The essential guide for medical students and junior doctors
GP training with challenge, adventure and diversity Northern Territory General Practice Education (NTGPE) offers training placements in urban, rural and remote parts of the NT. These unique opportunities will equip you to become a skilled GP who can practice anywhere in Australia and the world. Design your training journey, with support from an experienced team of medical educators, cultural educators and support staff.
Find out more, visit ntgpe.org.
The wealth of variety that comes through the door consistently is amazing. Throughout my clinical training whether itâ€™s been hospital based or GP based, the breadth I see is not what people see down south. If youâ€™re looking for adventure this is a great place to train. Dr Sarah Lord, RACGP fellow
2018 GPSN National Chair Megan Bleeze.
One club stands out from the rest — a club that provides you with opportunities to develop your skills in general practice, to shape your future career as a general practitioner and to have fun while meeting new people.
Welcome As a first year medical student at orientation week, you can often be inundated with information. There are many clubs and societies to join — some of the larger universities boast over 100 official clubs, societies and associations!
With so much going on at your university campus it is hard to know where to commit your time. However, one particular club stands out from the rest — a club that provides you with opportunities to develop your skills in general practice, to shape your future career as a general practitioner and to have fun while meeting new people. General Practice Students Network (GPSN) is all encompassing — a must-join for any medical student interested in general practice. There are GPSN clubs in medical schools across Australia. Each local club hosts their own events. Local GPSN events may include: clinical skills nights, guest speakers, trivia nights, movie nights and much more. I am always impressed at how the clubs find innovative and exciting ways to broaden perspectives and understanding of primary healthcare for medical students. Being part of a national network, each GPSN club has access to the resources and support of General Practice 2
Registrars Australia (GPRA). GPRA supports GPSN; they are with you on your general practice journey — from medical student, to prevocational doctor, to GP registrar. National GPSN activities run throughout the year. GPSN supports four national working groups (Close the Gap, Community, Rural and Research), connecting students who are passionate about influencing change in general practice, both nationally and in grassroots communities across Australia. I am excited to see GPSN provide medical students with even more unique experiences in 2018 — each opportunity is a chance for you to step outside the classroom and discover the depth and breadth of general practice. In particular, the Cultural Immersion Experience and Farm Stay, projects of the Close the Gap Working Group and the Rural Working Group respectively, come to mind. The best way to keep in touch is through the GPSN Facebook page, or by visiting the GPSN website. I truly believe that GPSN offers something for everyone. We would love to hear from you and hope you enjoy being a part of our network! Megan Bleeze GPSN National Chair 2018
Eastern Victoria GP Training Eastern Victoria (EV) GP Training delivers training throughout eastern, south-eastern and north-eastern metropolitan Melbourne, Mornington Peninsula and Gippsland. EV’s quality program oﬀers: • Both general and rural training pathways • FRACGP, FACRRM and FARGP endpoints • A wide variety of experienced and accredited supervisors, training practices, community health centres and Aboriginal Medical Services • The chance for registrars to meet personal learning needs and interests through our diverse training practices and supervisors • Full-time and part-time training
EV provides opportuni�es for registrars to extend their skills during training including: Academic research, adolescent health, anaesthetics, custodial medicine, dermatology, emergency medicine, family planning,
forensic medicine, HIV medicine, medical education, mental health, obstetrics, palliative care, paediatrics, sexual health, sports medicine and more.
There are lots of good reasons to choose EV: • Our people - experienced, passionate and dedicated GP supervisors and medical educators place registrar interests at the forefront • Program delivery - a range of learning approaches are used including hands-on workshops, small group learning and an engaging and innovative online learning program as well as individual in-practice teaching opportunities • Great support - registrars are well supported by our outstanding and experienced staﬀ
Find out more about our quality program on our website
www.evgptraining.com.au P: 1300 851 753 E: firstname.lastname@example.org 15 Cato Street Hawthorn Vic 3122
Suite B2, 50 Northways Road Churchill Vic 3842
Find inside p.11 GPRA patron message
p.7 Local club events
About GPSN p.5 What is GPSN?
Becoming a GP
p.14 How to become a GP
p.9 National Working Groups
p.17 RTOs & extended skills
p.41 Meet the GPSN national executive
p.15 Fellowship: RACGP and ACRRM
p.19 Prepare for graduation and beyond
p.18 What GPs can earn p.27 Study and exam tips
Tips & advice p.22 Dear first-year self
p.25 Making the most of your placement
p.40 Overcoming the challenges
Real people, real stories p.29 A unique placement
p.35 A specialist in life
p.33 A different pathway
p.31 From computer screen to clinic GP First: the essential guide for medical students and junior doctors Published by General Practice Registrars Australia Ltd | Level 1, 517 Flinders Lane, Melbourne Vic 3000 | 03 9629 8878 | email@example.com | gpra.org.au Copyright ÂŠ 2018 General Practice Registrars Australia. All rights are reserved. All materials contained in this publication are protected by Australian copyright law and may not be distributed, reproduced, transmitted, displayed, published or broadcast without the prior permission of General Practice Registrars Australia (GPRA) or in the case of third part material, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of this publication. No part of this publication may be reproduced without prior permission of General Practice Registrars Australia. All efforts have been made to ensure that material presented in this publication was correct at the time of printing and published in good faith. GPRA does not accept liability for the use of information within this publication. P12 image courtesy Leif JĂ¸rgensen. GP First team Rachel Sharp, Megan Bleeze and Iona Slater.
What is GPSN? General Practice Students Network (GPSN) is for medical students interested in general practice.
It is a network that provides you with opportunities to develop your skills in general practice, to shape your future career as a general practitioner and to have fun and meet people. A national network GPSN runs national activities throughout the year. GPSN supports four national working groups, connecting students who are passionate about influencing change in general practice, both nationally and in grassroots communities across Australia.
with local clubs There are GPSN clubs in medical schools in Australia. Each local club hosts their own events. Contact your club chair to get involved.
supported by GPRA General Practice Registrars Australia (GPRA) supports GPSN. GPRA is with you on your general practice journey from medical student, to prevocational doctor, to GP registrar. After graduation, GPRA supports you during GP registrar training, exams and employment.
General Practice Registrars Australia (GPRA) supports you on your journey to general practice. As a medical student, you can hone in on your interest in general practice by becoming involved with GPSN. During hospital rotations as a prevocational doctor, general practice stays on the radar with our Going Places Network (GPN). When you become a GP registrar, GPRA supports you through to fellowship and beyond.
Did you know? Five ways to get involved in GPSN
1. Become a GPSN member â€” itâ€™s free! 2. Attend your local GPSN club events (p.7) 3. Get social: facebook.com/gpsnaustralia 4. Join a GPSN national working group (p.9) 5. Attend a national GPSN event, such as the Farm Stay or Cultural Immersion Trip (p.9) 6
GPSN local club events The General Practice Students Network (GPSN) operates in 21 Australian universities.
