Going
LAUNCH ISSUE – FREE
Places Taking a fresh new look at General Practice
Dr Cindy Pan talks about
being a GP
Inside this issue A look at real life GPs who are going places True confessions of a 21st century intern 8 really compelling reasons to consider General Practice A personal PGPPP experience Crossword, Docrat & Dr Gadget
P
Going
Places Taking a fresh new look at General Practice
General Practice is a satisfying and fulfilling long term career path – that’s why Going Places will turn the spotlight on GPs who can share their experiences with you.
In each issue, a selection of GPs will talk about their journey and how they arrived at where they are right now. They’ll explain why they have a passion for what they’re doing – and why they’d personally recommend General Practice to you as a career move. You’ll find each of their stories motivational and aspirational – providing a fascinating sample of today’s GPs and how diverse the professional can be … demonstrating it can be what you want it to be. Dr Cindy Pan is a high profile GP who has become a well known and recognised media personality through her writing and regular appearances on television. We’re very pleased to have her enthusiastic involvement in Going Places. You’ll read all about why she’s so happy and satisfied – where her career path as a GP has taken her and the joy it brings her.
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In this edition of Going Places Dr Cindy Pan A high profile media personality– but still a GP at heart
You’ll find lots more of interest, including true confessions of an intern, a crossword, Dr Gadget and Docrat – so we really hope you’ll enjoy reading Going Places. You’re probably in the situation where you need to make a decision about the future direction of your career, so read on – and be inspired by these GPs to consider choosing General Practice for your future career choice. Don’t forget – if you’re interested in finding out more about how to become a GP, we’re here to help – and make it easy for you. All you need to do is call us or email us and we’ll send you an information pack that will tell you everything you need to know. Email: goingplaces@gpra.org.au Phone: 1300 131 198
a If you hauve ! s e c hat la w P s g Goin email and tell n o k c a b d a e n fe ut nd ome youernts se drop uysoau’d like to read abo a le p , We welcre om .org.au e, what few spa k m ur magazuinte! goingplaces@gpra o f o in th you can contrib even if you We would like to acknowledge the help and support provided by General Practice Education & Training Ltd. and Avant, which has made Going Places possible. Our sincere thanks to all the GPs who have generously given their time to be interviewed and photographed. Going Places is published by GPRA Level 1, 14 Queens Road MELBOURNE VIC 3004. Phone: 1300 131 198 www.gpra.org.au
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GPs who are going Places GPs who want to share their journeys and experiences with you
True confessions of a 21st century intern Our own undercover intern reporter submits his diary notes
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Eight really good reasons to become a GP Tick off all the benefits and make a decision
+ Crossword,
Dr Gadget & Docrat
Designed, managed and produced by wam Pty Ltd Interviews with GPs by Fran Molloy Photography of Dr Cindy Pan by Mel Koutchavlis © GPRA 2009. No material contained within this publication may be
reproduced in full or in part without the express permission of the publisher.
Going Places – LAUNCH ISSUE
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COVER STORY
Dr Cindy Pan A high profile media personality – but still a GP at heart
GP at h ” Doing locum work, I realised that I loved General Practice. For the first time, I really felt like a doctor. I had that sense of being a real part of the whole story of someone’s life”.
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What’s your current role? I’m currently at home with my two sons, who are three and six, writing my third book about child raising – and I also write about health for newspapers and magazines. I’m involved in a number of charities and I’m a Trustee of the Australian Museum. I see my media work as public health education. It involves a lot of reading and research, so, for me, it’s a continuing medical education. While I’m not doing clinical work right now, I do plan to return one day. That’s the beauty of General Practice – you have a degree of flexibility to take a break.
Can you take us through your career path? I did my internship at Concord Hospital, Sydney and then started in General Practice, first as a locum and then eventually doing my FRACGP … in combination with lots of part-time acting and dancing and modelling roles! I initially worked at the Women’s Medical Centre in Macquarie Street, Sydney and then worked for years in a relatively big practice in Oxford Street, which was very cosmopolitan. I found it fascinating – especially after having a fairly rarefied existence growing up on the upper north shore, going to an all-girls school, then straight to uni and into hospitals! At that time, HIV was very prevalent and I developed a specialty in sexual health. Partly because it was initially such a weak spot for me – and I was so naïve! I actually ended up doing a Masters in Sexual Health. I became a medical presenter on a TV lifestyle program called Sex/Life and since then I have also done lots of other television and media roles, which I’ve really loved.
heart
What do you enjoy most about General Practice? I think it’s the fact that you are actually looking after the patient, not filling in forms or being one small cog in the wheel. You don’t need to know everything. All you ever have to know at any point is to know what to do next! Maybe you take their history, examine them, order investigations, refer or wait – as long as you do know what to do next, you don’t need the full diagnosis instantly. That’s what so terrific about General Practice - the patient has the option of seeing you again and that means you do get the chance to build continuity and develop an ongoing relationship. Sometimes in General Practice it can feel like you have all these old friends coming in to visit. Another of the great things about General Practice is that not everyone’s all that sick … and some aren’t even sick at all!
What advice do you have for young doctors thinking about doing General Practice? General Practice isn’t just one homogenous group of doctors. All GPs will develop some personal interest that will dictate and determine the way their work goes. Some are interested in talking about relationship problems or mental health, others are more interested in doing procedures. Every doctor has an innate style and certain patients will be drawn to certain types of doctors and, in fact, that moulds the type of doctor you end up being. For me, because I was fascinated and took time to treat sexual health, I developed this profile as a sex doctor and then did postgraduate studies in that area. It was really as a result of all these patients deciding that ‘yes, you’re going to fix me, because I trust you’. If you’re interested in General Practice, give it a go. Think about the sort of area you’d like to practice in and the sort of patients you’d like to see, the sort of doctors you’d like to work with. Not all General Practices are the same – the opportunities are endless.
What influenced your decision to do medicine and then to become a GP?
Growing up, I wanted to be an author or a ballerina or an artist! Through being a GP, I’ve actually had the opportunity to combine all of those with medicine. I spent my early years on a CSIRO field station, where my dad was a research scientist and my mum was a theatre sister. I chose medicine because I could see the point of it – I wanted to learn about how the body works and learn about people. Of course, I didn’t really have any concept of what being a doctor actually meant! As an intern, at the bottom of the ladder, I felt I had little control of what was going on with the patients. In hospitals, GPs were just these people you wrote letters to. But I liked emergency medicine – the way you see the medical story from the beginning and you’re the first to do something to help. Doing locum work, I realised that I loved General Practice. For the first time, I really felt like a doctor. I had that sense of being a real part of the whole story of someone’s life.
Photography: Mel Koutchavlis
Going Places – LAUNCH ISSUE
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GP
TheEntrepreneu DR MAREK STEINER
Six weeks after Marek Steiner had completed his training and received a provider number from Medicare, he opened the doors on his own solo GP practice in Sydney’s inner-west. Two years later, he has started building his purpose-built clinic for four GPs and numerous visiting allied health professionals – and the new practice will open mid-2010. Photography: Diverze Photography
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“ My goal from the very beginning was to have my own independent practice”
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Marek’s background No doubt Marek’s strong entrepreneurial background helped a lot. He qualified as a civil engineer before working in management consulting for a US-based company. “I was always tinkering, wanting to find out how things work. Now, I’m fascinated by the human body – but I went into civil engineering to understand structures,” he says. Soon realising engineering was not his thing, Marek then went into management consulting and finance for several years. Moving from Australia to Poland with his family as a teenager, Marek was diagnosed with bone cancer in his femur at the age of 20. During treatment, his left leg was amputated above the knee.
