The sky is the limit
In his second year of medical school, Dr Dan Wilde fell in love with the idea of being a GP in a small town.
“But I was an undergraduate entry into medicine—17 years old when I entered,” says Dan.
“I mentally fast-forwarded the clock and I thought to myself, ‘I don’t know if I necessarily want to finish my general practice training at 24 years old, and then find a medical practice where I’ll be for the next 50 years’. I thought, ‘I need to do something else beforehand’.”
In his third year of medical school, Dan found out about the Australian Defence Force (ADF) Defence University Sponsorship (DUS) program.
The DUS program allows individuals to have their fees paid while studying for a relevant degree at their choice of accredited university. While studying, individuals receive a salary and commence in an ADF position upon graduation.
In return, upon graduation, students are expected to commit to full-time ADF service for the number of years of university sponsorship plus one year (a minimum of three years of service). This is called a return of service.
Time spent during internship and residency are time-neutral—they do not count towards return of service, nor do they add to it.
Dan was placed in Cairns Hospital for his internship and residency year—a place where he found a great learning environment and a good culture for junior doctors.
“There can be a cut-throat environment in hospitals as junior doctors compete to get on specialty training programs.”
“Knowing that I was going to do general practice in defence meant that I wasn’t concerned about getting a job after my residency because the ADF have guaranteed positions.”
Choosing between the Army, Navy or Air Force was an easy decision for Dan.
“My grandad was in the Royal Australian Air Force (RAAF). The other factor influencing my decision was the medicine I was most interested in was aviation medicine and medical evacuation medicine.”
Dan chose to complete his Fellowship with the Royal Australian College of General Practitioners (RACGP).
Experiencing rural medicine
Dan also participated in the Longlook program, a longitudinal integrated rural clinical placement program for medical students, where he was placed in Goondiwindi, Queensland.
“My supervisors were Dr Sue Masel and Dr Matt Masel. They really inspired me to eventually become a rural or regional GP,” Dan says.
“I was able to watch the quality of care that they provided to the people in their community, and then reciprocally seeing the response of the people that they were looking after, and seeing how much they appreciated what they did for the community.”
“It wasn’t just about the medicine, when I went back to do the Hell of the West triathlon, Dr Sue was on the sideline handing out oranges and blocks of ice to people. The nurses that I worked with at the hospital were at the end of the race giving towels and water to people.”
Training in the Northern Territory
Dan has completed a portion of his GP training on the RAAF Base Darwin. On base, his patients are mostly of the same demographic—which means exposure to a lot of mental health, spatial medicine, administrative medicine, and preventative medicine.
To ensure well-rounded GP training and exposure, Dan also works as a GP registrar at a civilian medical centre in Darwin for two days a week.
This includes gaining experience in areas such as Indigenous health, paediatrics, geriatrics, chronic disease management.
“Having two GP supervisors is advantageous because I see how different Fellows practice and then I get to take the best bits and try to make that my own practice.”
With breathtaking national parks as little as 30 minute drive from Darwin, Dan trains in one of the most geographically beautiful and diverse locations in Australia.
As an avid runner, he makes good use of the surrounding area by being a member of not one, but two, triathlon clubs.
Darwin, and the RAAF base located there, provide key support to other countries in the Asia-pacific region.
“In our Indo-Pacific region we have a lot of responsibility in terms of providing a healthcare response. It’s pretty different to what you do day to day in general practice.”
The ADF difference
According to Dan, one of the biggest benefits of GP training with the ADF is the access to extra courses.
Dan completed the compulsory Initial Officer Course— which teaches skills in leadership, communication, as well as essential military skills.
“The leadership training was invaluable. It teaches you how to lead and manage groups, how to communicate with people, how to give feedback, how to cooperate effectively in a team, teaches organisation and planning skills,” Dan says.
“These are soft skills in terms of them being difficult to quantify, but they’re definitely things that have helped me be a better GP registrar.”
Dan also completed a course in aviation medicine, where he became a Designated Aviation Medical Examiner (DAME)—which comes with an equivalent civilian qualification.
“Most things are possible in the ADF if you can justify to your chain of command why support for you to do an extra course or training would benefit or improve the capability of the ADF.”
In the Air Force, a manageable injury such as a broken finger could potentially have a huge effect on a person’s unit, on their role, and on their career progression or their ability to be employed.
Dan has learned how to handle these difficult conversations.
