Stories and Media
Stories and Media
Featured Stories
21 June 2022
Tropics has it all for infectious diseases specialist
Infectious diseases consultant and microbiologist Dr Carly Hughes has seen her specialties come to the fore during the COVID-19 pandemic. “People have realized what infectious disease (ID) physicians are and what they do,” the Townsville University Hospital (TUH) specialist says. “People are considering ID as a career, and it's a really rewarding one. It brings a lot of aspects of medicine together.” Innisfail-born Dr Hughes graduated from James Cook University in 2007 and did her junior doctor and basic physician training in Townsville. She finished her five-year dual training program in ID and microbiology in Newcastle and Melbourne before returning to Townsville early in 2022 as a specialist. COVID’s beginnings Working as an ID consultant in Melbourne for the first two years of the pandemic, Dr Hughes was at the coalface when a returned traveller from Wuhan became Australia’s first confirmed case of COVID in late January 2020. “We had the first ever COVID patient in Australia in my hospital in Melbourne,” she says. “Initially in 2020, when we had COVID wards full in Melbourne, we had nothing to offer patients. It was quite a shift for us. There were no treatments, and a lot of people were dying despite our best conservative measures. We weren't used to that. “Now there are a few treatments that are effective, and the vaccines that have been developed demonstrate scientific research to practice. It just shows what the scientific community of the world can do when they have the right funding and the impetus to create new things. “We're seeing fewer hospitalisations, but the patients we have here are still quite complex. TUH have done a great job in their COVID planning and the infectious disease unit is really well run. General medical and specialty colleagues are admitting their own patients with COVID as well, so there's both an inpatient role and an advisory role.” The specialties Dr Hughes is employed full-time as an ID consultant at TUH: “We manage inpatients with complex or difficult-to-manage infections, a proportion of COVID work, and consult on other specialties to provide assistance in managing infections. “The second side of my training is microbiology, which is the lab aspect of diagnosing infections. Microbiologists work in the microbiology laboratory alongside scientists. This is where they culture, for example, samples for bacteria, as well as the molecular diagnostics for pathogens, and serologic testing looking for antigens or antibody production in response to infections. “Microbiology is a laboratory-based specialty. They assist with diagnostic and management advice, as well as antimicrobial stewardship, infection control and intensive care rounds. Without it, the hospital would stop. Every diagnosis that doctors make usually has some pathology results behind it.” The Royal Australasian College of Physicians (RACP) and The Royal College of Pathologists of Australasia (RCPA) work in tandem to deliver an education program that is split into three years of training in microbiology and two years of ID. Infectious diseases in the Tropics “I call ID a thinking specialty,” Dr Hughes says. “You have time to sit down and think about your patients and think about what could be going on and what tests would be best to diagnose that infection and then you know how best to treat them. Dr Robert Norton was one of my supervisors as a medical student and junior doctor and working with him and his colleagues and training under excellent registrars drew me down that path a bit. But I also really liked that it's one of the few specialties where you can cure people most of the time, there's usually a treatment and they usually get better.” “I came from Melbourne in a very large metropolitan centre with a very busy caseload. When I looked at the consult list on my first day back here, there was such a spectrum of infections, some things I hadn't managed a lot of ever, really, and there were multiple cases ranging from tropical infections to very unusual presentations of infections to heaps of common ID things. “The caseload here is fascinating. I think it’s a real drawcard for infectious diseases physicians to work somewhere like this. There are lots of different things going on, lots of really good intellectual things to get your teeth into, but also a large spectrum of work." “Particularly if you want to work in the north, infectious diseases is really rewarding. It's a very interesting and varied specialty. You don't see infection presenting the same way twice and there's a potential for curing patients. There's a real need for further research and advancement of our specialty. “Every specialty has their own infections, but we get the complex and difficult diagnostic ones and it can be really rewarding when you get that right and you can offer some treatment and the patient gets better.” Training pathways “You can do pure infectious diseases, which is a three-year training program through the college of physicians (RACP) after you’ve completed basic physician training. You can do dual training, which is the two specialties, infectious diseases and microbiology, in five years. You can combine