At each university, the local GPSN club holds events which promote general practice as a vocation, educate students about GP training programs, as well as fostering an appreciation and understanding of primary healthcare. These events can vary from academic and clinical skills nights to networking and social gatherings. The interests of the student members at each different university are unique. Local GPSN clubs organise events that meet the demands of their student membership and ensure active engagement in primary healthcare throughout medical school.
Exam preparation GPSN Bond, together with Bond University Physicians’ Society, hosted an exam preparation night, the “Second Year OSCE Practice Night”. This event was a chance for students to refine their skills in history taking, physical examinations and imaging interpretation in preparation for the integrated OSCEs exams. Students said the event helped in their exam preparation.
At Bond University GPSN
Preparing for exams.
Clinical skills Students learned new skills and brushed up on old ones with GPSN Bond’s Clinical Skills Night. This event was co-run by GPSN and BUSHFIRE, and featured a diverse range of skills including suturing and surgical knots as well as how to use medical instruments such as otoscopes and ophthalmoscopes. The event, targeted at second and third year students, had tutors onhand at each station. The booked out event provided invaluable, hands-on practice, as well as dinner and door prizes.
Practicing surgical knots and other skills.
Careers night Four GPs from various metropolitan practices, each with different backgrounds and interests, attended the 2017 GP Careers Night at Monash University. The speakers presented to over 100 students from all five year levels about their career paths, the people they have encountered, and the most significant life lessons they have learned. One speaker took the time to outline the current process of becoming a general practitioner. This was something the final year students found very useful, particularly with job applications due soon after the event. This is one of the GPSN events medical students and GPSN members at Monash University look forward to every year, and was once again a highlight of the first semester calendar.
At Monash University GPSN
Dr David Chen explains the vocational pathway for GPs
Clinical skills day Clinical skills days are always a highlight of a medical studentâ€™s life; it is one thing to learn mountains of theory, but another to be able to apply skills. The clinical skills day started with a presentation from a local GP before students rotated through the different skill stations, which included pap smears, cannulations, ENT examinations and suturing. Facilitated by friendly and talented doctors, physiotherapists and older medical students, this day was yet another opportunity presented by GPSN for students to take advantage of the wealth of experience being shared. For many students, especially those in first year, this was their first opportunity to learn proper clinical skills, and was thoroughly enjoyed by all.
UNE students learning to cann
At University of New England (UNE) GPSN
Contact your local club chair to learn more about upcoming local GPSN events at your university.
GPSN national working groups
Close the Gap
The Close the Gap Working Group aims to increase awareness and encourage all medical student to make Aboriginal and Torres Strait Islander health a priority in their future practice.
The Rural Working Group focuses on projects which will foster an appreciation — if not passion — for rural and agricultural health amongst medical students.
The poorer health outcomes of Aboriginal and Torres Strait Islander people are recognised by our government.
An exciting initiative of this working group is the development of a pilot ‘Farm Stay’ program for 2018 in conjunction with Australian Medical Students’ Association (AMSA) Rural Health and National Rural Health Student Network (NRHSN).
Medical students play an important role as Australia’s future doctors in helping to improve this situation so that equality can be achieved. The Close the Gap Working Group is working on a variety of projects. In 2017, we helped run the Cultural Immersion Trip, which saw ten students from across Australia experience life, health and culture of Kakadu country. With over one hundred GPSN members applying for a spot on the trip, the immersion was a huge success. We endeavour to expand upon this success in 2018, working on more projects which do their part to help ‘Close the Gap’.
The aim is to provide medical students with the opportunity to experience rural and agricultural medicine in a hands-on, real-life environment We recognise that it is next to impossible to teach medical students about rural health in a big city lecture theatre, so we hope that through exposing them to life on a farm they will have a better understanding of both the challenges and joys of rural medicine. Ongoing projects include a mentor database, which will provide an avenue for students to connect with rural doctors who are willing to mentor and host clinical placements.
About national working groups The GPSN national working groups are student-inspired, student-run groups for GPSN members who are interested in a particular area of primary healthcare. Each group is made up of GPSN members from across Australia. The groups are self-directed, selecting their own projects to work on, with the support of GPRA. Past project included national events, research papers, local and national initiatives, pilot programs and more. These national initiatives provide opportunities to experience and pursue roles in policy making, research, community involvement and public health. Youâ€™re invited to get involved!
Community The Community Working Group has an active role in providing opportunities for students to actively give back to the broader community. This includes the newly established Refugee Health Initiative, with a pilot food-drive project planned to be hosted in Armidale. Weâ€™re hoping to build on making this a national effort in future, bringing to light the difficulties faced by this population and providing much needed supplies. Research is also ongoing with our Homeless Health initiative having conducted surveys gauging the level of teaching on this often-overlooked area of health, with input from shelters and other organisations on how we as students may be able to help. With all of these projects and more we hope to build upon what has been achieved in the previous year and continue to create a positive impact on medical students and the wider community.
Research The Research Working Group produces research that focuses on the priorities of GPSN members. With almost all medical schools in Australia shifting to a Doctor of Medicine degree, GPSN recognises there is an expectation of students to undertake research. As GPSN has a strong, large and wellengaged membership base, there is the perfect opportunity and resources for students with a research interest to be supported and assisted through the process. An example of the research this working group has done is investigating the links between personality types and undergraduate degrees with mental health in medical school. This research is of high importance given the concerning and increasing number of suicides in junior doctors. In the coming year, we have many more interesting and exciting research projects planned. You are invited to join us!
You are the future of general practice
GPRA Patron Professor Michael Kidd shares his thoughts on contemporary general practice, and reflects on the critical role of general practitioners in healthcare systems in Australia and elsewhere in the world. 11
GPSN is one of the fastest growing medical organisations in Australia, ensuring that every student at our nation’s medical schools has the opportunity to explore the possibilities of a wonderful future career as a general practitioner. Our nation’s medical students are the future of our great professional discipline. GPSN champions to medical students the vital contributions of our nation’s GPs to the health and wellbeing of the people of Australia. And it does so in a positive and fun way.
Now more than ever, Australia needs strong general practice. International evidence is clear about the population health benefits provided by strong systems of primary healthcare, which includes strong general practice.
The WHO has recently established a new centre for Primary Health Care in Kazakhstan with the intent of supporting countries in their efforts to strengthen primary healthcare.
There will be a global focus this year on our work as general practitioners, as 2018 marks the 40th anniversary of the Declaration of Alma-Ata, which was adopted in 1978 at the international Conference on Primary Health Care held in the Central Asian city of Alma Ata in what is now Kazakhstan.
The centre’s work includes a focus on three key areas: integration of primary healthcare with public health services; improved coordination between primary healthcare and other health services, including hospitals and specialised services; and better integration of primary healthcare and social care.
This declaration, adopted by the governments of the nations of the world, urged all governments, health workers, and the world community, to protect and promote the health of all peoples.
I find the focus on improved integration with social care particularly interesting, as this is a key to addressing the rising needs of our growing population of elderly people, and to improving the support provided to many disadvantaged and vulnerable members of our community, including people with disability and people with mental health concerns.