“Everything I did in the last year or so of registrar training was about working towards setting up my own practice.” “A lot of my interest in medicine came from my first-hand experience in hospitals in Poland. I kept thinking, could this be done better?” he says. “The GP system in Poland is not as community-based as Australia. I really like the Australian system of independent practice where you can really get to know your patient.” Poland has huge GP clinics and Marek would see a different doctor each visit. “It was the same model of care as a hospital.”
Becoming a GP Returning to Australia, he married and had a son – then, a couple of years later, he enrolled in the postgraduate medical degree at the University of Sydney. “I wanted to do something more satisfying with my life – so I set my sights on General Practice from the very start.” While at university, Marek had little exposure to General Practice until a couple of community-based terms in his fourth year; by that stage, like most students, he was focusing more on his internship and residency. “My strongest influence towards General Practice occurred before I went to university, with all the medical care I had personally.” He believes most students don’t realise that only the last five percent of medicine happens in hospitals, while the majority of medicine is done outside. Although Marek enjoyed the range of terms he went through as a junior doctor at Nepean hospital, he couldn’t wait to leave.
“I didn’t like the hospital system in general, although I enjoyed the work. I didn’t like the bureaucracy and the shift work and the fact that I wasn’t really in control, I was always being told what to do.” He did enjoy the close-knit teams in hospitals, sometimes hard to find in General Practice. “A GP needs a variety of personal and clinical skills. You never know what will be required and how much time you need to devote to an appointment. And you need to listen to patients because what they seem to be asking is not always the actual question that deep down, they need an answer for.”
Building the practice When Marek graduated, his wife (a corporate manager with an MBA) left her job to help him establish a solo practice. The couple fitted out a former convenience store with two consultation rooms and a treatment room in Breakfast Point, a suburb of Sydney. “It can be a bit daunting by yourself, there are financial risks, and you wonder if you’re going to get patients – but it’s worked out really well.” But within a month after the practice opened, Marek’s days were fully booked out. Since the practice opened two years ago, it has grown to three GPs, with visiting allied health professionals including a podiatrist, a psychologist and a paediatrician. Building approvals for his new clinic are going through Council at the moment, he adds. “Four GPs will be perfect because we want to remain a community family General Practice,” he says. “I don’t really want to lose touch with that personal interaction with patients, but the good thing will be expanding on the other services, like podiatry and physio.” With four GPs in the practice, the range of specialty interests expands significantly. “I’m interested in antenatal care, paediatrics, musculoskeletal medicine, preventative health, travel medicine and e-health, so I’ve tried to make my practice as paper-free as possible.” As a GP, Marek Steiner has managed to retain his entrepreneurial interests while practicing community-based medicine with long-term patients. He’s also recreated his favourite part of the hospital system (the close-knit team of health professionals) - all without the bureaucracy and lack of control that he so disliked.
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” I really like the multiple roles you have and the education opportunities as a medical officer to re-invigorate your knowledge of things like trauma, anaesthetics and the military culture”.
Dr. Nam Tran
I work four days a week as a GP in an inner-city General Practice in Brisbane and another day each week as the Hospital Liaison Officer (HLO) for Central and Southern Qld Training Consortium (CSQTC). The practice I work in has a pharmacy and is closely allied with a psychology centre. We also have a lot of allied health staff in pathology and radiology very close by. I also work with the military, in the Army Reserve, as an active medical officer in the Gallipoli Barracks. I like having these three different roles, it keeps my mind fresh and keeps me well-rounded. I grew up in a relatively strict Asian family who had come to Australia as refugees on a boat after the Vietnam war. I was raised in Brisbane where, from the start, my parents expected me to become a doctor, so I never thought about any other career choice. Fortunately, when I did medicine, I really enjoyed it. From my early experiences with GPs and throughout my medical student years I think I always knew that I wanted to be a GP because they were usually interesting and well-rounded people. When I was going through university, I got the highest mark for the General Practice term in my university cohort which confirmed this was what I was meant to do. I wanted to learn so much in the hospital to get ready for General Practice that it took me three years until I finally made the leap into General Practice training. That was enough to give me a lot of broad experience in other areas of medicine. Telling a patient ‘I’ve seen this once before in hospital,’ gives you that final encouragement that you really know what you’re doing because you’ve seen it before.
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Photography: Warren Fleming
Dr. Nam Tran conducts a Hospital Workshop
But each of the specialty terms I did in the hospital had such narrow and limited bands of knowledge and I really wanted variety, which is definitely what I have now. As a kid, my first impression of my GP was that he was this godly encyclopaedia of knowledge who was highly respected in the community. I think that I have a much more realistic impression of a GP now, but I still really respect those GPs who put so much back into the community. GPs have to have a core set of knowledge and procedural skills but also they need to be willing to be patient and keep learning and developing as a professional. Because medicine is exceptionally dynamic, GPs
have got to continually educate themselves. If you don’t do this, you just basically fall terribly behind and you become burnt out and potentially even obsolete. Being the HLO is partly a promotional role and also a career guidance role. I’ll be going to hospitals throughout Brisbane to increase the visibility of general practitioners in the teaching rounds at the hospitals and amongst junior doctors. Working with soldiers and medics is very different to working with patients in the community, and I like that challenge. A lot of the injuries are musculoskeletal injuries. However, because issues of rank and promotion can interfere in the military environment, you have to treat each with a different set of eyes, assessing how an injury affects function in a high pressure environment. Depression is also hard to uncover, as people can be very guarded with their true feelings and stresses. As a military medical officer, you get the opportunity to go out into the field and
practice running a regimental aid post, a resuscitation team and also re-invigorate your interest in things like trauma … and there’s a lot of field training provided for potential deployment. I’m about to embark on some training to learn helicopter evacuation and to learn a little bit more about the early management of severe trauma in that environment. My father used to be an army reservist with the South Vietnamese Army. My parents were initially upset by me signing up but they’ve come around to liking the idea. I really like the multiple roles you have and the education opportunities as a medical officer to re-invigorate your knowledge of things like trauma, anaesthetics and the military culture. I love keeping fit so I have a dog who I run with every day. I used to do martial arts as well. I have a good social life and good friends and family around me. I think that General Practice may be the only career path that will allow me to do so many things at the same time. The practice that I work for is able to give me the time off that I need, especially with my commitments with the other two jobs.
