six-day training regime of swimming, cycling, gym and sprint circuit training.
‘My thought process was, “no matter what, I’m going to do this”,’ he says.
‘I thought to myself, “If I need to walk to the end, I’ll get it finished. It doesn’t matter how long it takes. I just want to get it done”.’
His mental grit never wavered. But at times, his body did.
Just six weeks out from the triathlon he could barely run two minutes at a time before his ankle flared in pain.
He also suffered a repetitive strain injury to his right hip from running around the same oval, continually turning in the same direction.
‘It was definitely touch and go for a while,’ he says. ‘I was quite nervous.’
‘It was only about three or four weeks out that I could run continuously for the entire time.’
Competition day came around quickly. And a year after what should have been his first Noosa Triathlon, Dr Cain was finally standing at the start line.
But his dalliance with pain wasn’t done yet.
‘You start the triathlon with the swim, which is my most comfortable event. Sadly, it turned out to be my least favourite part of the race,’ he recalls.
‘In the first 50 metres, I got kicked in the face and got a blood nose. I did the entire swim with my head out of the water, choking on blood.’
The cycle didn’t go much better. He’d packed his bike for the flight from Adelaide. Putting it back together hadn’t gone to plan.
‘It was the first time I’d reassembled it. Obviously, I didn’t do a good job because my steering was very stiff, and my bike stopped shifting gears about nine kilometres into the ride.
‘I ended up losing about 20 minutes on the cycle.’
Dr Cain completed the triathlon in under three and a half hours – a valiant effort by any measure, especially given his limited capacity for training.
He’s already planning to return better and faster in this year’s event.
‘When you’ve suffered a major injury, it’s important to have a goal. Have something set in stone and a date when you need to perform,’ Dr Cain says.
‘It doesn’t matter how well you perform – you just have to do it. That really helped push me and helped mend my ankle faster.’
‘ If I need to walk to the end, I’ll get it finished.’
(ROAD)TRIP DOWN MEMORY LANE
Long-time medicSA car reviewer Dr Robert Menz reflects on three decades at the wheel.
It was while driving a top-of-the-range Pajero Sport test vehicle along Adelaide’s beautiful jacaranda-lined streets last spring that I began reminiscing about my time as one of the reviewers of new cars for medicSA.
I began writing for medicSA in 1992 when Dr Phil Harding was president of AMA SA and I was a member of our Council, representing general practice. Phil was one of my medical heroes. He was also a renowned motor enthusiast and, as the owner of the first Mazda MX5 in South Australia, was the inspiration for me having owned three.
Phil offered me a BMW325i four-door manual to test-drive.
Younger readers may have never had the sheer driving pleasure of a ‘manual’ car with three pedals on the floor, the left one a clutch, and a gear lever
or ‘stick’ that needs to be moved to change gears while the clutch is depressed. I recall being very impressed with the BMW and wrote about its ability to accelerate up Willunga Hill in top gear with a full complement of passengers and luggage. I also wrote about driving up Gorge Road in the days when the speed limit was 110 km/h and being able to stick to the speed limit in that curvy section past the Kangaroo Creek dam. The current speed limit is 80!
For those who don’t know how car reviews are arranged, motor car companies provide ‘press cars’ to motoring journalists around the country. These are provided for a week and are collected with a tank full of fuel. They do not need to be refilled or cleaned prior to returning but are expected to be undamaged. There is basic insurance but often an excess of between two and five grand to encourage careful driving.
In my early years as a ‘motoring journalist’, I wrote the occasional article, including my impressions of the Subaru WRX in 2001. This test was notable for two reasons. Firstly, it was the only time I have received a speeding fine while driving a test car: I was caught doing 54 km/h in Mary Street, Unley, while taking my daughter to the Royal Adelaide Show.
Dr Robert Menz test-driving a Honda HR-V for medicSA’s December 2022 issue
Secondly, I was foolish enough to write about managing to get the car airborne while driving rapidly between Mount Lofty and Mount Bonython.
The then-medicSA editor and former AMA SA president David Game (another of my medical heroes) did not invite me back.
But times and personnel change. When Phil became editor, I became the regular motoring columnist, sharing the driving and writing with him – often in the same article.
I have been lucky enough to be behind the wheel of well over 60 new cars, including Audis (A3RS, Q7, E Tron, A5), BMWs (420i, X5, M5, 3180i) Mercedes, (A, B and, C class), Lexus, Citroen, Mustang, Peugeot, Toyota (Hilux, Landcruiser, Yaris GR Rallye), Subaru (Outback and Forester), Kia Stinger, and Honda (Civic, CRV, HRV, ZRV).
Phil was always keen to explore the latest automotive trends and designs. He had a particular interest in EVs, both hybrid and full electric, which led to me having opportunities to drive the Audi eTron, Polestar 1, Tesla model S, Nissan Leaf, Mitsubishi Outlander and Eclipse Cross.
One of the more forgettable cars was a red Holden Calibra, GMH’s somewhat short-lived attempt to emulate Toyota Celica, Honda’s Prelude and Mazda’s MX6. The article appeared in the May 1992 edition of medicSA (which back then was called SA Medical Review), which was memorable because the front cover featured a certain metropolitan GP and motoring enthusiast giving an influenza (which autocorrect wanted to call influencer) vaccine to one of his patients. Not quite the cover of Rolling Stone, to which Dr Hook also aspired.
I was clearly more lyrical in those days. My review began: ‘There is something evocative about the colour red. Red – the colour of blood. I always think of the highly desirables: crayfish, raspberries, Grange, Ferraris.’.
I know at least two people who have had their choice of next vehicle heavily influenced by articles in this magazine. (If you or someone you know has also been helped by our reviews, please let us know! It will help us secure test cars and advertising.)
