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29 April 2025

A career built from the ground up: Dr Jason Yates Reflects on 25 Years of JCU Medicine

When Dr Jason Yates walked through the doors of James Cook University’s fledgling medical school more than two decades ago, he was part of a bold experiment — the first cohort of a new generation of doctors, trained in the North for the North.

14 April 2025

Yesterday, Today, and Tomorrow: Celebrating 25 Years of JCU Medicine

Northern Queensland Regional Training Hubs (NQRTH) is proud to sponsor a milestone symposium, bringing together delegates from across the region and beyond to reflect on the experiences and achievements of James Cook University’s Medical School since its inception.

8 April 2025

Dr Prue Wallin: A Passion for Rural Medicine

For Dr Prue Wallin, medicine has always been about connection—caring for patients holistically and understanding the broader community context.

1 April 2025

PEHA: leaders in patient-focused emergency care

We are thrilled to welcome Private Emergency Health Australia (PEHA) as the Gold Sponsor for the JCU Medicine 25 Year Anniversary Celebration this May!

28 March 2025

How JCU Medicine paved a rural and regional path for Dr Girgenti

Having grown up in Ingham with a passion for improving outcomes for rural and regional Queenslanders, JCU’s fledgling Medicine program was the perfect fit for Dr Kaylene Girgenti.

21 March 2025

From Aerospace Engineer to Regional Medicine

In fact, before she donned a stethoscope and stepped into the bustling Emergency Department (ED) at Cairns Hospital, Heather was part of a very different world — working as an aerospace engineer on military F/A-18F Super Hornet jets for Boeing Defence Australia.

20 January 2025

A Doctor’s Leap into Regional Medicine

Dr Rupert Dwyer’s journey is one of many examples of why junior doctors are choosing regional Queensland over metro hospitals.

10 January 2025

Bringing Compassion to Rural Care

Dr Georgia Edwards’ journey into medicine was sparked early by a fascination with the medical field.

28 November 2024

Mentorship and Medicine: Orthopaedic Surgeon empowering Townsville’s Healthcare Community through Education

Associate Professor Kaushik (Kosh) Hazratwala is a world-leading orthopaedic surgeon who has dedicated his career to advancing education and training in the medical field.

11 November 2024

Inspiring medical students and junior doctors to dive into research

Professor Andrew Mallett, a trailblazer in the field of kidney genetics, has been awarded the prestigious Researcher of the Year Award by the Townsville Hospital and Health Service, recognising his remarkable contributions to advancing medical knowledge and improving patient outcomes.

24 October 2024

Doctor's Legacy of Education and Innovation

After three decades of dedicated service at Townsville University Hospital, Dr Robert Norton has retired, leaving behind an extraordinary legacy in the fields of microbiology and infectious diseases. As the Clinical Director of Microbiology, Dr Norton has been at the forefront of diagnosing and combating some of North Queensland’s most challenging health issues. Beyond his clinical work, one of his greatest passions has been mentoring the next generation of healthcare professionals, particularly junior doctors and medical students from James Cook University. Dr Norton says the rewards of mentoring are twofold, allowing him to continue his own education while inspiring others. "It is an opportunity for me to continue learning and to hopefully encourage the next generation to appreciate the importance of infectious diseases in our region," he says. Throughout his career, Dr Norton has been deeply involved in various education events through the Northern Queensland Regional Training Hubs, including career fairs and pathology training information sessions. He sees these activities as vital for sparking interest in careers in medicine, microbiology, and infectious diseases. "They are very important," he says. "It’s an opportunity for our students to informally meet doctors in a variety of fields and to discuss what the job entails and, more importantly, whether it is for them."

4 March 2024

Something in the Ayr

For General Practice (GP) Registrar, Dr Ashleigh Attard, there is no place like home. After receiving hands-on GP training and experience practising in regional and remote clinics across Northern Queensland, Dr Attard returned home to complete her final GP practice placement in Ayr. Ashleigh said, the decision to move home to service the community was an easy one. “I thought it would be nice to come back and work at home, in a community that I'm familiar with,” she said. “I wanted to give back to the community where I've lived my whole life and all my family still lives here. It was an easy decision to make.” During the 18-month placement at Outback Family Medicine, Ashleigh received support, supervision and training from her cousin, an experienced GP working at the practice. “I had that family connection to the workplace already and it was a great environment to do my training in,” she said. “My cousin was a great mentor. The practice has really great patients and staff.” Working as a GP Registrar in a rural community, Dr Attard gained a wide scope of practice providing continuity of care to patients with diverse clinical presentations. “I see a lot of patients across the spectrum from young to old,” she said. “I look after the Home Hill Nursing Home and I have a lot of patients that I go to visit once a week. “I have lots of antenatal, and I'm involved in the antenatal care of some of my friends from school who are having babies. “You really get immersed in the community, and you will know so much more about your patients, and you feel like you really are making a difference in people’s lives definitely more so in a rural town.”

29 February 2024

Bridging the gap

After witnessing the negative impacts that the transience of General Practitioners (GP) had on the Mackay community, Dr Kate Bialy wanted to bridge the primary care gap. In 2019, Dr Bialy fellowed from GP training and began working at a clinic in Mackay. “My husband and I wanted to go where we could be of the most help, and we noticed there was high transience and turnover of people in the medical sphere here,” she said. “When it comes to continuity of care in medicine high turnover creates a huge gap. “I started working at Health on Central in Mackay essentially as soon as I fellowed from GP Training.” Five years later, Kate continues to make a positive impact on the health outcomes of her patients at Health on Central. Dr Bialy said, providing primary healthcare services to the Mackay community is extremely rewarding. “Being able to practise as a GP is a lifelong dream of mine,” Kate said. “Working as a GP in a regional town is extremely rewarding; seeing my patient’s health improve is the biggest highlight.” “If you are keen to make a difference in a big way to a small community, it’s very easy to do that in regional medicine.”