infectious diseases with other physician specialties, so commonly people will do infectious diseases plus general medicine, which is a nice combo. You can do pure microbiology which is a five-year training program through the college of pathology (RCPA) so you don't have to do physician training first.” Work and play Dr Hughes is one of a number of early JCU medicine graduates who have returned to North Queensland as consultants recently. “My colleagues from JCU who are back here are the people I reached out to, to get the lay of the land of the hospital. They all encouraged me to come back and said Townsville was a great place to work, and perhaps even more importantly than that, a great place to raise a family.” “It has a small-town hospital feel with every specialty represented. Training in big cities, you might not get your specialty of choice, and you might not meet half of the consultants in the team. For example, in Melbourne, there were between 20 and 30 ID physicians at my hospital, whereas here there are currently five. Here, the students are integrated into the team. The clinical experience here is superior to down south, especially for exposure to specialties they may not have considered because they get access to every specialty here. “It was difficult in Melbourne in lockdown with a young family. We really missed family contact, socialising, friends and the North Queensland way of life. When this job came up, it was a good opportunity and time to move home. Coming back here we've just noticed such a lifestyle change. We're out doing something every weekend and everyone's so welcoming and sociable. It's just a really nice place to live and work, and that's so important.” ‘Everything's available here’ Dr Hughes did placements in Mount Isa, Charters Towers and Townsville during her JCU studies. “Having a wide exposure to a number of different specialties here really helped consolidate my career path,” she says. “I had significant career uncertainty even though I knew I wanted to be a physician, I didn't know what type of physician. I did renal, neurology and ID here and enjoyed them, which made it a bit more difficult to come to a career decision. “There were fewer of us then, but Townsville is unique in that as a medical student, you get one-on-one teaching and tuition, and you get to develop mentor relationships with clinicians you admire. You have the opportunity to go and then train in any of the specialties. Everything's available here. “Part of the reason I came home was that a lot of my colleagues from university are back here. I loved training here and I love the medical school. It has a good reputation, and I think the JCU students are recognised to be very competent doctors.”
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19 May 2022
Cardiology Spotlight: Far north local’s heart for rural health
Cardiologist and JCU alumnus Dr Anthony Brazzale took an ‘all in’ approach to pursuing his career in medicine and it has certainly paid off. His journey into cardiology has taken him from Far North Queensland to major health services across the country and back again. As a Consultant Staff Specialist at Cairns and Hinterland Hospital and Health Service (CHHHS), he is part of one of the country’s leading cardiology units and is committed to helping address outback Queensland’s escalating heart disease epidemic. The grandson of Italian immigrants, Dr Brazzale grew up on the family tobacco farm (now mango farm) in Mutchilba, a small community an hour and a half drive north-west of Cairns. His first exposure to cardiology came at a young age from an unexpected role in supporting his grandfather through treatment for heart disease. “I was always very interested in biology and medicine, but the experience with my grandfather’s illness left an impression on me and was a driver for sure,” Dr Brazzale says. “They don't know the cause of his heart failure, but his heart was functioning at 10% of what is considered normal. Because my parents were working long hours on the farm and I could speak a little Italian, I would go into town to appointments with him and translate what the doctor told him,” Dr Brazzale says. Graduating at the top of his class from Mareeba State High School, Dr Brazzale decided to pursue his childhood dream and enroll in Medicine at James Cook University (JCU). “I didn't have a backup option because there wasn’t anything else I was that passionate about. It was either medicine or going back to the family farm. “Given my country upbringing and JCU’s focus on rural health, it was the perfect fit for me,” Dr Brazzale says. After graduating with First Class Honours and completing his internship in Cairns, Dr Brazzale made the move to Brisbane and subsequently the Sunshine Coast to pursue cardiology training. Once he had developed a solid foundation in clinical cardiology he headed further south for a year of sub-specialty training in Interventional Cardiology at Western Health in Melbourne. Keen to return to the Far North, Dr Brazzale moved back to Cairns in 2017, commencing at Cairns and Hinterland Hospital and Health Service (CHHHS) as a Consultant Staff Specialist in Interventional Cardiology. He also works in private practice offering a range of services in contemporary cardiac care.