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s n o i s s e f n o c e Tru tern of a 21st century in Written by Dr. Ernest Tecrin
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Dear Journal, So I had finally arrived. After 1 year of kindergarten, 6 years of primary school, 6 years of high school, 6 years of university and endless exams, I was finally an intern. The last few weeks had been a constant high after graduation, farewell functions and purchasing a flashy new wardrobe for my first day. After watching almost every medical show on TV, I was completely prepared for whatever the hospital could throw at me. Or so I thought. I got a call from my new registrar the day before my first rotation, Surgery. 6am start. I blink a few times and ask him if he’s sure that patients will be awake then. No, that doesn’t really matter, 6am it is. Apparently we have to see our twenty patients, attend radiology meeting as well as Grand Round before morning theatre starts. Sounds easy enough I reply. The phone call ends with an almost maniacal laugh from my registrar – I guess that’s what a few years in hospital does to you. The next day, I drag myself out of bed and roll into the hospital. I’m wearing a nice tailored shirt with matching cufflinks and a Versace tie my girlfriend bought me for good luck. My registrar is already waiting for me, dressed in scrubs, his final destination pre-determined. With as little as a ‘hello’, we start the round with a pile of folders stacked on a trolley still slightly sticky from yesterday’s cordial round. As we race from patient to patient, I become acutely aware that those calligraphy classes my grandmother purchased for me are completely useless as my recording of the events of each patient visit are reduced to ‘Obs stable. Patient ISQ. CCMx’. At the end, we race to the Radiology meeting as the Nurse-in-Charge chases after us, demanding to know what the plan is for the first patient we saw. We lose her at the lift, promising to come back as the doors close. Radiology meeting is uneventful except for the snore of our most senior consultant in the back row as the radiologist, who clearly chose radiology thanks to his winning personality, drones on about the subtle differences between grey and less grey on the screen. Winning stuff. The Grand Round is a who’s who of designer suits and dark eyes as consultants discuss their latest car purchase and latest new wife, whilst the registrars pray that they avoid the weekly barrage of questioning from the Professor of Surgery. It’s a chance to see the other interns (and, like myself, they seem to have a look of ‘Holy Crap! I have no idea what I’m doing’ plastered across their faces). This is in direct contrast to the medical students, knowing their lowly but obvious role, who started taking notes at ‘Good morning’ and stopped at ‘get out, the lecture’s over!’ I return to the wards and am met by the Nurse-in-Charge flanked by her two assistants. They lay down their rules for how their ward works. I nod and smile knowing that any movement that suggests cockiness or arrogance could put me in a world of pain. Once my ‘orientation’ to the ward is finished, I set about doing my jobs. It’s at this time I discover the joys of my pager. The pager’s origins are unknown – it’s a parasitic organism that thrives on the corpses of weary interns. It does not participate in a commensal relationship with its host, instead choosing to torture with incessant beeps, buzzes or outdated melodies … … IVs, IV re-sites, unhappy patients, unhappy families, and more; the pages keep on coming. Just as I’m about to use the restroom, I get three pages about low urine output. I wonder whether anyone is paging my mother about my urine output – I’m sure I’d be getting a catheter if I was lying a nearby bed. Actually on second thoughts, that isn’t such a bad thing. I manage to get through all my jobs before my registrar comes up. He looks almost relieved that I’m still there and haven’t run screaming out of the hospital, leaving Australia to join an Ashram in Nepal to rediscover inner peace and quell the conflict that dwells around me. He asks how my day goes and then takes me down for coffee. Stunned, I sip quietly as he tells me about his first day. At the end of the day, I’m exhausted and weary. I cannot wait to get to sleep. I happen to walk past one of my patients, an elderly dear who’s come in to get her gallbladder out – and possibly escape from her 20 grandchildren. She takes one look at me and offers a chocolate from a box of Roses brought in by a visitor. I initially refuse saying I don’t need one, but she quickly pushes one into my hand. She looks me straight in the eye and says ‘You need all the energy you can get if you’re going to look after us properly”. And it’s then I realised the whole idea behind being an intern. It’s not the suit, the meetings, the bosses or even the nurses. It’s about looking after the patients, in amongst the chaos of a busy hospital system. Nodding gratefully, I turn and walk towards the elevators. Elated to be finished, I’m reminded of the future as my patient calls out to me “See you tomorrow!”.
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The name and identity of the writer have been changed to avoid recognition and provide complete anonymity!
Dr Stuart Anderson
showing there’s total flexibility in General Practice I work in a seven-doctor practice, in Maffra, country Victoria. My partner, Sally, is on maternity leave from the same practice, with our 3-month old and we also have a two year old. I grew up in a small country town called Nhill, in far western Wimmera in Victoria. My father was an old-school GP, who was also an obstetrician and anaesthetist. I went straight from school into university to become a GP. That was what I’d always wanted to be. I did my internship at a generalist hospital, Box Hill in Victoria – then, after a rural placement in Bairnsdale, I went down to Launceston in Tasmania for a year. The hospital was crying out for junior doctors and I could take my pick of some pretty good generalist jobs and my partner, Sally, could get a job there as an intern.
I didn’t want to refine my broad medical degree down to one area and nothing else; I want to talk to people, I want to see them for all their illnesses, I want to deal with the medicine, the surgeries, the paediatric. I want a spectrum of medicine, not just a small part. I’m not a big fan of the hospital system’s treatment of junior doctors – the workloads, the hours and the rigid hierarchy where you have to kow-tow to the important people to achieve anything. As a GP I have my interests. I went back and worked as a surgical registrar for a year and now I do quite a bit of work in cancer
Photography: Geoff Parrington
medicine. Of my four and a half days a week in the practice, a full day is minor surgery. I do some casual lecturing at Monash Uni and I’m a medical educator with a registrar training program. I’m also involved in medical politics. From registrar liaison, I’m now the registrar nominee Director of the Board of GPs who oversee GP training. It has been a fascinating experience. One thing I found a real challenge when I started in General Practice, was dealing with mental health. As a medical student, you’re in the psychiatric wards with people who are psychotic or so catatonically depressed that they can’t communicate. They get better and you send them home or there’s medical treatment. But then you find yourself in General Practice, sitting at a desk in a room all by yourself and a patient sits down and says “Oh, thank god you’re a new doctor here, I’ve been wanting to tell someone this for 20 years, I’m so depressed” – and breaks down in tears. You just pass them a tissue box and think – well, what the hell do I do next? You’re three years out of medical school and this person has come and laid their life on the table … it’s a huge responsibility. I have the box of tissues within easy reach now! It’s very confronting, you wonder about your role as a doctor – do I intervene, give out the pills, get them off to a psychologist? Or am I here to just sit and listen and let them talk. And often, that’s what they need. In General Practice, you’re not obliged to either make a diagnosis or solve the problem before you send someone home. That was a shock after the hospitals. You’ve got the time and the luxury of asking them to come back – you’ve got colleagues in your practice you can ask for support. So it’s not as isolating as people think.
The work-life balance is excellent, as each partner works four and a half days a week. With seven doctors, we do about one in six on-call weekends and on-call nights.
Sally and I provide one full time doctor’s worth, plus a bit, to the practice – and how we work depends on what’s happening with the kids. Last year I worked three days a week, Sally worked four days a week and our daughter had one day of child care. This year I’m four and a half days while she’s on maternity leave and we can chop and change that a bit if we need to. Most days it’s a 9am start and we’re usually out by 5.30pm, with an hour and a half off in the middle for lunch. It was a very conscious decision to run the practice like this. The view that all the smart people go off to specialties is a fallacy, as General Practice is very intellectually demanding. You make a good living – not that of an interventional cardiologist – but you have a heck of a better lifestyle. You’re not in the hospital at 3am putting catheters in people!