27 February 2024

Adventure Calls in Tropical Island Paradise

Enticed by a tropical adventure, Dr Joshua Baker travelled almost 5,000 kilometres across Australia to seek out the rural medicine experience in Far North Queensland. Reality more than met his expectations and prompted a permanent switch from the Outback to the Tropics. “It always was a plan to head to Cairns in the year following internship back home in Western Australia,” Dr Baker says. “The whole ‘Rainforest meets the reef’ lifestyle really appealed to me. I wanted to spend some time up here and I guess I just haven’t left!” Dr Baker says. While completing his junior doctor years at Cairns Hospital, Dr Baker got a glimpse of the general practice scene in the Cape and Torres region and was immediately drawn to it. “When I saw GPs there, I thought they had the best job in the world. You’re getting to do a diverse range of clinical work in the emergency department in the hospital and out in remote clinics. These guys are at the forefront of primary care.”

23 February 2024

A warm welcome to Orthopaedics in the Tropics

Growing up in Western Australia, Indigenous doctor Tamika Ponton had not given much thought to a career in medicine let alone a competitive specialty pathway. But once she began the medical journey and got a taste for orthopaedics she was hooked. When she asked seasoned doctors where to pursue the specialty, one location came up repeatedly; Cairns, Far North Queensland. An ever-popular tourist destination, the tropical city has a strong and growing reputation for its outstanding training experience across a range of specialties like orthopaedics and cardiology. “Once I had settled on pursuing orthopaedics I began looking at the sites that have had a good reputation,” Dr Ponton says. “Every conversation seemed like it kept coming back to Cairns. Everyone had good things to say; the support, the extent of the training, the lifestyle.” After completing her internship year in WA, Dr Ponton made the move to Cairns Hospital to gain as much orthopaedic exposure as she could before applying for the program. “The junior doctor years before specialty training is about building up those skills for your chosen pathway. For me, it was about stepping up, being challenged to become a good all-rounded doctor,” Dr Ponton says. Dr Ponton says the Orthopaedics Department doctors have been extremely helpful in ensuring she gets the experience she needs to set her up for applying for the specialty pathway. “The scope of practice in orthopaedics in Cairns is really what drew me here in the first place. You see a lot of soft tissue and acute injuries, chronic arthritis and seasonal injuries given the tourist influx. Cairns is the first port of call for the region, and we are servicing a wide area of the Far North.”

23 February 2024

Going the distance

Obstetrics and Gynaecology (O&G) Registrar, Dr Amanda Wee, is passionate about providing women with the women-centred care that they need. “I've always been interested in women's health,” Amanda said. “I just knew that I wanted to specialise in Obstetrics and Gynaecology.” Dr Wee has travelled across Queensland doing obstetrics and gynaecology specialty training in metropolitan, regional and rural centres. After completing an impactful third-year clinical placement in Townsville, Dr Wee who is currently in her final year of training, has returned to Townsville to complete a two-year advanced gynaecology fellowship. “Since I got on the training pathway, I've had to move around the state quite a bit,” she said. “I came to Townsville for my third year, and I really enjoyed my time here. I got to work with such good surgeons, they just really inspired me to come back again. "I think the reason why they were so inspiring for me was because they were all great role models who took pride in their work, and provided women with the women-centred care that they need, and that is my real passion.” Amanda said, that she couldn’t pass on the opportunity to work alongside and learn from the experienced supervisors at TUH. “When I had the opportunity, I applied and interviewed for a job at TUH, and very luckily got offered the job,” she said. “Now, I've come back up here to do a two-year advanced laparoscopic gynaecology fellowship. The team here in Townsville are extremely skilled with difficult endometriosis and other endoscopic surgeries. I want to get that skill and be able to perform those surgeries one day. It’s a good experience learning how the bosses perform surgery, and what tips and tricks they have. That's why I wanted to come back up here.” “I think also it's a combination of the fact that we're doing tertiary level things in a hospital that's not as big, and everyone knows each other. It's like a small hospital feel but you're doing a lot of the big stuff that you'd be doing at the metropolitan centres.”

22 February 2024

An abundance of opportunity in regional Northern Queensland

Dr Emma-Lee May was set up for career success when she chose to do her internship and PGY2 at Mackay Base Hospital. “I absolutely love the hospital; it is so tailored to learning,” Dr May said. “The medical education unit here is really good. “You have the opportunity to be one-on-one with a consultant or a registrar and that really helps to build connection. “In a metropolitan place, you may be the fourth or fifth person in line to perform a procedure whereas, in a place like this, you are the person doing it.” As the referral hospital for the region, Mackay Base Hospital has a diverse mix of patient cases, Emma-Lee said. “I’ve always been that medical student who likes a bit of everything,” she said. “I just finished my rotation in the Emergency department (ED), and I like the versatility of cases. “The other day, I had a 101-year-old patient, and my next patient was a two-month-old.” In April, Dr May will be starting a role as a Senior House Officer (SHO) in the Anaesthetics and Intensive Care Units. She said, that working as an SHO in PGY2 is a testament to the career advancement opportunities available to doctors in the region. “There are so many opportunities that you may not get at a metropolitan hospital,” she said. “Junior House Officer (JHO) is usually the PGY2, and SHO is usually PGY3. “I've got a six-month SHO job in anaesthetics and a three-month SHO job in ICU.”

21 February 2024

Home away from home in the Tropics

The Tropical Far North is an idyllic place for a working holiday, which was the kind of experience Dr Ana Liddie Navarro had in mind when she travelled over from the United Kingdom. Fast forward eight years and Dr Liddie Navarro is still in Cairns, recently fellowed, embracing the barmy weather and loving a job that she had never even considered doing. Dr Liddie Navarro completed her medical training back home in the United Kingdom (UK) before deciding to do a year abroad as a Resident Medical Officer, working in hospital settings in Townsville and then Cairns. “I’d never been to Australia, but wanted to try working in a completely different setting with what I had heard was a very interesting mix of work. Australia is unique with its Aboriginal and Torres Strait I Islander communities. You also get tropical diseases that we don’t get in cold and cloudy England!” Three years in the region was enough to motivate Dr Liddie Navarro to stay in Cairns to pursue a career in general practice. As part of her training, she worked at an Aboriginal Medical Service, a private general practice, and the Royal Flying Doctors Service (RFDS). “Doing your training in the Far North, you are more likely to have a very broad understanding of more health issues. It’s interesting and rewarding, and it’s great professionally because you’re building a skillset that really I think enables you to work anywhere.”