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18 May 2022
A will to succeed: My path into medicine
A former elite judo athlete and nurse, Dr Celeste Barrington took an unconventional path into medicine. Dr Barrington, a Medical Education Registrar and Emergency Department Senior House Officer at Townsville University Hospital, shares her medicine story and her tips for students and junior doctors deciding on a specialty pathway: “Medicine was always my dream, but juggling rigorous training and a heavy international competition schedule representing Australia in judo meant my sporting aspirations took priority at the time and I didn’t finish high school. I studied nursing as a stepping stone to medicine in the hope it would one day make me a better doctor. In 2014, after four unsuccessful applications to study medicine domestically, I applied to Oceania University of Medicine and was accepted. I thought I was good at juggling until I hit med school. My MD degree took me four and a half years to complete. During this time, I had two babies, worked as a clinical nurse 0.6FTE in PICU/ICU and studied fulltime. As an international medical graduate, I had to pass the Australian Medical Council examinations prior to being able to apply for registration with the medical board. In 2020, after 21 years as a nurse, I realised my dream to be a doctor and started my internship at Townsville University Hospital. My life experiences, motherhood and the obstacles I have faced on my journey in medicine have influenced my trajectory and resulted in me having very different career goals now to what I did 10 years ago. I am no less motivated to have a successful career in medicine, but my perspective and priorities have definitely changed. I am currently the Medical Education Registrar and I work within the Medical Education and Workforce Service Team at Townsville Hospital and Health Service (THHS). My role is to provide support to our interns and Resident Medical Officers. I work collaboratively with the Mater Medical Education Unit, James Cook University Townsville Clinical School, Northern Queensland Regional Training Hubs and the Clinical Simulation Centre to facilitate workshops and educational opportunities for our junior doctors and support doctors in difficulty. My other key portfolio is oversight of our Prevocational Medical Accreditation Queensland (PMAQ) accreditation for our Intern Program. I completed most of my rotations locally in Townsville as a non-JCU elective student. I was very much supported by the Clinical Dean and JCU Clinical School staff. I spent most of my time attached to a JCU fifth-year group and was able to participate in tutorials and other educational opportunities, which enabled me to network and further build on my existing professional relationships across THHS.” Dr Barrington’s top tips for a student or junior doctor deciding on a specialty pathway: When deciding on a specialty, the key considerations will likely be slightly different for all of us, and I think it can change at different stages of our lives. It’s important to consider your interests and passions, personality type, values, family/work life balance goals, length of training pathway, availability of positions long term, and financial goals. Make sure you take the time to explore different rotations and options. You don’t have to decide your long-term career pathway while you are still a medical student. Consider your personality type. Are you naturally suited to your chosen career or are there things you need to work on to make you better suited? Do your research. Find out as much as you can about different pathways then compare them. It’s OK not to know or to change your mind. Don’t simply pursue a pathway because someone else says you would be good at it. Consider your own motivation, goals and values. NQRTH connects medical students, intern and junior doctors with a network of opportunities and resources designed to create a supportive and clear path to specialist (including general practice) training, and beyond, in our regions. Our network works together to strengthen medical specialist training with the view to build a health workforce prepared to meet the health needs of our regional and rural communities in Cairns, Central West, Mackay, North West, Torres and Cape, and Townsville. NQRTH is facilitated by James Cook University, who partner with hospital and health services and training providers to create a connected career pathway beginning at the medical undergraduate level right through to fellowship. EXPLORE SPECIALTIES IN NORTHERN QUEENSLAND
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17 May 2022
Why I decided to stay in North Queensland
For some doctors, it’s the breadth of interesting clinical medicine and close consultant contact that draws them to North Queensland for their medical training. For others, the clear winner is an easy tropical lifestyle that cuts out the tedious commute and means more time for family, recreation and community. Obstetrician and gynaecologist Dr Vanessa Lusink landed in Townsville from Sydney to train in advanced laparoscopic gynaecological surgery with leaders in the field and enjoyed it so much, she and her partner decided to stay. Similarly, British doctors Andrew Livingstone and Susannah Bond fell in love with Townsville after arriving as psychiatry registrars and have gone on to help shape their specialty in the region and take full advantage of coastal life with their young family. BreastScreen Mackay Director and Surgeon Dr Wendela Schimmer and Cairns Orthopaedic Surgeon Dr Andrew Graham found professional and personal reward in their adopted northern homes, on the doorstep of some of the Sunshine State’s most beautiful natural attractions. Here, they talk about why they decided to put down roots in North Queensland.