“These are people that I have lunch with every day and then after lunch I have to see them for an appointment, and so I have to tell them that because they’re not compliant with their treatment I have to downgrade them medically, which means that they can’t do this course, or they can’t get this promotion.”
“In the ADF you’re not just doing medicine, you have a role as a leader and as a people manager. Even though you’re a doctor, you’ll be expected as you progress in your career to have people that you look after under you…it is not something you necessarily do in normal general practice.”
“There is an amazing variety in the things you’ll be asked to do. You could get asked to be a part of Operation Bushfire Assist, or you could get sent over to do humanitarian assistance and disaster relief in the Pacific Islands.”
“Mateship is one of the things I like most about being in the ADF…the operations that you go through with people are quite intense and usually fairly emotional, and so, the kinds of friendships that you make are really deep.”
As an AVMO in the Air Force, Dan is employed to look after anyone who is considered air crew—including
the Air Force’s pilots, air traffic controllers, and combat officers.
In a high-performance, safety-critical environment, there are strict guidelines—particularly regarding health conditions—on allowing or disallowing pilots or aircrew to perform their role.
The most common emergencies in Dan’s experience include hypoxia, physiological episodes, smoke and fume inhalation, and the effects of G-force. In the event of an aircraft crash, an AVMO learns their role in managing the scene—training which Dan used when attending to a civilian mayday.
“A light private plane couldn’t get their wheels down so they had to do an emergency landing. We were the first response to when they landed on the ground,” Dan says.
“Thankfully, as far as crash landings go, it was relatively smooth. No one was seriously injured, but we looked after the pilot and the passengers after they landed.”
Operation Bushfire Assist
In the middle of sitting the online Key Feature Problem (KFP) practice exam, Dan got a call from his operation cell.
He was told to pack his bag—his medical team had been activated and he was needed down in Melbourne in two hours to assist with the bushfire operations.
“My first thought was, ‘Damn, I can only do this practice exam once’,” Dan jokes.
“I got a call back an hour later and [the operation cell] said, ‘Stand down. It’s okay. We can delay you 24 hours.’ I was very grateful because I already had a full day of patients in my civilian practice the next day.”
Dan flew to Melbourne and then immediately made his way to the RAAF Base East Sale where the team were to make their way to Mallacoota.
However, complications struck—all roads to Mallacoota were still completely cut off by the fires.
The medical team had to repack their supplies to fit in an PMV-A (Protected Mobility Vehicle, Ambulance variant), one of the few vehicles which could safely access the area.
Dan was prepared for injuries such as minor burns and smoke-related injuries such as asthma, smoke inhalation and irritation—and a lot of mental health care.
When Dan’s convoy arrived in Mallacoota, their small team, which consisted of an environmental health officer, two doctors, a nurse, and two medical assistants, set up in the local high school.
Their role was to support the emergency response, provide medical assistance to the civilian population in Mallacoota, as well as the ADF personnel.
“Because Mallacoota was cut off from the local hospital, we provided a monitoring facility for patients that were treated by Ambulance Victoria. We were also there to respond to serious medical conditions where extra support was needed.”
An integral part of Dan’s role was to travel out in convoys on closed roads to visit isolated people and do health checks, and if needed, provide basic medical care and assessment.
“Everyone was very appreciative of the efforts made by the ADF, specifically of our primary healthcare team who got to go out and to let these isolated people know that someone is concerned about their welfare.”
“Operation Bushfire Assist was one of the most rewarding things I’ve done so far in my ADF career.”
“We felt like we really became part of the community. We got involved in the events that they hosted to try to maintain the spirit of the community. They would have a barbecue on the weekends. We played a sports game against the local kids.”
“Operation Bushfire Assist was one of the most rewarding things I’ve done so far in my ADF career.”
Soon after this interview, Dan was scheduled to be deployed to the Middle East as part of Operation ACCORDION.
The mission’s aim is to support the sustainment of ADF operations, enable contingency planning, and enhance regional relationships in the Middle East.
“Being a part of Operation ACCORDION is probably the pinnacle of my return of service to the ADF. It also counts towards my general practice training. This is not necessarily something that other GP trainees would be doing,” Dan says.
After the completion of Dan’s return of service, the sky is the limit.
“You don’t need to be in the Defence Force for your entire life. It is a really good thing to do for a couple of years if you want something completely different. The time you spend in the ADF will be invaluable to your future experience, whatever you decide, both personally and professionally.”