20 February 2024

The Best of Both Worlds

With idyllic fishing, hiking, and camping spots aplenty, the Cape and Torres Region offers an enviable coastal lifestyle, but there’s a lot more to it than that. Doctors who head to the Far North are discovering the training, research, and career advancement opportunities on offer in this Tropical Island Paradise. Rural generalist registrar, Dr Joshua Baker travelled to the Cape from Outback Western Australia, enticed by adventure and a unique medical training experience. Based on Thursday Island (Waiben), Dr Baker works across hospital, primary health centre and outreach clinic settings. “As soon as I saw doctors working on the island, I just thought they had the best job in the world. You’re getting to do a diverse range of clinical work in the emergency department in the hospital and out in remote clinics. These guys are at the forefront of primary care,” Dr Baker says. "Thursday Island is a really interesting place to train because the doctors here have a range of different experiences and backgrounds. There are a lot of procedural cases here for the obstetricians and a lot of clinical experience in critical care. You also develop your problem-solving skills with logistical considerations of providing care to outer islands. The medical workforce here is focused on investing in the education of students and junior doctors.” It’s a sentiment echoed by Dr John Hall, Director of Medical Services – Western, Torres and Cape Hospital and Health Service. Based at Weipa Integrated Health Service, Dr Hall says the training experience offered in the region sets junior doctors up for success. “Places like Weipa, Thursday Island, and Cooktown are fantastic breeding grounds for doctors. You get exposure to a broad range of specialties and pathologies, and the maturity you gain is invaluable,” Dr Hall says. “You develop clinical autonomy earlier in your career, you’re placed in situations where you’re the first responder, and you’re taking responsibility. “I’ve always found that candidates who cut their teeth in rural and remote sites become more advanced candidates clinically. I can assure you that clinical supervisors who are assessing your entry into specialty training value that experience as well.

19 February 2024

Outback Obstetrics: specialist skills and rural generalism

Eager to put his skills to best use, Dr Craig Acton relocated from Brisbane to the small Southwest town of Saint George to commence general practice training in 2020. Recently attaining Fellowship in 2023, Dr Acton has seen the impact of bringing specialised skills to the role of rural generalist and is well and truly settled into this beautiful Outback community. “I wanted an opportunity to use my skills to benefit a community, and I wanted to go remote,” Dr Acton says. “I have a strong background in obstetrics and gynecology, and I knew a place like Saint George could benefit from having these skills in town,” Dr Acton says. Dr Acton has praised the general practice training experience, saying that there has been a lot of flexibility in tailoring the program based on his experience and previous training. “They developed a program where I could complete pediatrics and emergency on rotation, essentially as a hospital internship, while doing general practice at the same time,” Dr Acton says. There have been plenty of opportunities for Dr Acton to put his new and existing skills to use. The South West Queensland region operates on a hub-and-spoke healthcare model, with Saint George as the primary healthcare hub servicing many surrounding communities. “If we did not have maternity services here people would have to travel up to four hours. We may only have about 30 deliveries locally each year, but it is part of that wider antenatal service provision which people really value.” “Providing care in the community; that’s a big win and being able to have that impact is very motivating as a doctor,” Dr Acton says.

16 February 2024

Laying down roots in the Tablelands

One of the many reasons to love general practice is getting to be there for your patients throughout many life seasons. It was this continuity of care that enticed Dr Jessica Wilcox back to her childhood home region of Far North Queensland. Now close to fellowing, she has no intentions to leave and is encouraging other registrars to settle down in this Far North paradise. After graduating from JCU in 2019, Dr Wilcox spent her internship and junior doctor years in Cairns and Mackay. While she loved the experience, she says she always had her eyes set on a move to the Atherton Tablelands, near her childhood hometown of Mt Garnet. “I always knew I wanted to settle on the Tablelands,” Dr Wilcox says. “I’m passionate about my job and my work in medicine, but I knew I could do primary care anywhere, which is the beauty of it. I wanted to live here because of the lifestyle. I love the landscape, the people, the small-town vibe, everything,” Dr Wilcox says. The appeal for general practice came in when Dr Wilcox realised how much she liked getting a taste of all the different specialties during her JCU rural placements. “The issue was I liked elements of every job that I did through placements and rotations! No matter the rotation I found that I enjoyed the clinic-based job and building relationships with patients. It just naturally attracted me to primary care. As part of GP training at Atherton Clinic, Dr Wilcox treats a diverse range of cases and has a mix of areas she is passionate about as well as less familiar areas to extend her skills. “I have a particular interest in women’s health, which I do a lot of, but I also do things I never expected to be doing. I am doing a lot of skin cancer procedures as well as geriatric medicine and men’s health. The work is just so diverse, it definitely extends you beyond your comfort zone.”

15 February 2024

Community care in the Curry

The small northwest town of Cloncurry stretches just a few kilometres along the Barkly Highway, an hour and a half out from Mount Isa. But don’t let its size fool you. Cloncurry is a growing and diverse community with some of the friendliest locals you’ll meet in your life. Cloncurry is also a place where junior doctors are discovering rich and rewarding careers in rural generalism and general practice. Dr Emma Gillmore moved to Cloncurry in 2020 with her husband and two young daughters to commence GP training through James Cook University’s program for registrars. After Fellowing in 2021, Dr Gillmore chose to stay and has been there ever since. “There's a really strong community spirit in Cloncurry. I think there’s a palpable difference being in Cloncurry compared to a lot of other places. There is a really strong sense of unity,” Dr Gillmore says. From a clinical perspective, Dr Gillmore says Cloncurry offers a broad scope of practice and diverse patient caseload, which provides the perfect opportunity for junior doctors to fast-track their growth and competency. “You see a lot of patients with significant chronic diseases that you wouldn't necessarily see in city areas. You manage everything out here. You manage strokes, heart attacks, car accidents, paediatric issues, gout, arthritis. You’re the rural GP, it’s up to you." “There’s only a couple of us in town, so if you’re on call then whatever comes through the door you’re the doctor who handles it. We had a patient who needed a lateral canthotomy, which is a really rare procedure. Another doctor and I performed the procedure, and it’s not something we would get the opportunity to do in a larger tertiary hospital setting,” Dr Gillmore says.