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Dr Jenny Lonergan loves her jobs. Yes,
jobs is plural, because like many GPs, Jenny usually works at two or more locations each week. At the moment, three days of her week are spent in clinical practice at the Redfern Aboriginal Medical Service in Sydney. She also spends two days each week as a medical educator with GP Synergy in a varied role that spans direct teaching of GP registrars, program coordination and administration, advising registrars – and even a little policy work. As a registrar, Jenny spent a term at Redfern’s Aboriginal Medical Service and loved it. “When I left, the staff gave me a purple boomerang so I’d come back. So I did, and I’ve been there for six years now.” Working at the AMS means an involvement in the local community – something Jenny regards as a privilege. “Most of my patients have a really dry sense of humour. Aboriginal people are quite resilient and they don’t tend to come in and see you unless they’re really unwell, so you do get a sense that you’re making a real difference to their health,” she says. Jenny is no stranger to her Central Sydney workplace, as she grew up in North Sydney, on the edge of the CBD. She moved to Newcastle after high school because she was attracted to the University of Newcastle postgraduate medical degree. “Medicine at Newcastle seemed more real-world,” she says, adding that the degree gave her a good exposure to General Practice. “As a medical student, I always thought that General Practice would be interesting – but once I started working as a resident, I lost focus on General Practice until I got to be an RMO 4 and realised I couldn’t keep being a junior doctor all my life!” Jenny says she had some great placements while in training; she spent a term in the Solomon Islands, and continued her studies with a Master’s degree in Public Health and an obstetrics diploma. “Each year I’d pick something interesting to do, like a rural rotation for the first half of the year and then come back to my base hospital, St Vincent’s –and then I’d pick from the other terms that were left. Eventually I realised, the only profession that really offers me a bit of everything was General Practice, so I made my decision and never looked back.” Never a fan of shift-work, Jenny says that her whole life changed when she started work in General Practice. “In hospitals, you weren’t able to have a regular social life, join a sporting team or do something every Wednesday night; now – as a GP – you have control over your own free time, which is great.” She has been pleasantly surprised by the intellectual rigour of her work. “General Practice was seen in the hospital system as an easy option,” Jenny says. “I was quite surprised by how hard it is. It’s actually quite a difficult, challenging job, but in the hospital system it’s portrayed as coughs and colds and minor ailments.” While there’s an element of routine illness, she says that the majority of her job is quite challenging. For Jenny, medical problem-solving is a highlight of General Practice. “In emergency, people are often so sick it’s pretty obvious what they’ve got; I still get a buzz out of
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being the person to make the diagnosis, and we get the majority of diagnosis in medicine.” In her first year of GP training, Jenny became a registrar liaison officer and eventually Chair of General Practice Registrars Australia (GPRA). “I was involved at a time when the profession was just starting to realise we had a really big shortage of GPs and dealing with issues like rural shortages and government initiatives of compulsory rural terms and rural incentives, so I travelled around Australia giving presentations to government and other stakeholders.” Of course, her GPRA work didn’t fit into the one day a week she had allocated and Jenny had to juggle it around four days of rural clinical practice, but despite the time pressures, she loved both jobs. “I was involved in policy, politics, media, marketing and business activities and being chairman of a board – in terms of career experience, it was really fantastic.” Jenny’s juggling days are far from over – she’s expecting her first child in a few months and says that she hopes to return to work part-time for a few years.
“ When you’re not a financial partner in a practice, you can choose to work as many sessions as you like. You can work pretty much any hours you want to - you can do overnight work or Saturdays. The flexibility that General Practice gives you for family life is unparalleled in medicine.”
DR JENNY LONERGAN
A love of teaching and indigenous health
“ In hospitals, you weren’t able to have a regular social life, join a sporting team or do something every Wednesday night; now – as a GP – you have control over your own free time, which is great.”
Photography: Diverze Photography
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really good 8 reasons why you should become a GP. 5 Flexibility and work-life balance.
1 You just never know
what’s going to happen. If you enjoy clinical diversity, being a GP will give you this – and a great deal more. So, why specialise and have predictability when you can have the thrill, enjoyment and surprise of never quite knowing what’ll come through your door next?! Just like on “Thank God You’re Here”, you are centre stage, as the star player. You’ll be exposed to a wide range of patients and be faced with all manner of medical problems you’ll need to attend to … and find solutions for! Your patients are in your hands – you can choose to treat them yourself or refer the patients for further attention.
2 Rise to the challenge.
3 Develop relationships with real people – not just as patients.
General Practice allows you to really develop relationships with patients, getting to know them, and build long-term relationships – often over a lifetime of change. That’s unlike many specialities – because, as a GP, you can offer a more “holistic” continuity of care; especially by understanding the issues and circumstances in patients’ lives that can have an impact on their health. Through your skills, experience and expertise as a GP, you have the capacity and capability to make a profound and substantial difference to people’s lives. In fact, not just to them, but to their families and loved ones, too. And even to whole communities … …
4 Treat healthy patients!
Remember that not everybody you see is going be ill! You’ll be helping a very wide range of patients, many of whom are healthy – and you can be pro-active in helping to keep them that way. (That’s just the opposite of a specialisation, where all of the skills are focussed on fixing end problems.) You’ll also be helping to manage the health of patients during the positive and happy times in their lives – for example, assisting them with family planning, pregnancy, post-natal care and young, growing families. There are so many and varied aspects of preventative health care, helping to keep patients fit and healthy. And you know you’ll be appreciated and thanked for your input.
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6 Let your skills take you wherever your heart desires.
One of the most rewarding, fulfilling and satisfying aspects of being a GP is the challenge – using all your knowledge to make the right diagnosis of whatever medical problem is standing, sitting or lying in front of you. OK, let’s be honest – making the correct diagnosis can be daunting, but every time you’re assessing a patient, you’re using all your accumulated professional abilities. You never stop learning through experience – that’s why it becomes easier and more intuitive. How intellectually stimulating is that? You’ll never be bored!
So, what we say is “go for it”. General Practice is the profession for variety, flexibility and work-life balance! Wherever you want to go, General Practice can take you there!
As a GP, you have the opportunity to decide where you work – and when you work. In fact, you have flexibility to tailor your hours and your workload to suit the stage of life you’re at, and your career path. You may choose not to work full time, or even “regular” hours. Working part-time is ideal if you have a young family. Surveys indicate that virtually everybody now working in General Practice nominates flexibility as one of the most appealing aspects of being a GP. In reality, it’s the perfect combination of being able to have a fulfilling career and having an enjoyable lifestyle, with plenty of quality time.
With all the skills you have as a GP, you’re sure to be in demand wherever you go, or your travels take you. You don’t need to be metro-bound, if you don’t want to be. If a sea-change or tree-change appeals to you, why not follow your instincts and head coastal or rural? Cold climate or hot climate – Australia is a big country and has plenty of diversity! You may even prefer to be more mobile, moving from place to place – or be almost permanently on the move, on the sea or in the air! Your choice of location is only limited by your imagination and aspirations.
7 Develop and pursue your own specialist interests.
As your career develops and progresses, it’s likely you’ll find an interest or fascination with certain parts of General Practice. As you’ll read in the interviews with GPs in this magazine, many have found specific interests, which they enjoy and look forward to. These can range from paediatrics and anaesthesia through to sports and indigenous medicine. It’s likely that something will particularly interest you, and there’s enough flexibility as a GP for you to develop your skills in whatever area has captured your attention. You may even want to become a GP media personality!