The declaration called for “Health For All People”; a vision to secure the health and wellbeing of people around the world by promoting health and human dignity and enhancing quality of life. It was one of the first instances where the importance of primary healthcare was emphasised at a global level. Member nations of the World Health Organization (WHO) continue to this day to uphold the vision of health for all people, now called Universal Health Coverage.
We know that many people miss out on access to healthcare services. We know that we need to partner with those outside the health sector to deliver the sorts of services that many of our patients need. This is an exciting time to become a general practitioner as we are being brought into this global movement to become champions of “Health for All People”. I hope you will join us.
GP TRAINING IN SA:
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How to become a GP in Australia There are multiple pathways into general practice in Australia. The most common pathway is through the AGPT program. The Australian General Practice Training (AGPT) program is a Commonwealth Government initiative that provides training for registrars towards Fellowship and gaining specialist (general practitioner) registration. The AGPT program is three to four years of full-time training offered in urban, regional and rural locations nationally, delivered by the Regional Training Organisations (RTO). Each RTO delivers training towards two vocational endpoints. The two vocational endpoints recognised by Medicare Australia which allow you to practice as a GP are: • Fellowship of the Royal Australian College of General Practitioners (FRACGP). • Fellowship of the Australian College of Rural and Remote Medicine (FACRRM). AGPT training can be taken via:
The AGPT pathway...
Graduate from medical school • Four to six years. • At a university medical school. • MBBS or equivalent.
Complete your hospital training • 12 months (minimum). • At an accredited hospital. • General registration with Australian Health Practitioner Regulation Agency (AHPRA).
• the general pathway in urban and rural locations • the rural pathway, where training must occur in regional or rural areas.
Application to the AGPT program Before applying to enter the AGPT program check that your preferred RTOs can provide training for the pathway, fellowships, training posts and special interests that you want to pursue. When applying for the AGPT program, you will be asked to nominate RTOs and rank in order of preference. The online application period is typically from mid-April until mid-May each year. You may apply during your internship year (hospital year) to commence the following year. You can also apply later in your hospital training. GP registrars gain practical experience in rural and urban practices, in extended skills posts, as well as procedural and academic posts. Registrars are supervised by experienced GPs. The training includes self-directed learning, face-to-face educational activities and in-practice education.
Understand the details... While the Fellowships from both ACRRM and RACGP allow you to practice as a GP in Australia, each vary on the details. When deciding which college to apply to, be sure to understand these details. 14
Complete GP registrar training and exams • Three to four years. • Pick which end point (college Fellowship) (ACRRM or RACGP). • Select an RTO to deliver your training towards your Fellowship. • Be employed as a GP registrar at an accredited practice; training must occur at multiple practices, most GP registrars work at three or four different practices throughout their training. • Both Fellowships require you to sit both clinical exams and written exams. • Fellowship of the Royal Australian College of General Practitioners (FRACGP) OR Fellowship of the Australian College of Rural and Remote Medicine (FACRRM).
Fellowship through RACGP Information courtesy of The Royal Australian College of General Practitioners (RACGP) The RACGP provides GP education and training. They have supported more than 23,000 GPs achieve Fellowship since 1958.
RACGP offers two Fellowships through the AGPT Program: â€˘ Fellowship of the Royal Australian College of General Practitioners (FRACGP) â€˘ Fellowship in Advanced Rural General Practice (FARGP). To be selected into the RACGP program, candidates sit the Candidate Assessment Applied Knowledge Test (CAAKT) comprising of knowledge test questions and situational judgement questions. The CAAKT is based on the RACGP education framework and the assessment focuses on your current knowledge, skills and attributes in relation to becoming a GP. For further information on RACGP selection, express your interest at www.racgp.org.au/agpt-eoi
RACGP Fellowship examinations Once you have completed two years equivalent of active training time, including all of General Practice Term (GPT) 1 and GPT2, you will be able to sit the RACGP assessment. The RACGP assessment comprises three segments: the Applied Knowledge Test (AKT), the Key Feature Problem (KFP), and the Objective Structured Clinical Examination (OSCE). You will need a pass in both the AKT and KFP exams before you can take the OSCE. For more information visit racgp.org.au
Decide which pathway is right for you. Visit gpra.org.au for more information.
RACGP program structure AGPT hospital training (first 12 months) The first year of the program is spent in a hospital which can be completed anywhere in Australia, not necessarily in the region of your RTO. You will need to complete the following rotations before starting your general practice training: general medicine, general surgery, emergency, paediatrics, and a range of other rotations to provide a breadth of experience. Prior to commencing your general practice term, you will need to have completed a basic life support course in the previous 12 months. In certain circumstances, you may be eligible to apply for an exemption for the first year of the program via Recognition of Prior Learning (RPL). General practice placements (18 months) Your training organisation will have a list of the placements you will need to complete. You will receive supervision and teaching from GP supervisors. Registrars in the general pathway need to complete at least 12 months in outer metropolitan, rural or Aboriginal health posts during their training. Registrars in the rural pathway must complete at least 18 months in a rural practice setting. Extended skills (six months) The six months of extended skills training provides an opportunity to develop your general practice skills and can be completed in a variety of RACGP-accredited settings. There is a range of options for extended skills, including palliative care, sports medicine, sexual health or skin cancer medicine. Optional advanced rural skills (12 months) This leads to an additional Fellowship in Advanced Rural General Practice (FARGP). This training year is undertaken working in accredited rural training posts and accredited advanced rural training posts. There are two core modules which must be completed. 15
Fellowship through ACRRM Information courtesy of Australian College of Rural and Remote Medicine (ACRRM) The Australian College of Rural and Remote Medicine (ACRRM) provides a training program that specifically focuses on the needs of rural communities. Rural or remote GPs need a broader set of procedural and other skills to address the diverse needs of the community. An urban general practitioner may refer cases to a specialist or tertiary hospital, but a GP in rural or remote communities may not have a specialist hospital close-by. This can mean extending from primary to secondary to ongoing care.
ACRRM has three pathways that lead to Fellowship: • • •
Australian General Practice Training (AGPT) Independent Pathway (IP) Remote Vocational Training Scheme (RVTS).