14 February 2024

Unbeatable Northern Hospitality

It might seem like the Northwest mining town of Mount Isa is in the "middle of nowhere", but the experience it offers is far from isolating. For the doctors who head there, they are embraced with a warm welcome, a supportive and passionate workforce, and a vibrant social scene. Junior doctor Dr Georgia Bulley had her sights on a career as a rural doctor before she had even graduated from JCU in 2021. After an extended placement on Thursday Island, Dr Bulley wanted to find a rural experience for internship to hone her clinical skills. So, she headed to Mount Isa, and outside of a short stint in Cairns, has been there ever since. Dr Bulley says the hands-on training and scope of practice is a major drawcard, not only for her own development as a doctor but also for the fulfilment she receives from her work. “The cases you see in this region are completely different to what you would see in the city. You see significant complications from conditions like diabetes or hypertension, melioidosis, and tropical diseases that you just do not get down south.” “We come into medicine to help people, and I definitely feel like in these rural hospitals, that's where you make the biggest change and the greatest influence on a community.” The North West Hospital and Health Service offers internships on the Queensland Rural Generalist Pathway (QRGP). The hospital provides interns with rotations in medicine, emergency, surgery, paediatrics and OBGYN, which Dr Bulley says is difficult to get into during internship.

14 February 2024

Finding balance as a Mum and GP

For GP registrar Dr Courtney Rasmussen, general practice training in the Wide Bay region has provided the perfect blend of a rewarding clinical career and the work-life balance she was looking for as a mum. Dr Rasmussen was born and raised in Bundaberg, living there her entire life until moving to undertake undergraduate medical training in Newcastle. As her training progressed, Dr Rasmussen found herself drawn to a career as a GP because of the broad scope of practice it offered. “As a GP you never know what kind of case is going to come through the door, which is exciting and daunting at the same time. You must have the knowledge and clinical expertise, but you also have to be prepared to be the first line of support for the patient. You are their advocate; you reassure patients they are not alone in the health issue they are facing,” Dr Rasmussen says. Always intending to return home to the Wide Bay region, Dr Rasmussen began the Queensland Rural Generalist Pathway immediately after completing her medical degree. Currently practicing at Burrum Street Medical Practice in Bundaberg, Dr Rasmussen has enjoyed the balance of clinical autonomy and a supportive environment. “Rural general practice involves a lot of problem-solving. Here you don’t often get ‘textbook cases’, so it’s quite interesting going through the process of putting the medical history and all the factors together and working with your patient to get the best outcome. “My supervisors are so supportive. They have been GPs in this region for a long time. So, you are drawing on both their clinical expertise and their understanding of the community. My supervisor is the ‘open door policy’ type which has been very positive to have someone you can call on!” Dr Rasmussen says.

12 February 2024

Embedded in Outback Community

From medical students to mentors leading primary health care in the small outback town of Barcaldine, rural generalist doctors Priscilla and Welwyn Aw-Yong exemplify the impact you can make working in, with, and for a rural community. When the Aw-Yongs were deciding where to pursue their GP training, a second-year JCU medicine rural placement in Barcaldine came straight to Priscilla’s mind. “I got a very positive impression of Barcaldine in the four-week placement, so that’s what we applied for,” Priscilla says. “Just seeing how the practice was run and watching the doctors and the way they work; they were relaxed and approachable to us students. I think that’s what drew us to Barcy (Barcaldine).” The couple moved to Barcaldine in 2018, quickly becoming embedded in the community and advanced in their training and careers. With plenty of training and development opportunities on offer in rural settings like Barcaldine, it wasn’t long before positions in medical education and hospital leadership positions came their way. The broad scope of practice is a major drawcard for GP registrars who choose to train in rural Queensland. Rural GPs see a wide range of presentations, perform a range of procedures and provide other services to improve the overall health of rural and remote communities. Welwyn loves the diversity of his combination of roles. “Barcaldine is the type of place where you have to think on your feet. Sometimes there might not be anybody else; you can’t just refer them ‘down the road’,” he says. “You do all these investigations and emergency procedures yourself, particularly as you get into advanced skills training. You have this really broad scope of practice and that is very rewarding.”

16 January 2024

New doctors seek out the Tropical Far North experience for Internship

New graduates from across the country join a strong contingent of Far North Queensland locals in the cohort of medical interns commencing at Cairns Hospital. After years of studying, the next chapter of the medical journey has begun for 59 interns joining the Cairns and Hinterland Hospital and Health Service in January, 2024. One in five of the cohort are from the Far North Queensland region, and 26 are North Queensland trained as JCU graduates. The Interns will rotate through a variety of units during the 12 months, including general medicine, surgery, emergency medicine, and additional terms in other specialised areas. It ensures they get diverse experience across areas such as acute and critical care, chronic condition health care and perioperative care. Among the interns undergoing orientation is Sophie Gampe, a born-and-bred Atherton local who completed her training at JCU. Sophie said she was passionate about rural medicine, in particular obstetrics and gynaecology. “My mum is a doctor at Atherton Hospital, but I didn’t really want to follow in her footsteps until I explored my studying options in uni,” Sophie said. “I applied for medicine at JCU and got in and discovered a passion for women’s and reproductive health.” Pictured: Intern and JCU graduate Dr Marco Soncin with Dr Sophie Gampe and Cairns Hospital Acting Director of Medical and Emergency Services, Dr Lachlan Gordon.