8 Be well remunerated for your skills – reap the rewards!
There’s a shortage of GPs – and that means the economics of supply and demand work in your favour! GPs are now well remunerated, with good money to be made … it really depends on how hard you want to work! You’ll find there are generous incentives for GPs to work in areas where there is a shortage of doctors – typically rural areas. But even if you decide to be metro-based, you can be assured you’ll be well rewarded for all your hard work. And that means you can enjoy the lifestyle your profession as a GP brings you. Deservedly so, for all the hard work and training you’ve invested in your chosen career!
about becoming a GP? information Want full information ail us and we’ll send you an
ll us or em know. All you need to doyoisucaeve rything you need to l tel ll wi 198 Fax: (03) 9820 1983 131 pack that 0 130 e: on Ph u g.a .or pra @g Email: goingplacesu waiting for? – So what are yo
Dr Joseph Ngui
A GP who’s never bored! “ In medicine, I couldn’t pick one specialty I wanted to do for the rest of my life; I like surgery, anaesthetics, paediatric, obstetrics, psychiatry,” he says. “So General Practice suited me well.” Dr Joseph Ngui admits he has a short attention span. “I’ve got a trillion hobbies, I get bored very easily.” He’s carried that penchant for diversity into his work life. After finishing his registrar training less than a year ago, Joseph now works as a country GP in picturesque Colac, a large town bordering the Otway ranges, less than two hours from Melbourne. “In medicine, I couldn’t pick one specialty I wanted to do for the rest of my life; I like surgery, anaesthetics, paediatric, obstetrics, psychiatry,” he says. “So General Practice suited me well.” Extra training in anaesthetics has led to a regular position at the Colac hospital, where he is also a surgical registrar. Like many rural GPs, Joseph is closely involved with the local hospital, often working there one to two days a week. He can admit his own patients and perform procedures at the 50-bed facility. With a role that combines General Practice with emergency physician, anaesthetist, surgeon and occasionally psychiatrist, Joseph says he’s never bored. “It’s really a job where you can do anything you fancy and that you are competent of doing; it’s very satisfying professionally and also challenging. I like challenges.” Despite his full and varied work schedule, the young doctor manages to keep up with his many outside interests. Throughout his life, Joseph has played various musical instruments; he’s also a keen amateur photographer and occasionally tags along with professional wedding photographers. He photographs friends’ weddings and enjoys landscape photography. Joseph loves sport and plays soccer once a week – he’s also in the local Photography: South Western Studo
basketball team – “I’m probably too short to play basketball, but it’s a bit of fun.” Somehow he also manages to find time to meet every fortnight with a group of other GPs and surgeons who, like him, are all keen wine buffs. “Each person will bring a bottle and we have a bit of a tasting and compare notes.” Though he relishes the community contact his job involves and clearly fits into country life as though born to it, Joseph grew up in cities. Raised in Hong Kong by his Malaysian Chinese parents, Joseph moved to Australia with his family at the age of 16 and went straight from high school into medicine at Melbourne University. After spending several months in hospital following a car accident when he was six, Joseph decided that he wanted to be a doctor. By the time he had gone through a few clinical placements, before his graduation, Joseph was considering a career in rural General Practice. “Rural placements were more hands-on, you would see patients and do a few small procedures,” he recalls. “And they would involve me in the community, inviting me out socially or to play sport.” Like many medical students, he says that until he did a rural GP placement, he didn’t seriously consider a career in General Practice, thinking it was all about coughs and colds - and if there was anything more serious, you’d write a referral. “Most of our placements are predominantly in hospitals and most of our lecturers are specialists, so your contact with established general practitioners is quite limited – that’s why you think the prestigious thing to do is be a physician or a surgeon,” he says. In field experience with rural GPs he realised how much the role involved
comprehensive, holistic and procedural medicine. “The best doctors I’ve met in my life are general practitioners, not just in terms of knowledge but also the ways that they deal with patients and how they can manage holistic medicine, looking after not just the physical illness but the mental illness, the social issues, the family.” He admits he has a tendency to be impatient and has had to work to develop his listening skills. “I still have to constantly remind myself to shut up and let patients talk first before I step in and ask them the blunt and direct questions. Listening is actually therapeutic for the patient – no matter what problem they have.” While some GPs have fond memories of working in hospitals, Joseph says he couldn’t wait to leave. “Even doing my two years of GP registrarship, I had a fair control over the hours I wanted to work and how much on-call to do and when to have my days off – which is impossible if you’re working in a hospital. I have a far better life and work balance, in terms of seeing my wife and hanging out with my friends.” He’s also relieved to be out of the hospital hierarchy. “I don’t have to answer to anyone above me, I’m independent, making my own decisions – I really enjoy that responsibility.” And while his future plans involve travelling and working overseas, running a marathon and climbing a few mountains, he believes that – as a GP – he’s not going to run out of challenges to keep him happy. “There’s also a great sense of continuity of care in being a general practitioner. You really look after a person’s whole life and, for better or for worse, you are there and you really get to know people really well … and I think that’s a real privilege.”
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What’s your current role – and how did you get there? I’m a GP Registrar working in Bundaberg in Queensland and also the Team Doctor for the Australian Schoolboys rugby union team. I’m currently completing a Masters in Sports Medicine. I started my working life as a physiotherapist. After four years in the hospital system, I moved from Brisbane to Bundaberg with my family, believing a provincial town would provide me with a diverse range of experiences and opportunities. I work alongside very experienced GPs and enjoy excellent specialist support locally.
You have a specialisation in sports medicine – what does that involve? My involvement in sports medicine means getting out of the practice setting and being involved with local sport and games, from rugby league to hockey to soccer to cricket and others, usually on weekends. I see the athletes when they’re participating, and attend to them on the spot if they’re injured.
General Practice is also very diverse and varied and I enjoy that. Also, General Practice training appealed to me. The experienced GPs I spoke to were very collegial, reasonable and approachable. I can see myself as a GP for the long haul and with my special interest in sports and musculo-skeletal medicine, I have the freedom to explore what I really like doing within the GP setting.
Have your impressions of General Practice changed since you entered the profession? General Practice itself has changed, so my impressions of General Practice fifteen years ago are different to the situation now where there is a much bigger emphasis on preventative health care. In many specialties, while the background knowledge that you gain from medical school is vitally important, eventually you end up not using a lot of it. In comparison, in General Practice, a very high percentage of what you learn at medical school is relevant – whether it’s your counselling skills, psychiatry, your basic medicine knowledge and its application, paediatrics, all the various disciplines, ear, nose and throat.
Having such a large number of trainees each year (relative to some specialties) also means resources for learning are very, very good. FRACGP does require life-long learning and commitment.
What do you like about your work? I enjoy the variety, the primary contact that General Practice provides and enjoy the holistic approach. Even though you’re not making all the management decisions for your patient and you’re referring to specialists for advice and counsel and for treatment, you do feel like you’re part of that overall process and sort of keeping everything together for the patient.
DR MICHAEL McLEAN
The
good sport
Treating acute injury on the field, as it happens, is very different to an emergency department. Some injuries are dealt with on the field, but others need the protection of a safe medical environment – like a first-time dislocated patella.
What influenced your decision to do medicine and then to become a GP? I had a fair bit of exposure to the medical profession as an allied health practitioner. This had a profound influence on me and, wanting to develop further professionally, I enrolled in medicine fairly late in life – actually in my late thirties. After over four years of hospital terms, doing other training programs and passing the entry exams for several specialties, I became disillusioned with certain alternatives and chose what was right for me and my family. General Practice is the centrepiece of preventative health care and there’s great challenges given the preventable disease burden out there.
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You need a sound basis of knowledge across a very broad range of disciplines to be efficient and effective in General Practice.