All pathways lead to Vocational Recognition with Medicare Australia, Specialist Registration as a General Practitioner through the Australian Medical Council (AMC) and are recognised in reciprocal arrangements with other medical colleges. Pathway
Australian General Practice Training (AGPT)
Independent Pathway (IP)
Remote Vocational Training Scheme (RVTS)
Recent graduates and experienced doctors who prefer formal, educator-directed learning
Experienced doctors, who prefer self-directed learning
Experienced doctors, who prefer self-directed learning
Must have general medical registration Must be an Australian permanent resident or citizen
May have general or limited medical registration May have temporary Australian residency
May have general or limited medical registration. May have temporary Australian residency
Recognition of prior learning
Up to two years
Up to three years
Up to two years
Training provided by
Regional Training Organisations (RTOs)
Metropolitan, rural and remote facilities ACRRM accredited post
Metropolitan, rural and remote facilities ACRRM accredited post
Continue to work and live in your rural or remote community ACRRM accredited post
Training — government-funded Assessment — self-funded
Training — self-funded Assessment — self-funded
Training — government-funded Assessment — self-funded
1. Apply to ACRRM for a specific region 2. Selection by ACRRM 3. Accepted by an RTO 4. Enrol with RTO
1. Apply to ACRRM 2. Selection by ACRRM 3. Enrol with ACRRM
1. Apply to RVTS 2. Selection by RVTS 3. Enrol with ACRRM
Usually February and October
June and January
ACRRM program structure AGPT hospital training (first 12 months) Core clinical training time working in metropolitan, regional or rural hospitals. You can apply to the training program as an intern and undertake your second year as part of GP training. There are compulsory rotations. Primary rural and remote training (24 months) Training takes place in rural and remote posts in hospitals, general practice, Aboriginal Health Services, community health services and other posts. You will build clinical and procedural skills, provide comprehensive and continuing care across the primary and secondary continuum. Advanced skills training can be integrated at this stage with ACRRM approval. Advanced specialised training (12 months) Training in one of 10 ACRRM-specified disciplines, extending your skills and knowledge in one specialised area relevant to rural and remote general practice. Training can occur in metropolitan, rural or remote posts. 16
What is an RTO? The GP training program is delivered by a national network of Regional Training Organisations (RTO). Before you start GP training, you will choose an RTO in which to undertake your training. An RTO deliverers GP education and training within a specific geographical region. The current RTOs and regions are below. Western Victoria Murray City Country Coast GP Training (see p.24) www.mccc.com.au
South Australia GPEx (see p.13) www.gpex.com.au
North West Queensland Generalist Medical Training (see p.20) www.gmt.edu.au
Eastern Victoria Eastern Victoria GP Training (see p.3) www.evgptraining.com.au
Western Australia Western Australia General Practice Education Training (see p.42) www.wagpet.com.au
South East Queensland General Practice Training Queensland www.gptq.qld.edu.au
Tasmania General Practice Training Tasmania (see p.21) www.gptt.com.au
Northern Territory Northern Territory General Practice Education (see p.1) www.ntgpe.org
New South Wales GP Synergy Limited www.gpsynergy.com.au For more information, visit: agpt.com.au
Extend your GP skills There are a range of extended skills posts available as part of the GP training program. Each Regional Training Organisation (RTO) offers different options. Extended skills posts to meet your clinical interests are negotiated between you and your RTO. Once you are with an RTO, talk to them about your interests in advance. This will help your RTO plan out your GP training.
Below: Dr Sophie Ping is a GP registrar undertaking a forensic extended skills post. Read more about her story on page 33.
Below are some of the extended skills posts you can experience as part of your GP training: • Aboriginal health
• emergency medicine
• academic research
• family planning
• aged care
• forensic medicine
• alpine sports medicine
• health policy
• aviation medicine
• hospital in the home
• child and adolescent health
• medical education
• chronic disease management
• obstetrics and gynaecology
• critical care
• custodial medicine
• palliative care
• disability medicine
• sexual health
• drug and alcohol medicine
• sports medicine.
• mental health
• skin cancer medicine 17
What can GPs earn? The difference between a hospital and a practice In a hospital, a set award covers your wage. There is not much flexibility for negotiation. When GP registrars enter the general practice environment, the situation is more flexible and you should seek advice before making commitments. An employment agreement is negotiated between you and your training practice before you start your employment. The agreement outlines remuneration, leave entitlements, work hours and other employment terms and conditions.
Your employment agreement GP registrar employment agreements are covered by the National Terms and Conditions for the Employment of Registrars (NTCER), negotiated by GPRA. The NTCER outlines: the minimum which GP registrars can be paid, leave entitlements (such as annual leave and personal leave), hours of work (such as ordinary hours, on-call, overtime) and more. Because the NTCER sets out basic terms and conditions of employment, you can negotiate with your employer for conditions and benefits greater than the NTCER. The current agreement covers all GP registrars, except those in community controlled health and Australian Defence Force workplaces, and registrars on remediation.
GP registrar working hours Full-time GP registrars work a minimum of 38 hours per
week. This includes education time and administration time. Consultation hours, the hours spent seeing patients, are usually between 27 and 33 hours a week. However, this can vary, especially in rural areas. GP registrars usually receive a base wage and a percentage of income generated by the number of patients they see in the practice.
2018 minimum salaries for full-time GP registrars GP term 1 — $74,215 GP term 2 — $89,226 GP term 3 and above — $95,295 Established GPs can earn good money. The actual amount depends on the nature of the practice and hours worked. In addition, there is the opportunity to run your own medical practice or work flexible hours. Find out how much you could earn using our calculator: gpsn.org.au/earnings-calculator
Incentive payments GP registrars may be eligible to receive financial incentive payments in addition to their salary. Most of these extra payments are offered by the Department of Health to encourage GPs to practice in areas of need, such as rural, remote and outer metropolitan areas. Payments vary, depending on experience and the location’s remoteness. For example, a first or second year GP could earn an incentive payment of $25,000 per year for practicing in Coober Pedy, South Australia or in Bourke, New South Wales.
Prepare for graduation While life for the next few years may be a blur of university exams and hospital rotations, here are some simple things you can do in preparation for becoming a GP registrar. • Talk to a GP or GP registrar. Ask them about their training, their career, their practice and for any advice. They may be able to give you insider knowledge on general practice as an industry and profession, advice on training and preparing for the fellowship exams and more. • Think about where you would like to work as a GP registrar or GP. This includes thinking about what area of general practice interests you, as your clinic’s location may determine the types of patients (for example, places with a high refugee population, or a high elderly population, or an area with mothers and young children). • Think about extended skills you would like to develop in your GP training and if these skills would suit your goals and clinical interests. • Research GP training program pathways (rural or general), the endpoint qualifications and fellowships. Think about which fellowship is right for you. • Research each Regional Training Organisation (RTO); each offers different options as to how your training is delivered, and where you training is delivered. • Check out the website of General Practice Registrars Australia (GPRA), gpra.org.au. GPRA have many resources online and are there to support you through your general practice training journey. • Remember to take breaks, relax and celebrate the small wins along the journey to general practice!
After graduation Don’t let general practice fall off the radar during hospital training. The Going Places Network (GPN) is for prevocational doctors, providing information and support for those interested in general practice while they complete their internship and hospital training.
Once you’ve graduated, update your GPSN member details Contact GPRA to let them know you’ve graduated and to update your GPSN member details. While you’re completing your hospital training, GPRA will: • keep you updated on the latest trends in general practice • provide you with resources to kick-start your training as a GP registrar.