3 October 2023

Straight answers to hard questions for rural docs

James Cook University (JCU) General Practice and Rural Medicine has launched a series of informative, straight-talking videos to assist general practitioners (GPs) in training to provide culturally appropriate care to Aboriginal and Torres Strait Islander patients. The ‘Hard Questions’ series includes around 40 short videos filled with practical advice, dos and don’ts, and local experiences from JCU Cultural Mentors based at Aboriginal Community Controlled Health Organisations (ACCHOs) across northern Queensland. Leading the video project is Henry Neill, Cultural Educator for JCU General Practice and Rural Medicine. He says the idea for the video series came from seeing a common theme to registrars’ questions over his six years of providing Aboriginal and Torres Strait Islander cultural awareness training. ‘The questions, as you can imagine, come from all corners,’ Henry says. ‘I hear time and again from registrars, “I don’t want to offend my patients”; they’re looking to better engage with Indigenous [people] and they want to understand the cultural significance of the community they’re working in. That’s where these videos will help.’ Cultural Mentors work in various roles across JCU’s 76 training posts – from doctors, to practice managers, wellbeing coordinators and CEOs. In the ‘Hard Questions’ series, they share information on topics like introducing yourself to an Indigenous patient, preferred language, the role of Elders, Sorry Business and much more.

26 September 2023

Bringing out the best in medicine's next generation

Mentoring and training focused on producing the best junior doctors and basic physician trainees is the key motivator for Mackay-based JCU College of Medicine and Dentistry senior lecturer, Dr Danielle Wu. Dr Wu, who is also a highly regarded Nephrologist at Mackay Base Hospital, says prioritising the training and education of the junior doctors who enter her realm is a great outcome for all. “We aim to help the trainees, it doesn’t matter which university or centre they have come from, we want to see the best out of the training time they have with us,” Dr Wu says. “The better the doctors are as a cohort, the better the outcome will be for the patients. We like to see our trainees getting ahead. We try to maximise the potential of all our trainees.” Pictured: Dr Danielle Wu (centre) receiving the Mackay Hospital and Health Service (MHHS) People's Choice Award 2021, as voted by patients and their families. Why Mackay is at the top of the class for trainees Dr Wu is passionate about working in the coastal city of Mackay and its hospital, close to the beautiful Airlie Beach and Whitsunday areas, and is eager to highlight the full spectrum of training opportunities available. She says Mackay is an ideal training ground for junior doctors. “You will also be exposed to complex medical patients that are the typical cases you will see in the Royal Australasian College of Physicians (RACP) clinical exam without having to look very hard for cases”, Dr Wu says. “As there is only one public hospital in Mackay, all the complex cases come into our hospital. There is a good case mix for the trainees who will see everything from common to rare conditions. As most of these cases are managed by the one hospital, they will have a wide range of exposures. “Trainees work closely with medical consultants. We have most of the sub-specialties available locally and you could have supervision from medical specialists across these areas on a daily base.” “The trainees learn to utilise the resources they have to help patients. We tend to have a holistic and wider view of a patient not only for their medical comorbidities, but also for their psychological and social health. The trainees will become very well-rounded physicians after seeing a range of interesting cases and pathology in Mackay as a result.” Dr Wu says the Mackay education team ensure the junior doctors work as doctors, under close supervision, and are not merely notetakers or observers. We teach our basic physician trainees how to make decisions to build their confidence to manage patients with supervision from early on in their careers. Maturity in decision-making, ability to synthesise complex medical cases, communication skills, and patient-centred care are important skills to have as a physician. “As the Basic Physician Trainees work closely with subspeciality consultants they learn decision-making directly from consultants,” she says. “The Basic Physician Trainees will have sub-speciality access to General Medicine, Cardiology, Renal Medicine, Medical Oncology, Respiratory Medicine, Palliative Care Medicine, Gastroenterology/inflammatory Bowel Disease, Neurology, and Infectious Disease. The medical department still needs physicians in Hepatology, Geriatric Medicine, Acute General Medicine, Rheumatology, and Perioperative Medicine. The medical department is expanding to care for patients locally in Mackay. “We also have an accredited General Medicine advanced training position with the chief medical resident position available for trainees who are interested in General Medicine training and developing leadership skills post-clinical exam. "We have a world-class bench-to-bedside gastroenterologist/inflammatory bowel disease expert, Dr. Robert P Anderson, who has recently joined us to mentor trainees who are keen on developing research and publication skills.

29 August 2023

Help shape our future medical workforce

Each year, James Cook University (JCU) puts the call out for volunteers from a variety of backgrounds to play an important role in the selection process for JCU’s highly regarded Bachelor of Medicine, Bachelor of Surgery (MBBS). The selection process is a rigorous one, with the university receiving upwards of 4,000 applications for the course annually. From this pool, around 650 will be invited to attend an interview with a panel. And that’s where you can help. The panel is generally made up of one healthcare professional, a representative from JCU and a member of the community. JCU is looking for more volunteers across the board to help select the 2024 first-year medicine cohort. As current and past volunteers will tell you, being part of the process is very rewarding. With guidance from the JCU Medicine Selections team, volunteers are well supported as they take on the important task of helping select a student cohort that is values-aligned with JCU’s commitment to rural health, and passionate about working in underserved communities. As we approach recruitment for our 2024 intake, we spoke to two of our volunteer doctors who have enjoyed volunteering on the medical selection panel for many years.

25 July 2023

Making a difference on the path less travelled

When it comes to medical pathways, Dr Mikaela Seymour has taken the road less travelled. Graduating medical school with surgical aspirations, Dr Seymour says she eventually realised the hospital pathway was not for her. Instead, she was drawn to practise medicine in one of the most disadvantaged parts of the world. “I'm one of those creative careers doctors you've probably heard of. I've certainly had an unconventional pathway,” Dr Seymour says in her keynote address at the 2023 AMAQ Junior Doctor Conference. Dr Seymour says her interest in developing world medicine started with a final year elective to undertake tropical medicine in the Western Province, Papua New Guinea district hospital. “I gained my general medical registration in Papa New Guinea and Australia simultaneously. I was this medical Batman, living dual identities in two different worlds,” she says. “Whilst I was here in Australia, I was assisting in advanced surgeries working in perfectly sterile theatres, with supply cupboards full of various types of sutures, dressings, and every sort of equipment that you can imagine, by comparison, my reality in Papua New Guinea was very different.” She cites findings from the Independent State of PNG Health System report, published in 2019, which found only 40 per cent of health facilities have a form of electrification, 55 per cent have any access to water, and only 33 per cent can transfer a sick patient to a higher level of care. Dr Seymour says that maternal mortality rates were approximately 43 times higher in PNG compared to Australia. “Another example in Australia that we take for granted is the absence of vaccine-preventable illness, and obviously, as a public health registrar, that's something very close to my heart. But again, these circumstances are very different in our immediate region,” she says.