People often ask about my favourite car. Like a child, it is not possible to answer with a single vehicle.
I have liked hot hatches since owning my first car, a Mini Cooper (not really a hatch, but certainly hot), and what I claim to be the first hatch, a 1969 Renault 16 TL, which had an engine transplant to TS
specification. The Audi A3 RS, and Toyota GR Yaris are also up there.
The X5 Beemer is one of the most comfortable. The Jeep came with a bike rack that came in very handy during my week with it. And more than one test car has possessed a towbar, so I was able to test the trailer-towing capability.
And when I am not driving someone else’s car, my daily driver is a 2023 Outback XT. On the weekend, either the red or the green MX5 suits me fine, provided it’s not raining.
In December 2024 I retired from clinical general practice after 44 years. Like many of my recently retired colleagues and friends, I find my days and weeks are full and it’s time to hand over the keys. I’m retiring from this writing gig in December 2025, and look forward to reading reviews from my colleagues in 2026 and beyond.
- Dr Robert Menz is a retired GP and remains an enthusiastic motorist.
Keen for a drive?
The medicSA Editorial Committee would like to hear from members interested in contributing car reviews on an occasional or ongoing basis.
For more information, please email: editor@amasa.org.au
Dr Robert Menz on the front cover of the 1992 South Australian Medical Review.
Celebrating in style
South Australia’s surgical community came together on 15 February for the RACS SA Surgeons Charity Ball at the Playford Hotel. Guests raised $36,000 for Interplast, a charity which trains nurses and surgeons in the Asia-Pacific region to perform life-changing plastic and reconstructive surgery.
Get ready for an exciting line up of events designed to empower and inspire you. Whether you're looking to network and gain career insights at Speed Mentoring & Finance for DiTs, or learn tips on Retirement Planning, Preparing for Private Practice, or Smart Investments, we've got you covered. Don't miss our major events, the AMA SA Gala and the Women in Leadership Breakfast.
See more events here
Stephanie Clota, Dr Phil Worley and Associate Professor Amal Abou-Hamden
RACS Younger Fellows
RACS CEO Stephanie Clota, AMA SA Vice President Associate Professor Peter Subramanian and Catherine Skinner
Guests enjoying dinner at the RACS SA Surgeons Charity Ball
Year of the Snake
The Australian Chinese Medical Association of South Australia (ACMA(SA)) hosted its annual Chinese New Year celebration at Adelaide BMW’s West Terrace showroom on 8 February.
Firecrackers and lion dancers ushered in the Year of the Snake and guests were treated to a performance by Matsuri Taiko Drummers.
AMA SA President Dr John Williams joined VIPs including Health Minister Chris Picton, Shadow Health Minister Ashton Hurn and China’s ConsulGeneral Li Dong.
AMA SA President Dr John Williams, Health Minister Chris Picton, ACMA(SA) President Dr Sheldon Chong
A/Prof William Tam, Rehab Hashem, Allison Teubner, Dr Sheldon Chong, Sophia Tian, Gabrielle Yoong and Dr Michael Ee
Dr Tanishq Mathur, Dr Ravi Cooray, Savitha Cooray, Dr Sheldon Chong, Dr Jaiveer Krishnan, Irfan Hashmi, Sobia Hashmi, Razbeen Shawket and Dr Aly Selim
William Moukachar, Simone Moukachar, Bernadine Wee, Dr Sheldon Chong
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Better with age
Phil Manser from winedirect explains why older vines, when properly handled, produce better wine.
Why celebrate old vines?
First of all, old vines are impressive as hell.
They can live for well over 120 years, with the oldest known grape-producing vine in the world coming in at over four centuries old.
According to Wikipedia, the world’s oldest authentic continually producing commercial vineyard is believed to be the Shiraz vines at Turkey Flat in the Barossa Valley’s Tanunda, originally planted in 1847.
We reckon the fact that old vines are so resilient is worthy of celebration, but it’s not just their survival skills that make them so, well, gnarly.
As vines age, they produce less fruit. The trade-off, though, is that the fruit they do produce is more concentrated, and generally of better quality.
This means that many producers are faced with the difficult choice of keeping precious old vines, which produce less but better wine, or pulling them in favour of new more productive plants.
Thankfully, we’re lucky to still have significant old vine resources here in Australia, in spite of the vine pull scheme of the 1980s.
But making sure that people appreciate the quality of old vine wines, and the resources required to maintain them, is crucial to ensuring that they’re around for many, many years.
What about new vines?
Don’t worry – new vines haven’t been forgotten!
The Old Vine Project aims to preserve existing old vines, but it also wants to ensure that younger vines, or vines planted in the future, will still be viable when old. A worthy consideration given climate change, which is threatening the world’s vineyard plantings.
Rosa Kruger, vineyard manager and founder of the Old Vine Project, shares a little on their website about ‘planting to grow old’, and the impact of climate change on vineyards.
‘If we want to plant vines now that we want to grow old, we really need to know where the climate is taking us,’ she says.
‘There are key actions that can be taken to become more climate resilient in viticulture: plan and plant smarter; capture rainwater effectively; design new vineyards within correct contours; plant higher and cooler; build a biodiversity of plants, animals and insects; build soil health; and plant acidretaining varieties or varieties that ripen before heat waves.’
Old Vine Day marked on 1 August every year celebrates vineyards that have survived the strains and stresses of a changing environment and promotes efforts to ensure old vine wines are still viable for decades (and centuries!) to come.
To order this exclusive AMA member offer, contact Phil Manser at winedirect. phil.manser@winedirect.com.au | winedirect.com.au
The Revelation Baker’s Dozen RRP $2,260
We’re big fans of old vine wines, and we have plenty to choose from. Here is a pack abound with old vine reds. Scan me for more details
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