‘The Perfect Mix’: Junior doctor's pathway to obstetrics training in the Outback

For Dr Sally Magoffin, a rural training pathway is more than a fantastic training opportunity, it’s a way of life. Growing up on a cattle station in Longreach, Dr Magoffin loved the community and lifestyle of the outback. While she got a taste of city life at boarding school in Brisbane, she knew it wasn’t for her. So she headed back up north to study medicine at James Cook University, which set her on the path to discovering her calling in medicine.

During a first-year observation placement, Dr Magoffin unexpectedly found herself on an obstetrics rotation and set her sights on the specialisation immediately. After graduating in 2020, she moved to the North-west town of Mount Isa to commence work and pursue obstetric training opportunities in the bush

“Obstetrics is such a beautiful and important specialty. It's the job for me that makes me want to bounce out of bed in the morning. It can be very tiring, but you go home with a smile on your face pretty much every day,” Dr Magoffin says.

The decision to work in a rural hospital setting is paying off for Dr Magoffin. With exposure to a variety of specialties and cases, supportive supervisors, and hands-on experience, she is a big advocate for pursuing training opportunities in North Queensland.

“There's been so much development in the north over the years and there are some incredible doctors who have helped take us a long way towards boosting our workforce and expanding the training opportunities on offer. We’re growing, and it’s an exciting time to be out here.

“You'll have the most wonderful time as a doctor in Mount Isa. We have a tight-knit community with the most supportive environment and wonderful training You just don’t get the same hands-on training opportunities as a junior in the bigger centres,” Dr Magoffin said.

About the specialty

“For me, obstetrics is the perfect mix of surgical and medical skills. It's a really interesting area, you get to care for two people at the same time; mum and baby. And it's just incredibly interesting. When things are going along nicely, it's a beautiful, part of a patient’s life to be involved in, bringing a baby into the world. When things aren’t going to plan, it’s an interesting, fast-paced specialty where you need to think and act very quickly.”

The Need for the Community

“There's a huge need for good antenatal care and options to delivery your baby locally in the outback. We have such a diverse population, and we have women coming from remote areas who might not have had the opportunity to receive antenatal care yet. The need for obstetric and midwifery-based care in this region is huge, and there's a fantastic opportunity that comes with that. As a doctor, you get to make a really big impact on the region and people's lives.

“Having these specialists in Mount Isa makes a huge difference from a travel perspective as well. Without the services here, you would have to travel a long way for something like a cesarean section. That can be expensive and stressful. So with obstetric specialists here, patients get to stay at home, be with their family and enjoy this time.”

My journey into obstetrics…

“When I was a first-year medical student at JCU, we had to do a short observation placement at the end of the year. I had one week with an orthopaedic surgeon and one week with an obstetrician. At the time, I was annoyed that I couldn't get two weeks with the orthopaedic surgeon because I thought that was the path I would go down as a doctor. I thought ‘I’ll go to obstetrics because I have to, but it’s not going to be for me’. I went and I loved it! Because I got a taste of it so early on, I’ve been deliberately working towards this pathway as a rural generalist ever since.

“I’ve now been at Mount Isa Hospital for one year and I can’t see myself leaving anytime soon. This year, I will rotate through the hospital specialties again, with a focus on obstetrics and gynaecology. Then I’ll spend next year doing Advanced Skills Training in obstetrics.”

Training opportunities in a rural setting

“I think it's incredibly beneficial to go somewhere rural in your junior doctor years. There is no limit placed on you by going to a more regional or rural site to do your training. You get great exposure to a variety of specialties and cases, you get a lot more hands-on experience, and you get more time with patients. You're not just someone in the background, frantically writing notes on the computer, you're actually interacting with the patients. In terms of meeting certain requirements for specialties and progressing through training, the experience you’ve gained as a junior at a rural site will be so invaluable.

“The senior team across all specialties here are incredibly supportive. They focus on getting the junior doctors heavily involved and encouraging them on whichever pathway they want to go. Just the other day I got to have a go at my first ever cesarean section, which two weeks into my second year is pretty unheard of! It was made possible because I’ve got a supervisor who sought out that opportunity for me and was happy to facilitate it.”

Work-life balance

“It's a lovely hospital community here. I’ve never felt this level of workforce morale anywhere else. You will be so included and welcomed into the Mount Isa community. You get to know your colleagues and the broader community from sporting or special interest groups, neighbours, and people you just meet about town. It’s such a friendly place to be that you could go to the pub by yourself on a Friday night if you were new to town, and you would have a group of friends by the end of the night! You literally can do that in this town. It's so friendly, inclusive and supportive, it's just a lovely place to be.”

The North West Hospital and Health Service (NWHHS) consists of one regional hospital, two multipurpose health services, three remote hospitals, four primary health clinics and five community health centres. Covering an area from North Western Queensland to the Gulf of Carpentaria, the service includes the communities of Mount Isa, Burketown, Camooweal, Cloncurry, Dajarra, Doomadgee, Julia Creek, Karumba, Normanton and Mornington Island. NWHHS serves a population of approximately 32,000 people across s 300,000 square kilometres.