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10 May 2022
‘The Perfect Mix’: Junior doctors 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 orthopedic surgeon and one week with an obstetrician. At the time, I was annoyed that I couldn't get two weeks with the orthopedic 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.
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9 May 2022
North Queensland: A Paradise in Medical Research
With a whole new level of responsibility, and a lot still to learn, the working life of a junior doctor can be full-on. If you aren’t currently involved in research, the prospect of adding such an undertaking to an already busy schedule can be daunting. But it doesn’t have to be. As medical students and junior doctors alike are discovering for themselves, northern Queensland is a paradise in medical research. Complementing your hands-on training experiences, you can grow as a doctor by conducting research aimed at improving the health outcomes of our regional, rural, remote, and Aboriginal and Torres Strait Islander communities. Right across our region, there are opportunities to get involved in a diverse range of translational, high impact research initiatives with James Cook University (JCU), Hospital and Health Services, and institutes including AITHM and TAAHC. By helping improve lives through research in northern Queensland, you can also shape your training pathway and career in medicine. Here’s how: 1. Research in NQ offers opportunities to investigate unique health issues affecting the Tropics Northern Queensland is a region of varying landscapes and demographics, and with this comes a range of health issues affecting our communities. There are a number of diseases and other health issues that occur uniquely, are more widespread or prove more difficult to control in Tropical and subtropical regions like northern Queensland. Cardiologist Dr Anthony Brazzale and the Cairns & Hinterland Hospital & Health Service (CHHHS) Cardiac Unit are currently conducting research into the outcomes of Patent Foramen Ovale Closure (PFO) procedures on scuba divers with a hole in their hearts. Dr Brazzale says this type of project presents an excellent opportunity for junior doctors. “Here in Cairns, we’re probably doing the most PFO closures in the country. We have a unique area up here in the Tropics, and we have a lot of divers here, so it provides these unique opportunities. “Junior doctors are collecting data and we help them with the write-up. From medical students to advanced trainees, there are all levels of training involved in research with our unit. If you show the initiative and you’re motivated, as consultants we will always look to support you,” Dr Brazzale says. Making the process easier for clinicians to get involved in research is the Tropical Australian Academic Health Centre (TAAHC). The centre is a collaboration between northern Queensland’s five Hospital and Health Services, the Northern Queensland Primary Health Network (NQPHN), JCU and AITHM. Through an emphasis on translational research, the TAAHC partnership is designed to enhance collective capability in health service delivery, health and medical research and workforce development. The centre also offers funding schemes for clinicians and clinicians, from micro-funding to major Fellowship scheme. Find out more about how TAAHC is funding research in northern Queensland. 2. Research in NQ can help your medical specialty training application stand out The application process for medical specialty training can be extremely competitive. Some colleges accept just a handful of trainees each intake. Seeking out research opportunities as a medical student or junior doctor can help open the door to your dream medical specialty. Dr Kate Swift is a junior doctor at CHHHS who can attest to what research involvement can do for your training pathway prospects. With the support of senior clinicians and academics from JCU, she has been investigating the incidence rates of appendicitis in Far North Queensland. “JCU and Prof Alan de Costa have been very supportive these last two years. The research project has actually facilitated my entry into the training program. Dr Swift was the first author of the research publication published in the ANZ Journal of Surgery in December last year. She commenced general surgery specialty training at CHHHS in January 2022. Dr Brazzale echoes the sentiments of the benefit of research in your application