Got questions about general practice during hospital training? Go to your GP ambassador! GP ambassadors are a part of the Going Places Network (GPN) — a network of prevocational doctors with a passion for general practice. These ambassadors are a point of contact for prevocational doctors wanting to know more about general practice. Contact your GP ambassador for answers to questions about general practice during hospital rotations, and to network and touch base with other prevocational doctors. See a list of GP ambassadors gpra.org.au/gpn If you’re interested in becoming a GP ambassador, email firstname.lastname@example.org with your name, your hospital and why you would like to become a GP ambassador. 19
Generalist Medical Training (GMT) is the regional provider of the Australian General Practice Training Program in regional, rural and remote Queensland FIVE REASONS TO TRAIN WITH GMT 1. Work across urban, regional, rural and remote locations 2. Receive guidance and support from skilled supervisors and medical educators 3. Undertake procedural and practical skills training across palliative care, primary care, anaesthetics, emergency medicine, obstetrics, Aboriginal and Torres Strait Islander health, oncology, skin cancer medicine, medical education, and surgery 4. Access Aboriginal and Torres Strait Islander health educational activities 5. Expand knowledge via workshops and online education and access James Cook University’s postgraduate and research opportunities
Early on in my career, I’ve been able to see such an improvement, and feel like I’m making a contribution to the community that I’m living in.
Dr Brendan Cantwell Generalist Medical Training Registrar
WANT TO PASS YOUR EXAMS IN A WONDERFUL ENVIRONMENT? COME TO TASSIE. Renowned for our high-quality, well-organised training, General Practice Training Tasmania (GPTT) provides exceptional and unique educational experiences throughout the beautiful state of Tasmania. GPTT is the sole Tasmanian provider of the AGPT training program. Our world-class team of professionals create a friendly, supportive and intimate learning environment for our registrars, and our results – among the best in the nation - speak for themselves.
GPTT’s monthly small-group learning meetings and workshops are held in lovely locations around the state, and thanks to our strong links with the University of Tasmania, we provide a range of extended and advanced skills. GPTT offers training in both the general and rural pathways with fellowship of ACRRM (FACRRM) and/ or Fellowship of the RACGP (FRACGP) and Fellowship in Advanced Rural General Practice (FARGP). In Tassie it’s easy to get about, and our clean air and dining experiences are also world-class. Come join us…
For more information visit www.gptt.com.au
Dear first-year self, Dear first-year self, Welcome to an intense marathon of learning and experiences. To start, pace yourself. Have a look at your learning blocks, break them down into digestible pieces and ‘To Do’ lists and then start chugging away. It’s easy and normal to be overwhelmed by the enormity of knowledge you need to collect. It’s also ok to struggle with concepts the first and even second time around. Buy some quality coloured pencils and an art book to make learning enjoyable. Find some giant whiteboard material from Bunnings and “mind map” those difficult and complex learning points.
Look after yourself first and foremost. Prioritise your study as well as time for family, friends, extracurricular activities, fitness and sleep. Give yourself permission to leave the ward round at 2pm for a nap if you need but also to stay late if you’ve come across a fantastic learning opportunity. Make sure you keep an eye out for your friends who may be struggling. Many medical students and doctors struggle with their mental health owing to the nature of our work and personalities. Be ready with an open ear and refer them on to the right services when they need it. Don’t give in to the competitive nature of medicine. Help your classmates by sharing knowledge, resources and opportunities. Be wary of the weight you place on the advice of others, including mine. Each rotation you’ll hear rumours of scary consultants, intimidating exams and mind-boggling topics. Each year the people above you will tell you it only gets harder. You’ll be bombarded with opinions on how to study and which knowledge is the most important. Approach each challenge with enthusiasm, kindness and an open mind, and don’t buy in to the negativity. Finally, just do your best, remembering that your best will change from day to day. Love from, Your future self PS Fry an egg on the sandwich press in the common room. Whack it on some rice and top with white pepper, chilli flakes, oyster sauce and sesame oil. It’ll blow your mind!
Written by Dr Claire Chandler 22
Dear first-year self, Dear first-year self, You probably feel like you can conquer the world right now, and you deserve to feel that way. Hold onto this feeling because it will soon get busy and you’ll find yourself at 1am wondering why you’re memorising the kreb cycle even though it doesn’t seem relevant to any clinical scenario ever! Know that you’re in for a tough, exciting, challenging, rewarding, invigorating few years. You’ll still be having fun, but I promise you will study harder than you have before. Speaking of studying, you should download a Pomodoro Technique app right now, it will revolutionise your study! The people you meet in medical school will be the ones who will share ward call shifts with you. Soon, you will have many in-jokes. Study in groups and use the strengths of others — not only will you share the learning load, but you will make life-long friends. A whole bunch of opportunities are about to cross your path — research, student clubs, teaching, and extra learning experiences. Welcome them all. You might think you know how you want your career to progress, but things are about to get confusing. Have a go at everything you can. Even if you don’t love whatever challenge you’ve taken on, I can guarantee you’ll learn something useful in the process. Always keep in mind that you still need to pass medical school. Don’t take on so much that this becomes a colossal task! Remember that medical school will come to an end. Invest time in things outside of medical school — your friends, family, and hobbies. Don’t make the mistake of telling everyone you’ll resurface in four years. These things help keep you grounded and happy. Finally, first-year self, there will be times when everything is difficult and it all feels pointless. Everybody has days like these, particularly around high-stakes exams. But if your bad days begin to outnumber your good days please talk to someone. While not many people will admit it, lots of us struggle, and that’s completely okay. Above all else, enjoy yourself! Medical school will be hard work, but it will also be fun and rewarding, and so very worth it in the end. In hindsight, End-of-residency self
Written by Dr Nicola Campbell 23
About the author Dr Nicola Campbell is a GPRA member who served as GPSN National Chair in 2015. She is completing residency at Toowoomba Hospital in regional Queensland and commencing psychiatry training as her advanced skill for rural general practice in 2018. When she graduated in 2015, Nicola was voted most likely to write a textbook. While this has not yet happened, we are sure she is well on her way there! Nicola is interested in junior doctor wellbeing and education. She is a part of the JMO forum of AMA Queensland Council of Doctors in Training. Nicola is a Going Places Ambassador at Toowoomba Hospital.
Making the most of your placement From his experiences hosting first and second year medical students, Dr Andrew Leech shares his tips on making your time spent on a GP placement more beneficial and valuable. When you think about your general practice term, what thoughts come to mind? For some, it may be apprehension, nervousness or fear. For others it is an exciting opportunity to see what happens in a real clinic where they finally meet real patients. When I completed my first few GP terms I found it overwhelming. It took me time and patience to understand what a GP does in a clinic and how they interact with patients. As a first-year medical student I would often sit in the corner, anxious about making mistakes. I was daunted by the idea of meeting â€˜realâ€™ patients, but at the same time amazed that I had finally made it to this hallmark stage of my training. Looking back at my approach, I know I was timid and could have tried harder to make my placements more worthwhile. I did not appreciate that patients are very understanding. They often enjoy speaking to medical students, telling their story and allowing students to take histories. Like an open medical textbook, each patient offers so much for you to learn from. So my message is simple, donâ€™t be afraid of your experience, but rather, take every opportunity as it comes. Every patient is a learning experience; be humbled by the fact that you are in the room with them, listening to what can be some very personal and moving stories. About the author A former GPRA member, Dr Andrew Leech graduated from Notre Dame University in Fremantle in 2009. Together with his wife and two daughters, he lives in Perth. He practices as a GP in Canning Vale. Andrew returned to The University of Notre Dame on a part-time basis as an educator for medical students.