Describe your training and placement experiences as a registrar. GP training is well structured, competency based, and gives plenty of ‘hands-on’ experience from the outset. I was surprised at how quickly I built my knowledge in General Practice. There’s definitely an element of learning on the job and learning from your experiences and learning from patients as a GP registrar. In registrar positions, there’s excellent support from GP mentors and senior GPs. I still learn quite a lot from the interactions that I have and support I get from specialists locally. Independent decision making, even with close supervision, happens early on. You quickly learn to be adaptable to the uncertainty of what the next consult may bring.
There’s lifestyle choices in General Practice – that means no night shifts, which I’m certainly enjoying at this stage. The biggest satisfaction comes from making a difference to patients’ lives. I remember after one busy day last year thinking, ‘What did I learn today?’ expecting that every day would bring some great revelation. I couldn’t think of anything and it occurred to me that maybe my role that day was just to be someone’s doctor. I think reflection upon your work is really important.
GP “ General Practice is the centrepiece of preventative health care and there’s great challenges given the preventable disease burden out there.”
Photography: Rhondda Scott Photography
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Are you practising good medicine?
Your health and well-being is one of your best assets. Professor Greg Whelan, CEO of the Victorian Health Program, has years of experience in clinical practice and in helping doctors to optimise their mental and physical health. He recommends that doctors in training should follow these tips:
Top 10 tips to being a healthy, stress-free and effective doctor! 1. Take your lead from your registrar – s/he should be your best guide. 2. Keep track of all tests ordered – you will be expected to know the results. 3. Avoid unnecessary hassles – get your X-ray (imaging) list in early. 4. Learn on the job – if you are not familiar with a medication you have to prescribe, look it up. 5. Develop good time management skills – this will assist in saving you from stress. 6. Keep your records up to date. 7.
Put time and effort into clinical handover – a shared understanding of information is crucial.
8. Don’t skip meals – make sure you take regular food breaks. 9. Get enough sleep – sleep-deprived interns and doctors in training make mistakes. 10. Exercise – block out time in your diary to exercise and keep your mind and body healthy. Professor Whelan is also a Medico-legal Advisor with Avant, Australia’s leading medical defence organisation. So, he spends significant time advising doctors on ways to minimise their risks in practice. Good health is one of them! Avant provides 24/7 medico-legal advisory services to its members. Doctors in training benefit from a $100 annual base cost* for membership and insurance**. Plus the ROCS levy, government charges and taxes from about $20–$40 depending on the state or territory where you practise. Rates current as at 1 May 2009 and are subject to change
*
IMPORTANT: Insurance policies available from Avant Mutual Group Limited ABN 58 123 154 898 (Avant) are issued and underwritten by Avant’s licensed subsidiary, Avant Insurance Limited, ABN 82 003 707 471, AFSL 238 765. Applications for insurance are subject to approval and insurance cover is subject to the terms and conditions of the policy and policy schedule. Before deciding to purchase or continuing to hold a policy with us, you should read and consider the Product Disclosure Statement (PDS) to determine if this product is appropriate for you. The policy and PDS are available at www.avant.org.au or by contacting us on 1800 128 268.
**
To find out more telephone Avant on
1800 128 268 or visit www.avant.org.au.
DR ADRIENNE BURCHARD
Fascinated by Student
sex in the
city I’ve just completed my registrar training. I work at a large Adelaide practice with around 14 doctors, spread over two sites. We have a practice nurse helping with a lot of procedural things like taking blood. Most GPs in my practice have a couple of afternoons or a couple of days off a week. One GP sings in the opera, another plays quite a high level of cricket. I studied medicine here in Adelaide, started my training in Sydney, did my country placement then came back into the city of Adelaide. This year, I combine clinical work with teaching medical students one morning a week. I started teaching as part of a research term that I did last year, looking into the sexual health of international university students in Australia. I had around two days a week for research and three days a week clinical work. After discovering that about a third of the terminations carried out at a large women’s hospital were on international students I designed a project to investigate the causes. After a literature review, I interviewed doctors who worked with international students and ran focus groups with young female international students. I found that students needed further education and help with sexual health issues and contraception. People are now lobbying for funding to increase sexual health education for international students. I’d love to see my research improving outcomes. I went into medicine because it seemed like it would help people the most. At seventeen, I was very idealistic. Throughout my medical training, I didn’t have strong ideas about what I wanted to do. I liked geriatrics and endocrinology, I really enjoyed obstetrics … but I didn’t want to be an obstetrician. My decision to be a general practitioner was a gradual one. I found the hospital system a little depressing. Patients were treated as pathologies rather than people. I felt that with each patient we were really focusing on the problem at hand and the reason for their admission rather than thinking about them more broadly. I wanted to be more holistic in my medical care. I also liked the idea of variety, working in different areas. As a medical student and as a junior doctor, I had the impression that GPs only see people with coughs and colds, old people and those
with chronic medical conditions. There are two things that are quite wrong with that assumption. First – you see every patient as a person who you build a relationship with over time, rather than a cold or a chronic disease. You’re not seeing a “chronic kidney pain” but interacting with a person about the way that their health is affecting their life. And, second, you actually see an amazing array of presentations. It’s like emergency medicine – you see people with quite acute or unusual, interesting conditions. In the hospital system it was quite depersonalising for a patient to be in a hospital bed, in a hospital gown and being regarded as just a number. I find it more rewarding to work with people in an environment where they feel empowered to really debate with their health professional about appropriate treatment. In hospitals, you don’t tend to ask patients whether they’d like to start a new medication or talk to them about the side effects and whether they think that that would be acceptable to them with their lifestyle. When you become a GP or even a GP registrar, there’s automatically a more collegiate atmosphere. While you respect the ideas and the knowledge of older GPs, they also have respect for the knowledge that you carry as a new doctor. An older GP will come to your door and say, ‘What’s the latest treatment for this, because I’m not sure?’ It’s nice, as a junior doctor, to get that attention from senior doctors. Eventually, I’d like to divide up my time between family, clinical work and teaching work, which I think can happen very easily in General Practice. Something happened to me the other day which reinforced that I’ve made the right choice in becoming a GP. My final patient at the end of the day before I went home was someone I’ve treated for a while. I’ve also seen a couple of her daughters. She said, “Thank you doctor, you’ve made the most enormous difference to my life and my family’s life.” I was really touched. As a doctor, that’s what I had always wanted to achieve: to make a profound difference in people’s lives. I truly believe that you can do that as a GP.
”I do a lot of women’s health at present. An older GP once said to me, there’s a tendency to attract people like yourself – and your patients grow older with you”.