process. “Research can help you in the application process because it demonstrates initiative. You don’t have to do an independent study that gets published in the Lancet, you just need to get involved. It could be an audit or poster presentation at a national meeting,” Dr Brazzale says. 3. Research in NQ can connect you with leading clinicians and researchers Right across northern Queensland, there are senior doctors and researchers with decades of experience who can guide junior doctors in their training and research endeavours. Townsville University Hospital junior doctor Tejas Singh has published more than 30 peer-reviewed research articles aimed at improving the management and outcomes for patients with vascular diseases. Dr Singh has conducted his award-winning PhD research under the mentorship of Professor Jonathan Golledge, an academic vascular surgeon and international leader in peripheral artery disease. Professor Golledge heads the Queensland Research Centre for Peripheral Vascular Disease (QRC-PVD), located at Townsville University Hospital (TUH) and JCU. “The support and research infrastructure available at QRC-PVD, JCU, have been instrumental in my PhD. “There’s ample opportunity to collaborate with other researchers nationally and internationally,” Dr Singh said of the Townsville-based PhD program. Dr Singh credits the Townsville University Hospital’s supportive environment and the breadth of clinical opportunities as two of the great advantages of training in Townsville. “As a junior doctor at Townsville University Hospital, you get more hands-on experience and opportunities to develop clinical independence in comparison to metropolitan hospitals,” he said. 4. Research in NQ is well supported Respected institutions like JCU and AITHM are dedicated to northern Queensland and provide opportunities for students and doctors who want to help make a difference in the health of our regions. Australian Institute of Tropical Health and Medicine (AITHM) is Australia’s only dedicated health and tropical medicine research institute. Based at JCU, AITHM focuses on diseases of high burden in the tropics, tropical health security and strengthening health systems. ATHM has research facilities in Cairns, Townsville, Thursday Island and Mackay. One way you can pursue research as a clinician is through the JCU AITHM Cohort Doctoral Studies Program. One of the first of its kind in Australia, the Cohort Program offered clinicians like Townsville-based medical oncologist Dr Sabe Sabesan the support, resources, and networking opportunities to conduct postgraduate research. “The launch of the Cohort Program was really good timing,” Dr Sabesan says. “It enabled us to examine our model of care while using research as a mechanism to develop the evidence base to demonstrate our impact.” “The Cohort Program gave us a methodology and a proven framework. The PhD process also strengthened different writing skills for me, which has led to writing policy for the state government. “From this project, you can see the legacy impact of clinician-led innovations on the broader health system and the broader communities.” Across the regions that NQRTH works in, there are a number of other leading research institutes: Mackay Institute of Research and Innovation(MIRI) facilitates research and drives innovation for the delivery of evidence and value-based, patient-centred care across Mackay Health and Hospital Service. MIRI supports clinical trials and is active in the new TeleTrial concept involving regional and rural hospitals and health services in northern Queensland. Murtupuni Centre for Rural & Remote Health(MCRRH) aims to build a healthy community and a skilled workforce in and for rural and remote Queensland through education and research. It is the foundation University Department of Rural Health in Queensland and spans more than half of Queensland, including the Central West. Townsville Institute of Health Research and Innovation(TIHRI), a purpose-built research facility at Townsville University Hospital, supports and translates research into innovative, high-quality patient care. Find Townsville HHS specialty research groups and contacts here. Discover more about what makes northern Queensland a paradise in medical research. On Thursday, May 12, NQRTH is hosting a webinar ‘Medical Research for doctors in training in NQ’ as part of our five-part 2023 Queensland Medical Recruitment Campaign webinar series. Find out more or register your attendance now.