18 July 2023

How attending the RANZCP Congress will be of benefit for working rurally

Jo Kaczmarek is a final-year JCU medical student who attended the RANZCP 2023 Congress during her Rural Internship rotation. She recently shared her experience from the congress and why the 2024 event will be a must-attend for rural GPs interested in mental health. If you’re a rural doctor with Advanced Skills Training (AST) in mental health, it’s a no-brainer! You should go to the Royal Australian & New Zealand College of Psychiatrists (RANZCP) Congress to keep current, meet like-minded colleagues from across Australia and NZ, and network with Psychiatrists (who are a very social bunch by the way!). Next year’s Congress will be on Ngunnawal land (Canberra) from 19-24 May 2024 and it coincides with the 60th anniversary of the very first Congress, so it’s shaping up to be huge! This blog is for the rest of you rural doctors out there – let me try to convince you why the Congress is beneficial for you to attend!

1 June 2023

Tropical paradise the right fit for new intern

When it was time set down roots after graduation, Cairns local Dr Georgia Krause had no desire to look too far afield. The JCU graduate is one of Cairns and Hinterland Hospital and Health Service’s newest doctors, currently undertaking her general medicine rotation and loving life in picturesque Far North Queensland. For Dr Krause, medicine and nature intersect, with the Cairns region proving the ideal playground to explore this holistic side of practice as she traverses her career working to heal both people and the planet. But it’s not just the natural beauty of the tropical north that Dr Krause finds endearing. She said the close ties and integrity of the humans in this region continues to impress. “In places like Mossman and the Daintree I’ve seen first-hand how stoic the locals are and just how strong the sense of community is here. “I think that is important to many but I recognize this is particularly important to me, it forms a sense of fulfillment, purpose and belonging and that’s what I want in my career long term,” she says. “I loved being in Mossman for that reason, the people get to know you by first name. You'd see them at the local market, grocery store and on the cable ferry that carries you across the Daintree River, and they always greet you with a smile, I want to live and work somewhere where that is possible. “I see myself living and working in the Mossman or wider Cape York Peninsula area, because I feel very deeply connected to this community and to give back through my profession would be extremely rewarding.”

16 May 2023

An 'Accidental' Rural GP in the making

Eager to escape the South East Queensland rat race, newly minted doctor, Tom Shannon, decided Cairns looked far enough away from the hustle and bustle. Currently working as a GP registrar at Mareeba’s Amaroo Medical Centre, Dr Shannon says he’s truly found his groove here in the tropical north. “After finishing medical school in Brisbane I was mulling over my preferences in terms of hospitals, I felt like doing something completely different and I haven’t looked back,” he said. Dr Shannon said the camaraderie among the Cairns hospital doctors struck him immediately. “The cohort of interns in Cairns were mostly JCU graduates. They were very tight-knit but very welcoming to outsiders as well. I immediately felt at home at the hospital and I continue to fall more in love with Northern Queensland the longer I am here,” he says. “My experience in Southern Queensland probably wasn't as positive, I remember feeling quite disjointed, like a bit of a wallflower and not really engaged. But at the Cairns hospital I immediately felt a very close, collegial atmosphere.”

9 May 2023

Meet Dr Stephen Lambert, Director of Clinical Training at Mackay Hospital

Medical education means much more than teaching for Dr Stephen Lambert, the Director of Clinical Training at Mackay Hospital. Dr Lambert, who landed in Mackay a decade ago as an International Medical Graduate from South Africa, takes a holistic approach to nurturing junior doctors’ development as head of the hospital’s Medical Education Unit. “The Medical Education Unit looks after interns and doctors who aren't on a vocational training program. We make sure doctors are well supervised and look after their welfare,” he says. “For us, wellbeing includes career development, so making sure doctors have good career counselling, that their career pathways are mapped out, not only in Mackay but across the North Queensland education programs. “It’s also ensuring they get good mentorship and coaching on the floor. We try to provide a supportive environment by creating a culture where doctors feel like they're getting coaching, mentoring and supervision while working.” Dr Lambert, a general practitioner at Southside Medical, started his Australian medicine career in Mackay, having completed his internship in Johannesburg. “I came to Mackay as a Junior House Officer, and I've been here ever since. I got regional rotations in Proserpine, Sarina and Clermont, which was really amazing in terms of preparing me for getting on to the GP training program,” he says. “My extended skill as a GP registrar was medical education. I was involved in delivering lectures to interns and doing simulations. We've had a number of GPs in Mackay come through the medical education registrar role and complete that extended skill here.” Mackay has plenty to offer interns and junior doctors, in addition to the professional and personal rewards of diverse practice in an area of need. Quality mentoring “The advantage of medical training in Mackay is the proximity of the experts – senior medical officers and consultants – to the intern. They're prepared to coach and mentor students, interns, junior medical officers as part of their day-to-day business. We're very keen on making sure interns actually operate as doctors, so you're not just the scribe on the team, you're not just shadowing – you’re actually treating patients, but you've got close supervision. “You've got someone watching over your shoulder, you've got someone who's coaching you through your career. If you look at the medical education evidence, that's the best learning is actually doing it with someone watching you and guiding you along the way. And I think Mackay does that really, really well. We don't have all the big hotshot professors in their fields, but we do have experts who are willing to invest their time and effort into your development.” Building your CV “You can complete all of your GP training in Mackay. Rural generalists can do advanced skill training in paediatrics, mental health, obstetrics and gynaecology, anaesthetics, and we hope to get general medicine across the line. You can do all of your psychiatry training in Mackay. If you're looking at critical care specialties like Emergency Medicine, Intensive Care Medicine, and Anaesthetics, you can do about half of your training in Mackay. In terms of basic physician training and surgical training, most only spent about a year in Mackay. “Mackay is a great place to get on to the surgery and orthopaedics programs. You'll get your logbook and your research components done as a Principal House Officer, which will set you up to get on to the program. Mackay is a good place to get the theatre experience and the research and build your CV to get on to those programs. “In terms of the physician and paediatric sub-programs, once again it’s a good place to do one to two years of basic physician training. For those specialties, it's a good place to prepare for exams, because you're exposed to a wide variety of patients. You're not spending all your time in a subspecialty; you're getting a little bit of everything, which is good for exam prep.” Research support “Medical education falls under our innovation and research portfolio, or MIRI, which is the Mackay Institute for Research and Innovation. We're really keen on making sure junior doctors get research opportunities. We can guide and mentor them through a quality improvement project, such as an audit, which is often the first place for a good research project. There are opportunities for research projects, poster presentations and working with special research programs.” General practice during internship “Southside was one of the first set of practices to take on the Rural Junior Doctor Innovation Fund, which is now called the John Flynn Prevocational Training Program. We're accredited for intern training, which means interns can do a 10-week rotation as part of their internship in our practice. Since then, Affinity Medical Centre in the Whitsundays and Awal Medical Centre in Sarina have also been accredited. “We know that interns make career choices based on what they’re exposed to in their prevocational years, so part of this program is exposing interns to general practice early in their career. We've had 17 interns come through over the time we've been accredited. “It's been a benefit to our practice, as well. When COVID broke out, the intern did a literature review on best practice in terms of patient flow in and out of the building. They helped set up our green clinic, which allowed us to keep face-to-face consultations. Anyone with respiratory complaints, which would match the criteria for COVID, is seen in a separate area to the practice to make sure there's no cross-contamination. The intern was helpful in getting that set up and it was a good research project.” A close-knit community “I think Mackay is a fantastic town in terms of enjoying your full scope of practice. the whole Mackay health region needs doctors. It's a good place to practise to the full extent of your training, which is satisfying. Mackay is small enough there are good relationships between the community and tertiary care hospital. In my role, I've got a hat in the hospital, but also in the community. I think there are some really good linkages in a town like ours where there are good close working relationships.” Find out more about training in Mackay.