Learn how the clinic runs Have a look at who is in the team, how they jell together and what each team member does for the patient. People in your team can include pathology nurses, practice managers, receptionists, and practice nurses – just to name a few. Each clinic is different, but every person plays an important role in running a clinic and treating patients. Spend time with each person in the clinic so you can understand what each role involves.
Listen to your GP and patient interaction During placement, you have a rare opportunity to observe the conversation between a GP and their patient. Remember what questions are asked, and how the GP answers each question. You will often hear GPs ask open questions to begin, followed by a series of direct and at times very focused questions unique to general practice.
Become involved Show interest and initiative at your placement by becoming as involved as you can during your placement. Ask the attending GP if you can take a history, perform an examination and present your findings. Ask for feedback on your presentation skills and don’t be afraid of constructive criticism. Ask if you can practise basic clinical skills such as spirometry, ECGs, BSLs and dressings. Practise as often as you can.
See every patient as an open book for learning From the moment a patient walks towards the consultation room, they are presenting clues as to why they are attending. You may note a persistent cough, an unsteady gait or poor eye contact. This is the start to observing the patient and understanding them the way a GP does.
Like an open medical textbook, each patient offers so much for you to learn from... every patient is a learning experience.
Med ic you w al schoo l times ill look b is a journ ack a ey. O when n n stress you were d reminis e day, c ful, fu e a a s Study n and e tudent â€” bout the ver yt well, hing it can be chill when o u need t and in betwe en ed. take In the brea . mean ks ever y time, one stre re h to ev ngths â€” as differe member e e that n f r t sk fec yo with back ne. Some tive study ills and grou distra nd m people looks dif c prefe f usic, other t others. r to erent w s S their before th ome peo hile noise study mind ple li e exa may k find this d off their a m starts e to cha t t with o i nxiet time strac help ie ti q room uietly thin ng and p s, while take o re . k work Find out ing befo fer to sp thers may re en s bes end how the tering t for y you o ou best the e Here s t n u xa dy, a exam y nd w m medi ou will fi d a y . hat c n are f al studen d simple uncti t t s i p s s t u oni tha dy exam day. ng effect well and t will help ively ensu on re the all y
Study Tips #1 Be consistent Allocate study sessions almost every day. Even if some days you can only fit in15 minutes at most, it is better to be consistent rather than “burning the midnight oil” and cramming just before exams. #2 Use useful and fun apps Handy apps include: Uptodate, Epocrates, Medscape, Daily Rounds for Doctors, MedCalc, Prognosis and Anki. #3 Remove distractions A good way to start is to list the things that distract you so you are aware of your weaknesses. Put your phone on silent, close your Facebook tab, put on your headphones, and study in a place that suits you and ask people not to disturb you during your study time.
Exam Tips #1 Get adequate sleep the night before Listen to your body. Going into the exam room with drowsy eyes and a heavy head won’t be helpful. #2 Plan your SwotVac/study break in detail The last few days leading up to your exams are crucial. What you read stays in your short-term memory — it may even decide which side you’ll fall into if you’re sitting around the borderline mark for passing the exam. #3 Remain cheerful and positive on exam day Good vibes can boost your mood on exam days, and the mood of those around you. Chuck in some elements of confidence (especially in OSCEs) and you’ll find exams more bearable.
About the author Celine Goh is the Chair of GPSN University of Tasmania (UTAS) and a final-year medical student. She is passionate about women’s health and children’s health. She believes in finding joy in whatever she does. In her free time, she enjoys playing the piano, hiking and exploring nature.
Christmas Island – a unique placement Jack Bradbury, during his final year at University of Notre Dame Fremantle, undertook a four-week placement with the Indian Ocean Territories Health Services, experiencing healthcare and life completely different to his hometown, Perth.
There is rural health and there is remote health... but Christmas Island is isolated health.
When Jack Bradbury was told to pack an Esky with fresh fruits and vegetables, he knew his four-week placement on Christmas Island would be challenging. “It’s like living on the edge of a knife… you’re isolated from the mainland in terms of supplies,” Jack says. “You don’t know when fresh food supplies will be arriving (on the island)…You need to ration.” Admittedly, Jack knew little of the island’s history before applying. “I knew it had a history of processing refugees and asylum seekers, but I would not have backed myself to pin-point it on a map.” As well as the lack of supplies, another major challenge in providing high-quality healthcare to patients was the isolation from the mainland — which included the lack of reliable internet. Healthcare professionals on Christmas Island require resilient clinical acumen. “A situation that might usually warrant a quick referral to hospital, suddenly becomes a decision that could potentially require the help of the Royal Flying Doctor Service.” 29
Left: Jack Bradbury. RIGHT: Jack’s stand promoting good kidney health on the island. Below: The stunning views.
followed the cave out to the ocean.
During the placements there were GP consultations, the opportunity to work in the two-bed emergency department and be the first contact for walk-in patients, and a considerable amount of public health.
Overall, the experience shaped
A highlight for Jack was conducting sexual health education classes for year 10 students.
“I would definitely consider going
World Kidney day also presented Jack the opportunity to hold a kidney health-screening stand at the pharmacy, taking the opportunity to engage in community health and provide information and education to members of the community.
on Christmas Island. I would go
Outside of the consulting rooms, Jack was able to try his hand at spelunking – the exploration of caves. He explored the partially submerged Daniel Roux Cave and, with the aid of only a headlight,
Jack’s perspective on a career as a rural GP. The placement emphasised the immense and tangible impact that a rural GP can have on the health of a community.
rural, and I would definitely consider locum work after my time back in a heartbeat,” Jack says. “It is a humbling feeling to see the extent to which even a fourthyear medical student can make a difference to how members of a community approach their health.” Jack Bradbury graduated in 2017, and is undertaking his internship at Fiona Stanley Hospital in Perth.
From computer screen to clinic
Below: Scott with his son, Clem, aged 2.
Working 70 hours a week in IT, Scott Wilsmore was 36 and had not forgotten his passion for medicine. But could he trade full-time work for full-time study? “I never felt comfortable in IT,” Scott says. “My wife, Michelle, knew that I was bored, that I was not happy…I wanted something challenging, something rewarding. I was always interested in medicine, but I had a good job and I was caught up in it.” Having acquired a Bachelor of Computer Engineering and spent 15 years in IT, the decision to move back to study wasn’t taken lightly by Scott. “Michelle and I had a long chat about me moving to a career in medicine. Our first child was on the way. She knew that this was what I wanted to do for over ten years. She was very supportive… So I finally bit the bullet and applied for medical school.” At first, Scott started his medical degree at the University of Newcastle, juggling his IT job part-time with study and caring for a newborn daughter, Tess. When it became clear that part-time work while studying wouldn’t work, Scott moved out of IT completely and switched to the University of New England. Luckily, Michelle is a qualified teacher and was able to work while Scott studied full-time.