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6 May 2022
How to pick your dream specialty
Choosing a medical specialty can seem daunting for doctors who haven’t settled on their path before or during medical school, or wish to make a career pathway transition. When weighing up clinical interests, preferences, experience on rotations, training time and financial demands, as well as lifestyle considerations, it’s a complex and life-altering decision. Medical career planning expert Dr Ashe Coxon recommends starting with the basics, first considering: “Am I aware of all of my options?” “Many people jump into a career without having a complete understanding of the other pathways available to them,” Dr Coxon says. “This is fine if you are certain it’s what you wish to do, but if you are uncertain, then I would recommend doing some research around all of the options you can pursue to help make your decision.” Dr Coxon, a Townsville-based general practitioner, became fascinated by career counselling during her postgraduate years and branched out not long after completing her RACGP Fellowship. After qualifying as a certified career development practitioner, she started a business helping doctors figure out their careers. She now works with medical students and doctors-in-training to assist them in their career goals, career uncertainty and career transitioning. With a Master’s in Clinical Education and a Graduate Certificate of Career Development, Dr Coxon runs Medical Career Planning as well as working as a clinical GP.
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27 April 2022
UK psychiatry couple find NQ paradise
Dr Andrew Livingstone and Dr Susannah Bond arrived as psychiatry registrars with their young family from the United Kingdom in 2017 for what was to be a 12-month Australian adventure. “A friend of ours did a year in Sydney and came back with glowing reviews of Australia. We were very excited by the prospect of doing the same,” says Dr Livingstone, a Townsville University Hospital psychiatry consultant. “It was meant to be a year out, but then we chose to stay because we very much enjoyed Townsville and the lifestyle.” Dr Livingstone is building psychiatry services for people with intellectual disability in the Townsville region, while Dr Bond is supporting junior doctors in the conjoint appointment of Deputy Director of Clinical Training (James Cook University/Townsville Hospital and Health Service). Intellectual disability psychiatry With his UK specialist training in intellectual disability psychiatry, Dr Livingstone has been embraced as a regional expert in the field in Australia. “Intellectual disability (ID) psychiatry is a specialism that's recognised in a lot of European countries,” he says. “However, there isn't so much a development of this specialty in Australia. There's an intellectual disability service in every region in the UK, and there isn't here. “In Townsville, we have a subspecialty clinic called the IDDC, which has grown enormously, supporting people with disabilities and autism. I’ve had the opportunity to train colleagues involved in the clinic and to present at the RANZCP Congress on this clinic and approaches to addressing this gap in service in Australia.” The clinic’s holistic care approach is geared towards enabling people with an intellectual disability to live a happy life. “Often people with autism or communication difficulties can present in a certain manner that might meet the criteria superficially for, say, a psychotic illness, but there may be something else going on from an organic perspective, like a physical health change or care setting change, which presents differently,” Dr Livingstone says. “There's a thing called diagnostic overshadowing, which is where a disability gets blamed for everything. So someone can have appendicitis, but when they present to ED they just appear behaviourally disturbed and no one presses their abdomen to find what is a relatively common and potentially fatal illness. That's where you need an expert who's got time to look at the bigger picture. You need a psychiatrist who understands psychiatry, but you also need a specialist who understands disabilities because the overlap is so high. “Sometimes it's about being a doctor, sometimes it’s about being a specialist psychiatrist, sometimes it's about being a social worker or an occupational therapist. The role of an ID psychiatrist is being a bit of all of those things wrapped into one. “It's a really interesting specialty. I think those who experience it properly would be very much attracted to the specialty even if they've never thought of it before. That's what happened to me. It's a different approach to medicine; it's a different approach even to psychiatry.” Nowhere we’d rather be Transferring their training from the UK to Australia was a costly and complicated process, but Dr Livingstone and Dr Bond see the sacrifices as worthwhile for their family’s long-term prospects and lifestyle. “Within a few months of moving to Townsville, I realised I didn’t want to leave,” Dr Bond says. “The