6 March 2023

The Pandemic President

Pictured: Dr Sarah Chalmers at the RMA22 Conference in Canberra, October 2022 (Image courtesy of ACRRM). When the COVID-19 pandemic hit in early 2020, the rural medical workforce needed to rapidly respond and adapt. Guiding on-the-ground efforts were seasoned rural generalists like Dr Sarah Chalmers, President of the Australian College of Rural and Remote Medicine (ACRRM). Taking the reins in late 2020, the JCU Senior Lecturer ensured the rural voice was heard in policy and strategic discussions that guided Australia’s health response to the pandemic. After completing her presidency term during the College’s RMA22 Conference in October last year, Dr Chalmers reflected on her time in the role, what she loves most about rural generalism and where her focus has shifted to now. Thank you for your time Dr Chalmers! Firstly, how did the opportunity to become ACRRM President come about? Over the years, I’ve had some amazing mentors through ACRRM, like A/Prof Ruth Stewart, Professor Lucie Walters, and Dr Maria Cowie. They’ve lived and breathed rural generalism for decades and were encouraging me to consider the role. It wasn’t a particular ‘life goal’ for me, but it has been an extraordinary experience and I wouldn’t change a thing! What was it like as president during COVID-19 and how did ACRRM respond to the pandemic? COVID-19 had been around for six or so months when I came in, but it was still quite an extraordinary time. I've been referred to as the ‘pandemic president’! It was back in the particularly scary stages of the pandemic when we didn't have a vaccination program, Australia still had closed borders and there wasn't very much domestic travel going on. There was certainly a lot of ‘rolling with the punches’ to adapt our college and registrars’ training during the pandemic. A benefit of being rural is that we were already well-experienced in delivering exams for registrars remotely. The other specialty colleges rely heavily on face-to-face, and we were the only college that had an uninterrupted exam cycle, which is something we are very proud of. ACRRM had a big part to play in the vaccine rollout, alongside the Rural Doctors Association of Australia (RDAA). Advocating for rural communities as part of this process was a big part of the first year of my presidency. Another significant COVID-related change to navigate was the introduction of Medicare rebates for telehealth appointments. Rural and remote doctors have been using telehealth for a long time, so we did quite a bit around best practices for ramping up the scale of telehealth and we produced some great resources to support practitioner education on telehealth services. Outside of COVID-19, what else did an ‘average’ day look like for you during your time as ACRRM President? The president's role is centred on advocating for rural health and participating in policy and strategic discussions. So, we were looking at some of the big questions facing our profession; how do we get more medical students to consider rural generalism? How do we encourage better teamwork between rural doctors and other health practitioners? How do we inform and direct national policy? There was a large body of work around the 10-Year Primary Care reform project, which has gone on to become the Strengthening Medicare Task Force. It's so important that rural voice be represented in these strategic and it has been a huge honour to speak on behalf of my colleagues at these forums. Beyond being president, my role as a rural generalist didn’t stop, and neither did my roles as a wife and a mum! Whenever someone gets to do something like this ACRRM opportunity, there is always somebody in the background keeping everything ticking away at home. I’m very thankful to be married to somebody who is so supportive and to my children who had to sacrifice a bit of mum-time during my ACRRM presidency!

1 February 2023

JCU signs agreements with GP Colleges

JCU will have a role in delivering general practice training in regional Queensland from 2023. We are pleased to be continuing as a training delivery entity officially from today under the College-led training model, with JCUâ€™s staff and structures committed to supporting ACRRM and RACGP.