Life as a mature-age medicine student “Being a mature-age student, I thought that I was younger than what I was. It was a shock to see the younger students. But I found out that they’re mature in other ways, like their work ethic. Everyone is so supportive of my circumstances,” he says. For Scott, success in medical school is about staying on top of everything and being prepared. “I am not a night owl, so I get a couple of study hours in after the kids have gone to bed. I study for one day on the weekend, and I usually leave one day of the week for the kids. There are always sacrifices. “My undergraduate degree was all about cramming. Medical school isn’t like that; cramming and medicine don’t go well together.” 31
General practice is so satisfying as a job. Patient interaction is rewarding, and you can help solve problems...Other specialties, such as surgery, have a big climb up the career ladder. You’re on-call in the hospital and work long, unusual hours — this is restrictive for a lot of mature-age students.
Why general practice? For Scott, general practice was the obvious choice because of the job satisfaction that comes from working in a personcentred profession. “General practice is so satisfying as a job. Patient interaction is rewarding, and you can help solve problems,” Scott says. As a mature-aged student, with a wife and two young kids, Scott found many barriers to pursing other medical specialties. “Other specialties, such as surgery, have a big climb up the career ladder. You’re on-call in the hospital and work long, unusual hours — this is restrictive for a lot of mature-age students. “If I did surgery, I wouldn’t be fully qualified until I was about 50. That’s tough, because you’re then competing against people in their 30s who have better eyesight and better stamina. At 50, you just won’t have career longevity — in this way, general practice is a great career choice.” Scott is in his fourth year of his degree. He is a member of GPSN. Long-term, Scott would like to practise in Armidale, a rural town in NSW. “I like rural medicine. Time can be so short in the city. A rural GP can have greater knowledge of patients because they often spend more time with them. You usually know the name of the patient’s partner, or you might play sport with the patient on the weekend.”
Dr Yusof Mutahar WAGPET GP Registrar
General practice. Everything you want it to be. General practice is a highly diverse and unique discipline that offers a life-long journey of discovery and education. As a GP, you have the flexibility to work wherever you want. You can choose the hours you work and the lifestyle you enjoy, while making a positive impact on the local community.
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A different pathway Dr Sophie Ping is a GP registrar undertaking a Forensic Extended Skills Post at the Victorian Institute of Forensic Medicine. Making a niche in forensic medicine Sophie Ping is currently with the Victorian Institute of Forensic Medicine and she says the pathway that led her there is not common. “As a general practitioner, I saw a lot of domestic violence. I saw a lot of women who didn’t have health literacy. Then it sort of came to me in a flash one day – the realisation that I wanted to do forensic medicine,” Sophie says. “Some of my mentors had done this previously and, in Ballarat, there are only two people qualified to do forensic examinations. In some ways I am creating a bit of a niche for myself.” Sophie’s role entails examining alleged offenders and victims of physical and sexual assault, and assessing people’s fitness for police interviews.
She says most referrals are from the police.
life you are there to help them and that is extraordinary.
“If the police are considering going ahead with charges, they will contact the Ballarat Centre for Sexual Assault to undertake a physical examination.
“A full sexual assault examination of a female with other injuries could take two to four hours and during that time you might see a shift in the patient.
“We take photos and samples. We also consider such matters as whether the person is drug affected or needs increased medical attention.”
“You actually develop a fleeting but intense relationship… they have a person who is there for them – who is entirely interested in everything they are feeling. They understand that what you are doing is to help them.
Sophie is intrigued by some people’s morbid curiosity about what she does. “They have a fantasy that it is like CSI. In some ways it is, but often it is just an extraordinary amount of paperwork. “It is tiring and draining and you need to be incredibly prescient and aware of what you are saying. You need to be careful not to use jargon or say something that might be misinterpreted. “You second guess yourself a lot. But at the worst possible moment in someone’s
“It requires a combination of skills. If you come out feeling that you have done the best you can for a patient, and you actually see a shift in how they are emotionally, over those few hours, it is quite extraordinary and you know you have done something. “The majority of the time people will come up and say thank you so much for taking care of me. It is really powerful.”
General practice training is only three years. If you are not sure which speciality you want, do general practice. There is so much in transferable skills. And we get to do so many different things. It is not sitting in a little room all day seeing people with coughs and colds... It is an opportunity to be really intimately involved in people’s lives without ‘an all care but no responsibility attitude’ taken. You get to see so many different things.
Before medicine Sophie first applied to do medicine straight out of high school. “I didn’t get in. That’s okay. I think things tend to happen at the right time for the right reason and, if I had gone into medicine when I was 18, by now I would be burnt out and very angry,” she says. “I did an Arts/Science degree. Then I did honours in science. Then I did a PhD in neurophysiology. I worked in research for a while. “I was a senior tutor in medicine physiotherapy at Melbourne University. 34
I was made redundant and that turned out to be the best thing that ever happened to me.” Sophie went to Samoa for a year and worked there at the University of Medicine, which offers mostly online programs. “Scholarships were offered to Samoans and Pacific Islanders to try and improve medical education. I ran the campus and taught the introduction to medicine module.” “It is a patriarchal, religious society with a lot of non-verbal communication which is tricky… they are keen to be seen to be helpful. Hence, some people
will say yes to everything but simply not do it. It can be very frustrating.”
Sophie left Samoa and went to Darwin for three years, where she coordinated the nursing science degree. She then decided to make the move to medicine. “I sat the GAMSAT and was fortunate enough to get in. “I went to the School of Medicine at Deakin where I was enrolled in the Integrated Model of Medical Education in Rural Settings program and spent third year in rural general practice. “Through this program I learned a lot and it did not diminish my desire to be a GP.”
A specialist in life... & a teacher, boxer, guitarist & DJ For General Practitioner David Lam, general practice provides the flexibility to have a life outside of medicine, and his job in rural Port Lincoln has no shortage of variety.
For a decade, medicine and music battled in me like Jekyll and Hyde.
PICTURED: David Lam (left) DJing at the 2017 AFL Preliminary Final. 35
David (second from left) with fellow Spanish Harlem band members on the set of their music video.
Did I always want to be a GP? Hell no! I didn’t even want to be a doctor.
out how they do that and give it a go next time.” Being able to read people well is essential to both too. As a GP, one of the best ways to help people is to sit back, shut up and listen to the patient.
I wanted to study jazz. I felt no greater joy in life than playing guitar – anything and everything from John Coltrane to Red Hot Chili Peppers.
Likewise, as a musician, I am constantly reading the crowd. I am observing to see whether they are singing along, whether they are dancing, and constantly checking for that look of rapture in their eyes in order to figure out what to play next and how to play it.
But it’s no secret that most musicians require a stable job in addition to the sporadic work that comes from playing gigs, so when an offer came up for medical school I decided to give it a go.
In both jobs, reading people works far better than pushing my own clinical agenda or musical taste down their throats.
I continued because medicine is fascinating. Bad things happen to the human body all the time, yet it seems to just want to fix itself if you know how to help it along.
