EXPERIENCES
Jen Lonergan gets the low-down from GP Registrars around Australia….
The suspects:
Tim, Nambucca Heads, NSW North Coast,(NCGPT)
Lori, Warrnambool, VIC, (GGT)
Belinda, Cairns, QLD, (TMT)
Jo, Echuca, Victoria, (Vic Felix)
Oscar, Nhulunbuy, NT, (NTGPE)
Ingrid, Berry, NSW South Coast (CCCT)
Sam, Melbourne, VIC (VMA)
Evan, Melbourne VIC (VMA)
Liz, Newcastle, NSW (Valley to Coast)
Anna, Canberra, ACT (CCCT)
Emma, Adelaide, SA (A2O)
What they said……
Why did you choose General Practice?
I like being a ‘Jack of all trades’, like procedures, want a flexible lifestyle with reasonable remuneration.
Tim.
I love hearing about people’s lives and the potential to help those lives become a little better.
Anna.
I wanted to work with people and experience all areas of medicine, but more importantly wanted flexibility.
Jo.
I was becoming burnt out with the pressures of the hospital system and craved a ‘mental’ not a ‘physical’ challenge
Belinda.
General Practice meets most of my criteria for being a doctor and providing good health care. Life circumstances did not agree with (other) specialist training (family, age, IMG status).
Ingrid.
Variety, flexibility, lifestyle.
Evan.
What kind of terms have you done?
I have worked in a major rural centre in Queensland for intern and residency and have also done a special skills term in O&G. I did my Basic term part time so I could spend some time with my young daughter.
Jo.
I have moved between Sydney and Newcastle then to Melbourne. I have done special skills placements in paeds, psych and O&G. I completed my Basic term part time in Melbourne and am currently working in a rural placement in Warburton – the variety of experience is great.
Sam
I completed an advanced rural skills post in anaesthetics before undertaking any of my GP terms, and this gave me a lot of the skills and confidence needed to do a variety of jobs in a remote setting for my GP terms, including anaesthetics and retrieval medicine.
Oscar
After an urban term I headed to the snowy mountains for my advanced term – becoming familiar with ski/ snowboard injuries. Then I returned to Canberra for part-time practice and part-time research/teaching.
Anna
I spent my intern and RMO years working in outer suburban hospitals in Adelaide – all these smaller places made for great GP preparation – I am now happily working part time in RRMA 4 rural Victoria for my Basic/Advanced terms.
Lori.
I did my internship and RMO 1 and 2 years in a major tertiary hospital in Sydney including terms of anaesthetics, geriatrics and completing the Diploma of Paediatrics. Then off to the NSW South Coast and rural pathway working full time in a small non-bulk-billing practice.
Ingrid.
What’s the best experience you’ve had?
A word at the right time to a young man, leading to a 20kg weight loss, 3 point drop in cholesterol, 15mmHg drop in BP and a total lifestyle change. The first time I almost certainly saved someone from an early death by MI.
Anna.
Being part of a team in a successful trauma resus; and experiencing the gratitude of the whole community.
Oscar.
While I was working in an inner city practice, a stripper on Workcover (who tripped after falling off her stilettos, causing a base of 5th Metatarsal fracture) showed me a pole dance during a consult.
Emma.
Resuscitating a near drowned 6 week old baby in my surgery and then going on to be her whole family’s doctor.
Belinda.
Driving home from a satisfying day of patients and stopping off at my surf beach for a swim, in pure, clear water, only my prints in the sand….
Lori
Having patients who are actually concerned about me and are thankful for my work. Not a familiar feeling from hospital jobs.
Tim.
What’s the worst experience you’ve had?
A long night in a rural hospital with suicidal patients.
Anna
The end of a long week – can be tiring. Sam
N/A. Evan
Covering ward nights! Liz
No major disasters –yet J Ingrid.
Being on 24/24 call 5/7 on a row and 9/14 days. Oscar
Having to manage a ‘near drowning’ resuscitation as an Advanced registrar while my supervisor was caught mid LSCS. Everyone survived but it was stressful. Emma.
Not had any bad ones to date, too early on. Tim.
And finally but most importantly, what would you say to anyone considering GP training?
I would highly recommend GP training for the following reasons: excellent quality of training, interesting, can specialise, sub-specialise, flexible, challenging. Liz
Go for it, get on the rural pathway, and get out of the smoke. Tim.
GP training can be just about any version of medicine you want it to be and has a greater chance of fulfilling those medical dreams than any other specialty. Lori.
Get the facts not the misconceptions. Evan Open the door to a huge range of opportunities. Tailor it to suit you! Anna
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TESTIMONIALS
As I walked through a metal detector and buzzed in through heavy doors it occurred to me that perhaps my general practice rotation was going to be a little unique! I was attached to a general practitioner with forensic qualifications who ran the medical clinics at both the Symonston and Belconnen Remand centres in Canberra.
It was with great trepidation that I attended my first session. As I sat waiting for the patients to be brought from their cells I had increasing anxiety as to how I would be received. Was my attire suitable? Certainly my standard greetings regarding whether they were missing work or school to be there today weren’t entirely appropriate.