Photography: Milbank Photography
Going Places – LAUNCH ISSUE
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5. The principal sugar the body produces (7) 6. Also called atopic dermatitis (6) 8. TV character from Scrubs (10) 12. … makes perfect (8) 14. Around 70,000 Australians have this form of arthritis (4) 15. The most common cause of severe gastroenteritis in early childhood (9) 16. There are two types of this contraception for women: the copper … and the Progestogen (Mirena) … (3) 17. University students frequent this place on a regular basis (3) 19. Something doctors often prescribe (5) 20. A common disorder of the female reproductive system (13) 22. A popular TV show is Grey’s … (7) 24. Leptin and oestrogen are … (8) 26. A medical test that detects cardiac abnormalities (3) 27. A group of cancers that affect the lymphatic system (8)
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Docrat
www.docrat.com.au
DOWN
1. This valve is found at the exit of the left ventricle of the heart (11) 2. … throat’, common amongst children and teenagers (5) 3. Have you taken any samples today? (5) 4. Champion boxer Mohammed Ali believed this activity impaired performance before an athletic event (3) 7. A vessel that carries blood high in oxygen to the farthest corners of the body (6) 9. a ‘glycosylated haemoglobin’ molecule associated with diabetes (5) 10. This is a popular over-the-counter antiinflammatory (9) 11. The largest specialty in medicine (2) 13. During the Italian Renaissance, these contraceptive devices were made of intestines and bladder (7) 14. The name of the cervical cancer vaccine (8) 18. A cancer of the blood-forming cells, which are made in the bone marrow (9) 19. A condition where a person ‘loses touch with reality’ (9) 21. People who receive medical attention (8) 22. A disabling sleep disorder (6) 23. The eyes of people with jaundice turn this colour (6) 25. Magnetic resonance imaging (3) you’ll find the answers at the bottom of the page.
Learning to look after yourself is as important as being able to look after your patients, yet it is a skill that is usually not taught. Dr Belinda Guest, GPRA Chair
R-CUBED is about resilience.
R-CUBED provides GP registrars, medical students and prevocational doctors with a regular newsletter and online resource that recommends effective ways to cope with pressure and staying well.
About the R-CUBED website – www.rcubed.org.au You’ll find useful information and help divided into two sections – Professional Resources and Personal Resilience Resources. These will give you the ammunition to stay healthy and positive.
Professional Resources • Managing workflow and paperwork • Planning and prioritising • Goal setting • Dealing with difficult patients • Conflict within your workplace • Managing a patient complaint • Choosing a Practice ... and much more
Personal Resilience Resources • Meditations (e.g. mini-meditations to listen to) • Self-motivation strategies • Get a GP – managing your own health • Time management • Fun stuff • Physical fitness ideas • Inspiration ... and much more
You can subscribe to the free R-CUBED eNewsletter at www.rcubed.org.au Crossword answers: Across 5. GLUCOSE 6. ECZEMA 8. JOHNDORIAN 12. PRACTICE 14. GOUT 15. ROTAVIRUS 16. IUD 17. PUB 19. PILLS 20. ENDOMETRIOSIS 22. ANATOMY 24. HORMONES 26. ECG 27. LYMPHOMA. Down 1. AORTICVALVE 2. STREP 3. BLOOD 4. SEX 7. ARTERY 9. HBA1C 10. IBUPROFEN 11. GP 13. CONDOMS 14. GARDASIL 18. LEUKAEMIA 19. PSYCHOSIS 21. PATIENTS 22. APNOEA 23. YELLOW 25. MRI
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DR SCOTT FINLAY
The banking futures broker turned GP One of the stranger items that Scott would specialise and had contemplated Finlay brought with him when he moved to paediatrics. But, after his second rural his current post in Moree was a surf-ski. placement, he was hooked on General Despite living five hours inland in Practice – and decided to move into rural country NSW, Scott often paddles on the General Practice. local weir. He’s not pining for the coast Scott has no regrets. As part of though – he’s a big fan of country life and Moree Hospital’s on-call roster, he’ll do the community which has embraced his anything from attending in the emergency family so warmly. department, delivering babies (he’s “This community really appreciates any done some obstetric training) to giving skill set you bring to it,” he says. He’s just anaesthetics – another skill he’s acquired. spent a weekend His General watching dance Practice patients fit recitals, the in around his hospital “Richard Bonner, a GP annual highlight commitments and mentor of mine, made me of his wife’s he loves the constant realise that being a good new ballet variety. school. Married “Local doctors rural GP meant having to a ballerina tend to self-select the ability to walk into any – and with areas where they three daughters require more in-depth situation and offer some aged between knowledge, so if you help – being present and three and eight don’t like an area, you effective. Australian medical – dance concerts can avoid it.” are inevitable There’s no such training provides just that.” for Scott, but thing as a typical thankfully there’s week, he adds. “Over no “Ballet Mothers” in Moree. “Everyone’s the last week, I’ve done some General more down to earth, they are just given a Practice consulting, I’ve given general job and they do it very nicely.” anaesthetics, delivered a baby, had Scott has taken a far less-travelled path inpatients at the hospital to look after and, to reach his current position, combining the on Friday, I drove down to Narrabri Hospital role of GP in private practice with that of to help out with a major motor vehicle Visiting Medical Officer at Moree Hospital. accident involving ten patients.” Starting out as a futures broker for He joined a critical care team from a large bank on Sydney’s North Shore, Tamworth and local GPs and registered he initially studied economics part-time. nurses who all came together quickly to But his disillusionment with the world of deal with the emergency, without shortfinance led Scott to pursue his childhood changing nearby hospitals. dreams of becoming a doctor. He says that his emergency department He ditched his economics textbooks to training back when he was in the hospital complete a medical science degree at the system is still helpful – but most of his work University of Sydney, then did postgraduate just requires just good quality General Practice. medicine at the University of Queensland. “The bulk of urgent medical issues can He spent three years in several Brisbane be sorted out with the resources that are hospitals, doing a number of rotations as a in town. Junior doctors often fear they’ll be relieving doctor in remote towns. left alone, but there’s always appropriate During his training, Scott assumed he supervision.” He adds that, as well as Photography: Wayne Pratt
senior doctors, skilled and experienced nursing staff will help in difficult situations. “It’s so important to deliver health to people in their community and in their context,” he says. “Even a General Practice registrar with basic training immediately brings a broad and important skill set into a community that does not take it for granted. You quickly give your patients a step-up purely by delivering good quality primary care.” Simple things like access to pap smears and smoking cessation advice can make a profound impact on people’s health, he says. He is critical of what he calls the ‘devalued’ view of General Practice given to students and junior doctors working within the hospital system. “You don’t experience General Practice properly, if at all, until you are in your postgraduate period – and then only if you choose to spend some time as a general practitioner.” Working as a GP in a smaller rural town is challenging, Scott says – but in a good way, with plenty of opportunities to do some really interesting medicine. “You don’t have to be superman to work in General Practice, whether it’s metropolitan or in the country – GP training and a willingness to help people is enough to solve most problems.” “Any time you don’t have the solutions yourself, the joy of General Practice is that you can follow your patients up, manage them over time and bring in resources as required. General Practice is a platform in which you can shape your career in the way you’d like it to turn out.”
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“My PGPPP Experience” Dr Shoshanna Slattery
Where did you do your PGPPP?