As a professional musician, I travel to and from Adelaide to play anything from weddings to AFL matches at the Adelaide Oval.
But the music never left me. For a decade, medicine and music battled in me like Jekyll and Hyde. When I was an intern I’d play a gig with my band, Spanish Harlem, or DJ a party with my crew, Lam Bros Disc Jockeying, and then have to jump straight in the car for an overnight shift at the hospital. I kept trying to convince myself that music was silly and I would “give up for real” in the next year.
hours in the day to be in theatre and be on stage. General practice was just right. The clinic hours meant a certain amount of predictability and flexibility. More and more I found it to be the perfect specialisation for me.
But I kept writing songs and people kept wanting to see us play, so I pushed on.
Rather than leading a juxtaposed double life, I discovered that the skills that made me a good DJ and guitarist were exactly the same skills that made me a good GP.
As an intern I was initially interested in surgical training, before realising that there just weren’t enough
Both engage my desire to learn new skills – to watch what someone else is doing and think “that’s clever, let’s find
Back in Port Lincoln, I am also the club doctor for the Port Lincoln Boxing Club and a primary carer for the Marble Range Netball Club. Because sport is awesome. I also teach final year medical students on rural rotations and first year students at the University of Adelaide. Are there busy days? Plenty. But I wouldn’t have it any other way. Each of my roles defines a different part of me and is a unique way to do good in the world. And most importantly, all of the above experiences make life fun.
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Variety is the spice of rural GP life In Port Lincoln, we don’t have resident hospital doctors, which means I work in the local hospital and emergency department as well as in my clinic. This makes my job both challenging and exciting. If someone gets horribly unwell in clinic, I’ll call an ambulance.
However, contrary to metropolitan general practice, I will then follow the ambulance in my own car and continue to treat the patient in hospital. Rural GPs sort out so many different types of problems – stitching up wounds, catching babies, fixing broken arms, cutting out skin cancers. Outside of rural general practice, there are few other jobs where you have the privilege of serving several generations of the same family simultaneously.
One day I was an obstetrician, delivering a patient’s baby. The next day I was a paediatrician, treating her sick toddler. The next I was a general physician, looking after her elderly mother in hospital. I initially worked in Port Lincoln as a student, and when I came back as a registrar I was reunited with one of the babies I delivered five years earlier. He was all grown up and I had the privilege of continuing to look after him.
A sense of community It’s also been great to support the local community as club doctor to the Port Lincoln Boxing Club, where I also train. My coach, Pete Williams, is like a father to me. He proudly travelled 700km from Port Lincoln to Adelaide to watch me graduate some years ago. Many of the boys and girls at the club are from broken homes and don’t have the money for club fees, but he takes them all in and treats them like his own kids.
What’s next? I will always do clinical work as a GP. I want to continue working in the country (at least fly-in fly-out) as there is still such a great need for healthcare out here. I dream of setting up more mental health programmes for teenagers and young adults in rural areas. I am also going to keep teaching with the university. I am keen to coordinate 38
programs for students in rural areas. In the near future I will undertake a Masters in Medical Education. Of course, I aim to keep boxing and to continue playing guitar and DJing. My band recently made our first music video, which was released on Triple J Unearthed, and I want to be playing big-name festivals next. I want to write a song that makes it on the mainstream Australian charts.
I also want to travel the world, experiencing the music of different cultures in order to inspire my own song writing. If you would like to contact David Lam about anything in this article, you can do so via GPRA by calling 1300 131 198 or emailing firstname.lastname@example.org. You can also find out more about his music at lambrosmusic.com.
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Overcoming the challenges in medicine Advice from Dr David Lam
Take overseas holidays Heed that old doctor saying: “if you are going to p*#$ off, then really just p*#$ off so that people can’t contact you!”
Don’t let go of the other aspects of your life Embrace the overlap in skills – it may just be that those skills you have in areas like sport, art, music or parenting are the same skills that make you a uniquely good GP.
Look after yourself, first and foremost! I was no good to anyone on the days I was too tired and angry to make good decisions. Get your own GP. In South Australia, Doctors Health SA provides after hours and weekend services to doctors and medical students. If you don’t have a regular doctor yet, get in contact with them or the equivalent organisation in your state. It made all the difference for me. Sometimes I was just too unwell – physically or emotionally – to work, and I needed someone objective to help me get better.
Know when to say “no”
Doctors are good at prioritising a lot of tasks. But sometimes there is just too much to do, no matter how skilled you are at prioritising. In my case, I had to be strict and tell myself “no flying to Adelaide to DJ” in the three months before the fellowship exams.
As much as possible, explain everything that you are thinking and doing to allied health staff, nurses, patients and their families. This is crucial to good general practice.
Exercise It sounds obvious, but physical activity is good for both the body and the soul. There were days when I was exhausted but just thirty minutes of exercise and social interaction at the boxing club would revitalise me — physically and emotionally.
Get your own psychologist Plenty of doctors, with or without mental health conditions, seek help from psychologists when in crisis. It took me a couple of tries with different clinicians before I found someone I gelled with, but it made all the difference. Tell your friends, your partner, or your parents what is going on with you – the good and the bad. Looking back, I was at my worst when I felt alone, and at my best when I shared with others and rationalised the struggles I faced.
Take your time with your career There is no shame in this. I was burnt out immediately after medical school and took six months off before starting a hospital internship. During this time I continued to teach and play guitar, which was exactly what I needed.
LEFT TO RIGHT: Terence, Anita, Megan, Vinay, Susanne Keshini, and Natasha (Elizabeth unavailable for photo).
National executive, national network GPSN is a national network for medical students, run by medical students. The National Executive team is an elected body made up of GPSN members from all over Australia. They provide leadership direction to GPSN. They meet at least twice yearly to discuss and plan GPSN activities and strategy, and to share ideas for the future. Appointments to the National Executive are year long terms. All GPSN members can apply for a position; elections are held towards the end of each year. Together with the GPSN University Chairs, the National Executive Team also forms the GPSN National Council.
Meet the 2018 National Chair, Megan Bleeze
GPSN National Executive Team 2018 National Chair, Megan Bleeze email@example.com National Vice Chair, Vinay Murthy firstname.lastname@example.org National Secretary, Terence Luo email@example.com National Working Group Officer, Keshini Visvanathan firstname.lastname@example.org National Events and Projects Officer, Anita Pratt email@example.com Local Events Officer, Susanne Kitching firstname.lastname@example.org National Sponsorship Officer, Elizabeth Wong email@example.com Promotions and Publications Officer, Natasha Hardikar firstname.lastname@example.org
Megan is in her final year of medical school at the University of Notre Dame. She has been involved in GPSN since her first year at medical school, and loves working alongside like-minded and inspiring individuals who are passionate about general practice and primary care. She is increasingly motivated by the possibilities that a career in general practice offers, including the diversity, connection with community and continuity of care. She has always been impressed by the high-quality events that GPSN university clubs host and canâ€™t wait to see what innovative, stimulating, and fun events are in store for 2018. 41
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Published on Feb 5, 2018