My first session left me in complete awe of the heart of my supervisor. Without judgment and with empathy his consultations ran true to the Hippocratic Oath. Patients were often in acute withdrawal from a cocktail of recreational drugs. I learnt very quickly the necessity of a good social history, not to mention a firm introduction to psychology. I watched my supervisor counsel those in withdrawal, encouraging them and using motivational techniques to empower them to own their health. As the weeks progressed I began to relax. The detainees became my teachers in some respects, educating me on an experience of life I still struggle to understand.
In a prison system, unlike normal General Practice, you can’t easily refer a patient for further investigations and I was continually impressed by my supervisor’s diagnostic skills and management strategies.
One evening we were called to the facility to attend to a detainee who was suffering significant extra pyramidal side effects from his antipsychotic
medications. I witnessed my first episode of quite pronounced chorea. With dignity and care, the GP administered the medication to counteract that which was causing the symptoms and I watched in disbelief as the man immediately began to improve. In the clinics I was able to participate more than I suspect I would have in the normal General Practice setting. Patients weren’t pressed for time. There was no waiting room.
General Practice tested my ability to be tolerant and often it was easier if I didn’t know why the detainees were there. On one occasion it became clear that I was partaking in a consultation with a paedophile. A little unnerved by this, I later questioned how my GP felt during these types of consultations. He explained that his role was to ensure they had adequate health care and that their reasons for imprisonment were the law’s responsibility, not his to judge. Never once did I see him sway from this. It’s one of the most important lessons I’m still learning.
There was a huge leap for me into mental health. Often I was a little afraid, not with concern for my safety, rather a realisation that sometimes there wasn’t something physical that you could put a bandaid on.
My GP not only worked in the remand centres but was often on call for forensic matters. On one occasion we were called to assess an individual who had committed suicide. His role was to assess the body and ensure that the individual was indeed deceased. I’m not sure I can adequately describe this experience. Seeing the body, surrounded and clothed in personal items, being able to relate to their appearance, still warm with life.
As my supervisor filled out the paperwork I stood staring at the chest praying with all my might that it would begin to rise and fall. That day I developed a huge appreciation for the fragility of life and the importance of addressing mental health. What an honour it is to be doing medicine. What a responsibility.
Despite our busy schedule my GP still had time to teach me the extreme importance of leaving work behind; stopping for coffee, enjoying music concerts and taking the occasional bushwalk. I learnt a valuable lesson – that your own mental health affects the way you treat your patients.
I think that before I began my General Practice rotation I seriously underestimated the importance of this profession: the opportunities for health promotion, being the first port of call for an individual with an ailment, the variety of presentations. General Practice is one of the areas where you are truly required to be a ‘jack of all trades’. I believe its one
of the hardest branches of medicine to do well. I also believe it is a privilege.
This article has been written by:
Vanessa Tatham, 3rd year Medical Student, ANU
In 2005 I spent one year of my clinical medical education based in General Practice in the Victorian coastal town of Lakes Entrance. As the name implies, Lakes Entrance is in the Lakes district of East Gippsland, and is primarily a fishing, tourism, and retirement town. There I studied the specialties of General Practice, Psychiatry, Women’s Health and Children’s Health concurrently throughout the year.
Spending a year in general practice, and particularly rural general practice, made me seriously change my future aspirations with regards to specialisation. When I began medical school I usually answered the ‘what do you want to do’ question with ‘not general practice’. I am still unsure about what I want to do, but for now General Practice is topping the list for the following reasons……
The biggest draw card for me is the variety of medicine that is available within General Practice. As someone who bores rather easily when doing the same thing over and over again, having to think about every type of specialty every day kept me interested all year. In any given week I could deliver babies, administer general anaesthetics, remove lesions and foreign bodies, provide emergency care for heart attacks, lacerations and head injuries or attend an acute psychiatric presentation. There was never a shortage of excitement at our clinic.
Another major advantage of general practice is the hours. While I enjoy variety in the medicine that I am doing, I also enjoy variety in the wider aspects of my life. There is no such thing as a 7am ward round in a GP surgery! Regular hours that were not ridiculous left plenty of time for other interests (particularly the snow!).
Finally, and perhaps most importantly, was the people I worked with, both the staff and the patients. As a general rule the patients were always lovely, and as clichéd as this sounds, I felt like I made a real difference for some of them. It is a great feeling to watch a young person with depression improve dramatically over a period of six months, or the excitement on an elderly gentleman’s face when his HbA1c drops to an acceptable level. The staff were probably the favourite part of my year. The other doctors, nurses and administration staff were like another family. Everyone got along so well, and there was none of the ‘us and them’ attitudes that I
often encountered between doctors and nurses in hospitals.
There are obviously downsides to General Practice as well, but for me they are well and truly outweighed by the advantages. In my year in Lakes Entrance I learnt that General Practice is a demanding and interesting career, which is very much a specialty in its own right, and quite probably the most diverse of all the specialties. I would highly recommend at least considering General Practice as a future career path for anyone who enjoys variety, flexibility and spending a decent amount of time with family and friends.
Annaliese Van Diemen, 4th year Medical Student,
Monash University
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