An inspiration to other new Fellows interested in setting up their own practice
In the heart of Brisbane, the Skyarch Medical Clinic stands as a testament to the vision and dedication of Dr Tatsuo Nagashima, an International Medical Graduate (IMG) from Japan whose journey embodies the essence of determination and empathy.
Tatsuo graduated from Jikei University in Japan in 2000 and became a paediatric specialist, later specialising in neonatology.
Tatsuo has had over 14 years of medical experience in Australia since emigrating in 2009 and starting his career here as a neonatal registrar at Mater Mothers’ Hospital in Brisbane.
He then completed the Australian Medical Council exams and a hospital rotation at Redlands Hospital, before deciding to pursue his career in general practice.
A Fellow of Royal Australian College of General Practitioners (RACGP), Tatsuo experienced several GP jobs in multiple rural towns in Queensland before eventually being inspired to set up his own practice in Brisbane CBD.
However, with a diverse range of experiences shaping his career, Tatsuo’s tale is more than just a simple biography – his remarkable story features formidable challenges and heartfelt triumphs.
For Tatsuo, it was an emotional life-and-death experience during the premature birth of his son which first inspired him to become a paediatrician, and ultimately a GP.
“My son was born in 1999 when I was in the last year of medical school in Japan, and he was an extremely low birth weight baby,” said Tatsuo.
“Due to this extreme prematurity, he was on the verge of life viability. At that time, no one could foresee what would happen to this baby, and I was deeply shocked and scared.
“As his father, an unprecedented heavy burden suddenly came down on both of my shoulders.
“Shortly after my son’s birth, I was called to come and see him in the Neonatal Intensive Care Unit, and I trod down to see my son for the first time.
“When I first saw him, my thoughts were completely changed. What I saw was the most unforgettable image in my life. This small tiny baby with lots of tubes was fighting for his life.
“He looked weak, but was grimacing his face and it looked like he was determined to live no matter what. This changed me. He was brave and this braveness was transmitted to me.
“I was given a life lesson from my own son who had only just arrived into this world a couple of hours previously.
“He told me you’ve got to be brave in this world. The thoughts of shock and scare went instantly. After a long hospital admission, he was discharged without major complications.
“This experience no doubt decided my career trajectory. I was determined to be a paediatrician and I subsequently became a paediatric specialist in Japan.”
Tatsuo’s commitment to patient-centric care is a testament to his unwavering dedication to the medical profession.
As the Chair of the RACGP Queensland New Fellow Committee and a GPs in Training (GPiT) Fellowship Support Program (FSP) representative, he wears multiple hats, each resonating with a deep sense of responsibility and empathy.
Navigating the intricate pathways of the medical landscape as an IMG has posed formidable challenges for Tatsuo. “The journey was fraught with uncertainties and obstacles,” he recalls.
Striving to establish himself in the realm of general practice, he embarked on a rigorous journey of skill acquisition and perseverance, charting his course through rural Queensland, accumulating invaluable experience one patient at a time.
The arduous years spent driving the vast expanses of the Queensland landscape, and the challenges of the independent pathway, forged within him an unwavering determination to serve his community.
“When I started GP training, I chose the independent pathway because I didn’t want my work placements to be selected by someone else and I wanted to search for workplaces which were commutable from my Brisbane home,” he said.
This is where the challenges of becoming a GP really started for Tatsuo.
“For an IMG like me to start a day time GP job, my journey was with the Rural Locum Relief Program (RLRP) through Health Workforce Queensland and it required at least two years of prior GP experience,” he said.
“As I was a paediatrician back in Japan and Japan is a unique country where there is no GP system in its medical industry, my prior GP experience was basically zero.”
Before the system was later revoked, Tatsuo’s only way at the time to be able to start a daytime GP job was to show two years’ experience of a nighttime home visiting job under the Approved Medical Deputising Service (AMDS), which was acceptable to be counted as GP experience.
However, the time spent by the AMDS job was counted as just half of its time, meaning Tatsuo needed to do four years of a nighttime home visiting job to get recognised as two years of GP experience by RACGP.
“It was tough and a dark time,” he said. “After that, finally my experience was recognised as two years of GP experience and I was able to enrol into the Rural Locum Relief Program (RLRP) and start a daytime GP job.”
Under the RLRP, Tatsuo was required to work in rural areas, including working at multiple Queensland rural towns such as Mount Tamborine, Bundaberg, Gympie, Warwick and Toowoomba to accumulate the remaining two years required to sit his Fellowship exams.
“It took nearly seven years for me to get the eligibility to sit my Fellowship exams,” he said.
“During that seven years, I drove nearly 30,000km in Queensland, which is equivalent to about seven laps of the earth’s equator.
“It was literally a long way to becoming a Fellow – not only the long driving length, but also experiencing a lot of problems which are fairly common to independent pathway trainees.”
Establishing his own practice in May this year was a testament to Tatsuo’s commitment to autonomy and encouragement.
“When I changed my career from a paediatrician to a GP, the biggest reason for that was I thought the GP field would be more feasible to establish my own practice,” he said.
“There are lots of adversities to setting up your own practice.
“However, if you have the mindset to recognise adversities more positively and if your prioritised factors outweigh those adversities, that is enough to set up your own practice.
“Owning my practice has allowed me to connect with my patients in a more profound way.
“I feel great privilege because GPs look after universal issues such as mental health, HIV medicine, and women’s and LGBTQIA+ health.
“These areas fire my heart. I can be a part of those people’s lives and can be an advocate in those fields.”
A strong believer in the significance of character traits, Tatsuo emphasises the necessity of respect in the realm of healthcare.
“Respect forms the cornerstone of effective patient-doctor relationships,” he affirms, underscoring the importance of empathy and understanding in the provision of quality care.
Looking into the future, Tatsuo envisions a path paved by dedication and commitment, highlighting the significance of the accumulation of daily efforts.
“Each act of care serves as a stepping stone toward unexplored territories and unforeseen discoveries,” he said.
Despite the challenges faced, Tatsuo looks on his journey to becoming a GP in a positive manner.
“During the seven rounds of the earth’s equator distance driving during my training in Queensland, a great thing happened to me,” he said.
“There were long times to think about life and meditate. During that meditation, I thought I needed to express something core in my heart.
“And I found the best way to express the core beautiful things in my heart was through music. Subsequently, my desire to explore music and create songs grew bigger and bigger.
“I started humming and creating my own songs, and I practised guitar and started busking.
“It is difficult to describe what are the core beautiful things in my heart. However, it is definitely based on something which can fire my heart.
“That could be my son’s story, playing music or an everyday story with a patient, something heartfelt.
“Therefore, I am hoping to be able to search for the way to connect those heartfelt stories, through my family, music and my job as a GP practice owner.”
On a final note, Tatsuo shares a profound sentiment, emphasising the significance of love and respect for the country he now calls home.
“I would like to say one thing to my fellow GPs,” he said.
“I feel very lucky that I have now come to love this country, and the more you love this country, the more positive things come true in front of you. This love is no doubt my driving engine.
“We should not forget that we are so blessed to be living in this beautiful country, and we can overcome adversities with this respect. Therefore, the following notion for me is not just prefixed sentences, but a true feeling.
“We acknowledge the land we are now standing and gathering. We pay our respect to the Elders, past, present and future.”
Tatsuo’s profound reverence for the land and its people serves as the driving force behind his commitment to overcoming adversity with grace and gratitude.
For Tatsuo, the sky’s the limit for him and his Skyarch Medical Clinic.