lifestyle was unreal and I loved the beautiful scenery, the weather, the friendly people. I was anticipating a tough few months after moving to a new town, but the reality was we fitted in quickly and Townsville became our home. Five years later, we feel really established here – we’re part of the community.” Dr Livingstone says, “When we arrived, we got a flat on Castle Hill and were woken up by the sunrise over the Coral Sea. It was absolutely spectacular. The cost of living was completely within our budget, and the lifestyle was immediately apparent, that we would be able to live by the beach and take our children to play and build sandcastles, as well as being active with sport and exercise.” Dr Livingstone plays in three soccer teams and closely follows the fortunes of Manchester United on late-night telecasts. “I've got a good social life here through sport, which is an important part of Townsville. It's a big fitness town and it didn't take long at all for me to find like-minded people who love sports and exercise,” he says. “But if you wanted to, you could just be there with your family on your balcony and make a little paradise around you. In the UK, we simply could not afford a detached house, let alone what we're aiming for with views of the ocean and space for the kids to run around. I don't think there are many places in the UK where you could do that and have no traffic, and all of those things that are glorious about Townsville.” Developing the specialty The couple both lecture with JCU and love being at the forefront of developing the specialty of psychiatry at Townsville University Hospital. “Much as there's an adventure with us changing countries, setting down roots and trying to build something for our family, we're also trying to do the same for our specialty,” Dr Livingstone says. ID psychiatry is only part of Dr Livingstone’s role at Townsville Hospital and Health Service. “My consultant psychiatry job is one of the most special ones – I do weekly clinics in Ingham and on Palm Island. I fly into Palm Island every week on a tiny plane. It's a privilege and an honour to have that role. If you're accurate, sensitive and culturally safe, you can make a lot of change. That is definitely a reason for sticking to a place like Townsville.” Dr Bond says the role of Deputy Director of Clinical Training is an exciting opportunity to work alongside the medical education team, with a major role in support and advocacy for the most junior members of the medical workforce: “This could include anything from career progression through to wellbeing which I hope, with my background in psychiatry, I will be well placed to support.” Psychiatry training in NQ Dr Bond says, “The support and opportunities I have been given during training have been incredible. It has gone beyond the need to merely get through training – there’s a willingness to really get to know and understand our circumstances. Our colleagues have become, in many ways, a surrogate family. We look out for each other.” Dr Livingstone says, “There is a wide variety of specialists here and you will have expert guidance. There's expertise from all over the world, and that experience of different healthcare systems is invaluable. “The great thing about Townsville is that it is an urban hub. It has urban-centric issues that you'd see in inner cities, but then you also get the rural and remote care, where you have to think outside the box, and you see a lot more of Aboriginal and Torres Strait Islander cultures. “You’re a quick flight from Brisbane or you're a quick flight to the most remote and rural places. It's both rural and urban in equal measures, so for a psych experience it's fantastic. “The hospital has excellent telehealth services. You can do a video assessment for someone 1000 kilometres away. It's innovative, it's modern, it's evolving and, similar to my experience with ID psychiatry, you're at the forefront. You can make it what you want, and you can develop the service. “When you choose psychiatry, you're actually opening up more options because there are so many subspecialties you can choose from, and you can get that experience in Townsville. We have specialty clinics which allow that variety of training in areas such as eating disorders, neuro psychiatry and perinatal care. “It's very easy to talk to the neurologist and to link in with the other specialties because it's a city but with a small-town vibe. There are infinite options for lifestyle balance in psychiatry, which I don't think you get in any other specialty. Townsville, especially, is the perfect place for that balance of lifestyle.”
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NQRTH is an initiative of the Australian Government's Integrated Rural Training Pipeline (IRTP) and is facilitated by James Cook University in partnership with public and private hospitals, Queensland Aboriginal and Islander Health Council (QAIHC), health services, Aboriginal Community Controlled Health Organisations (ACCHOs) and GP clinics.
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