Program highlights?
an HMO2 year at Geelong Hospital.
regular release sessions, which involved
Part of the program also included I undertook the PGPPP as part ofPGPPP? Where did you do your
I undertook the PGPPP as part of an HMO2 at Geelong intensive year small group tutorials run My placement was at Cambourne Hospital. My placement was at Cambourne Clinic, Warrnambool over several days with other local GP Clinic, Warrnambool on Victoria’s Registrars. These covered topics from South West Coast. on Victoria’s South West Coast. rural emergency skills to tips on how
How did the help you professionally? to navigate the complicated world How did the program program help you
of Medicare. These were always held professionally? After working as a junior doc in the hospital system, I found the in beautiful locations such as Port After working as a junior doc in the most rewarding aspect was my Campbell or the having Grampians, andown were hospital system, I found of thethis mostGP placement patients to lookaspect after. Having the autonomy to make to management a good opportunity debrief and have rewarding of this GP placement a bit of fun.as a doctor. It was was having my own look confident decisions allowed mepatients to feeltomore after. Having the the autonomy to makeof care of patients and observe also great to have continuity How did the lifestyle compare with management decisions allowed me to how things progressed time. hospital? feel more confident as over a doctor. It was also great to have the continuity of care After working long shifts at the hospital “Having the autonomy to make management decisions allowed it was a new experience to have no of patients and observe how things me to feel moreover confident as a doctor.” pager, no weekend work, no on-call and progressed time. no late nights. Working from 9 to 5.30 with a rostered lunch break was much “Having the autonomy to make more enjoyable! It was also great to get management decisions allowed me to There was a strong emphasis on learning at the clinic, both away from the city and spend some feel more confident as a doctor.” informally during consults and formally in weekly one-on-one time at the beach. teaching sessions. I haddelivered? access to a fantastic group of GPs who How was the teaching provided mentorship, guidance and constant encouragement. What advice would you give otherI felt There was a strong emphasis on learning doctors aboutsuch the PGPPP? at the clinic,to both informally very privileged have the during opportunityjunior to learn from a wealth I highly recommend the PGPPP consults and formally in weekly one-onof knowledge and experience. Their empathy and standard ofascare a fantastic insight into patient care one teaching sessions. I had access to for patients was inspiring beyond the hospital. a fantastic group of GPs who provided mentorship, guidance and constant encouragement. I felt very privileged to Dr Shoshanna Slattery is a GP Registrar opportunity to learn from suchregular with VMA who is currently doing herwhich first Part ofhave thethe program also included release sessions, a wealth of knowledge experience. General at Westgate Health involved intensive smalland group tutorials runPractice overTerm several days Their empathy and standard of care for in Melbourne. with other local GP Registrars. TheseCo-Op covered topics from rural patients was inspiring.
How was the teaching delivered?
What were the program highlights?
emergency skills to tips on how to navigate the complicated world of Medicare. These were always held in beautiful locations such as Port Campbell or the Grampians, and were a good opportunity to debrief and have a bit of fun.
How did the lifestyle compare with hospital? After working long shifts at the hospital it was a new experience to have no pager, no weekend work, no on-call and no late nights. Working from 9 to 5.30 with a rostered lunch break was much GPRA-Compass2009-internals-FA.indd 26 2/3/09 12:14:15 PM more enjoyable! It was also great to get away from the city and spend some time at the beach. 26
What advice would you give other junior doctors about the PGPPP? I highly recommend the PGPPP as a fantastic insight into patient care beyond the hospital.
Want a taste of General Practice while training in hospital? Then give the Prevocational General Practice Placements Program (PGPPP) a go. What’s it all about? The PGPPP – the Prevocational General Practice Placements Program – is a great way to experience General Practice during your hospital training years. Whether you’re seriously considering a GP career or you simply want to gain a deeper insight into primary care, it’s an experience that will enhance your medical training. You’ll work as a valued colleague in a city or country practice, live in the community and experience a real change of pace from the hospital setting. The PGPPP is divided into two components: • Practices in metropolitan and large regional areas that are managed by the Royal Australian College of General Practitioners (RACGP). • Practices in remote, rural and regional areas that are managed by Australian College of Rural and Remote Medicine (ACRRM).
Who is eligible? The PGPPP is open to Interns and Postgraduate Year 2/3 doctors. Terms are generally equal in duration to hospital rotations. You will be well supported with defined levels of teaching and supervision in an accredited training practice. The PGPPP funds educational resources, travel and accommodation (conditions apply). All salaries continue to be paid while on placement and superannuation, indemnity and industrial arrangements are managed by the hospital of origin, to ensure a seamless move from hospital to practice. Why not talk your Medical Education Officer or Director of Clinical Training about including a PGPPP rotation in your training plans?
Dr Shoshanna Slattery is a GP Registrar with VMA who is currently doing her first General Practice Term at Westgate Health Co-op in Melbourne.
Livescribe Pulse 2GB Smartpen I have managed to find a tool that is invaluable to GPs, especially when studying, at conferences or seminars – even consults. The device is the Livescribe Pulse Smartpen. Physically, it is a slightly chunky ball pen – but this pen will digitise everything you write and save it to a desktop application. An add-on called MyScript then does a reasonable job of converting it to typed text. The pen can also record the ambient audio at the same time and link it to your written notes. On the desktop, the whole becomes searchable and it seems to use the audio and text together to make the search quite accurate. Even better – you can return to your printed notes and tap on any word with the pen and it will play the audio from that point in the meeting. The secret behind all of this is the use of special paper, which is covered in microdots. You have to use special notebooks, but they are reasonably priced. Windows desktop software allows you to print your own paper on a laserprinter. The Mac software works well but, so far, lacks some of the features available to Windows users.
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The 2GB pen holds about 200 hours of audio and is available from Officeworks or smartpen.com.au for $329. A wide range of accessories is available from smartpen.com.au You can find more information at livescribe.com.
Where to from here? You’ve read through Going Places and now you’re interested in finding out more about how to become a GP? So – who do you turn to for more information?
We’re here to help – and make it easy for you. All you need to do is call us or email us and we’ll send you an information pack that will tell you everything you need to know.
We’ll include a copy of GP Compass – the comprehensive guide that covers all aspects of becoming a GP and explains about training plus a copy of the AGPT (Australian General Practice Training) Handbook, which provides full details of the AGPT program and all the Training Providers.
Contact us now! Email: goingplaces@gpra.org.au Phone: 1300 131 198 Fax: (03) 9820 1983
Would you like to hear about being a GP straight from the horse’s mouth? We have a stable of GPs who are willing and eager to give you advice – and help you with your decision to pursue a career in General Practice. Just call us on 1300 131 198 or email mentors@gpra.org.au and we’ll put you in touch!
Augmented Reality The other day I sat down with my seven year old daughter to show her a new iPhone app that I had installed. Not that this was a first – but what made this occasion different was my insistence that she remembered where she was on this day – the first time she played with a true augmented reality application. Such applications are really only possible since the advent of the iPhone 3GS which has a compass, GPS and accelerometers, which give it a fairly accurate idea of its location in three dimensions. For some time, web applications such as Google Maps have been overlaying data onto the maps and we have become quite used to finding information about surrounding businesses. The iPhone 3GS allows developers to go one step further by taking away the 2D view of the map and replacing it with a real-time view of the world using the camera and screen as a viewport. The application I was playing with is called NearestWiki. You start the application and move the 3GS to look at the world around you – then information badges appear in space, which draw information from Wikipedia. Probably the most exciting of such applications at the moment is called the Bionic Eye, which sadly does not yet have Australian data. This shows shopping and public transport venues nearby. When one is selected, you simply point the iPhone camera towards the pavement and arrows appear giving directions. I believe that fairly quickly such technology will perhaps find its way into an attachment for glasses and will become ubiquitous. Whilst the benefits of such data overlays are of interest in daily life, in medicine they are truly astounding!
Dr Gadget, Richard Clement
Going Places – LAUNCH ISSUE
24
New Doctor in Training Package Delivering value with a low flat rate Category
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First 2 postgraduate years
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Includes a $100 annual base rate plus the ROCS levy, Govt. charges & taxes of between $20 – $40, depending on the state or territory where you practise. Rates current as at 1 May 2009 and are subject to change.
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