25 January 2023

Upskilling our Outback Docs

NQRTH Grant funding enhances rural and remote healthcare services Rural generalists are an essential part of our rural and remote medical workforce. Across private practice, primary health clinics and hospitals, these resourceful and versatile doctors need to be prepared to provide a broad spectrum of primary, secondary and emergency care. The Northern Queensland Regional Training Hubs (NQRTH) is supporting our rural generalist and GP registrars through its annual ‘Grow Our Own Grants’. The program funds specialty training opportunities to develop additional skills or knowledge beyond the scope of mandatory training. In 2022, NQRTH awarded grant funding to 15 recipients across North West, Central West and the Cape and Torres Strait regions. The total funding pool of $58,320 was the largest annual distribution since the initiative’s inception in 2018. Among the recipients is Dr Caitlin Hurlock, an Anaesthetics Principal House Officer (PHO) and rural generalist registrar through the Australian College of Rural and Remote Medicine (ACRRM). Since graduating from JCU in 2018, Dr Hurlock has been based at Mount Isa Hospital and commenced rural generalist training in 2021. She applied for the NQRTH Grow Our Own 2022 grants to further enhance the services she can provide to communities of the North West region. The grant provided Dr Hurlock with the funding to complete an Ultrasound in Rural Medicine course at the Australian Institute of Ultrasound on the Gold Coast. “Ultrasound is an incredibly versatile investigation that can be performed bedside to help aid in diagnosis and disposition of patients in rural settings, where other imaging modalities are limited,” Dr Hurlock says. The five-day course covered a range of foundational skills in ultrasound for echocardiography, Focused Assessment with Sonography for Trauma (FAST) scan, vascular, lung, biliary tract, genitourinary tract, early pregnancy and soft tissue ultrasound. Dr Hurlock says the course was facilitated by experienced rural general practitioners who provided clinical cases and anecdotal stories to emphasise the relevance of the teaching to a rural setting. “With the confidence and knowledge the course provided, I will continue developing my bedside ultrasonography skills for the benefit of patients in my next training post at Emerald Hospital. I would highly recommend this course to anyone undertaking rural generalist training!” Dr Hurlock says.

6 December 2022

Discovering a rewarding specialty close to home

Principal House Officer, Dr Renee Brown, grew up in the small rural cane-farming town of Ingham in northern Queensland. While her two siblings would go into the family signwriting business, Dr Brown knew from childhood that medicine was the path for her. Training has taken Dr Brown across Northern Queensland and now, after completing an internship at Cairns Hospital, she has relocated to Townsville and commutes to Ingham Hospital. Recently, she shared some of her favourite parts of medicine, her training experience in the North and her advice to fellow junior doctors. What inspired you to choose a career in medicine? I knew early on that medicine was the career for me. My decision to become a doctor was driven by my inherent fascination with the human body and the idea of being a part of a profession focused on helping others. I completed my dual Bachelor of Medicine and Bachelor of Surgery degree through James Cook University. I attended the Townsville campus for my non-clinical years, before moving to Cairns to complete the final three years of my studies. What do you love most about being a doctor, and is there a particular specialty that is standing out to you so far? I love that working in Medicine is unpredictable, interesting, challenging, and profoundly rewarding. I like a bit of everything – which is why I chose general practice. I was successful in securing a college position with the Royal Australian College of General Practitioners (RACGP) on the Australian General Practice Training (AGPT) program in 2020. Recently, I have completed the hospital requirements. I will be commencing the next part of my training, as a General Practice registrar, at Bluewater Medical Practice, just outside of Townsville, in 2023, while continuing to work part-time at Ingham Hospital. I have my site set on becoming a Rural Generalist.

30 November 2022

Specialty spotlight: Rural generalist medicine

For Dr Helen Fraser, rural generalism has not only offered diverse and challenging medicine, it’s also been an opportunity to champion health equity for rural hospitals and take a clinical leadership role for the region. Senior Medical Officer (SMO) at Ayr Hospital for the past six years, Dr Fraser chairs the Townsville Hospital and Health Service Clinical Council, which gives clinical staff a voice in the management of the region’s health service. Dr Fraser grew up on a farm between Hamilton and Warrnambool in southwest Victoria. “Some of my friends’ parents were the doctors in town and they practised rural generalism before it was known as rural generalism. They were the people who I really looked up to at that time.” After graduating from James Cook University in 2012, she stayed in Townsville for her intern and Registered Medical Officer (RMO) years and completed advanced skills in emergency medicine and anaesthetics before taking up an SMO role in Ayr, 88km to the city’s south. “As a rural generalist in Ayr with advanced skills, we're using all of those emergency medicine skills and then we're using internal medicine skills because we look after everyone on the ward,” Dr Fraser says. “I use my anaesthetic advanced skill for emergency presentations with imminent airway risk, but also with our obstetric deliveries and providing epidurals after hours. We do a lot of gastroenterology procedures, and going forward, we're hoping that more surgery will be performed in Ayr.” Life as a rural generalist The National Rural Health Commissioner, Adjunct Professor Ruth Stewart, and trainee rural generalist Dr Preston Cardelli, a JCU graduate, talk about the rewards and rich experiences of rural generalism.

28 November 2022

Tackling health at population level

JCU GP registrar Dr Jay Short has been part of North Queensland’s public health response to everything from COVID-19 to monkeypox, bat bites, melioidosis, meningococcal disease, diphtheria, Hendra virus and Japanese encephalitis in 2022. In December, Dr Short becomes the first Australian College of Rural and Remote Medicine (ACRRM) registrar to complete Advanced Specialised Training in population health in Townsville. Dr Short worked as a remote area nurse across Australia for 13 years before completing his medical degree at James Cook University in 2018. His deep knowledge of the region’s remote Aboriginal and Torres Strait Islander communities has proved invaluable for the Townsville Public Health Unit, which manages multiple disease outbreaks concurrently across a vast area. Dr Short’s JCU supervisor, public health physician Dr Nishila Moodley, draws an analogy between public health specialists and the sci-fi secret agents of the Men in Black films. While the COVID-19 pandemic has elevated the specialty’s profile, much of their work still goes under the radar. “If we do our job correctly, no one knows we're there. That's why people don't know who we are. I always tell them, we're like the Men in Black,” says Dr Moodley. “In Townsville, we've never really had an alpha or beta COVID-19 outbreak because we had responded clinically to those individual cases so rapidly that infection didn't get a chance to establish itself here.”

22 November 2022

An intern's top 3 tips for medical students

Internship at Townsville University Hospital has been a first-rate training ground for aspiring rural generalist Dr Harjyot Gill. Dr Gill looks back on her first year as a doctor, her med school experience at James Cook University (JCU) and gives her top three tips for med students: “Internship is very exciting. Finally, you've made it, you're a doctor and you get to go to work and make a real difference to people’s lives each day.” “My first term was in ED, which was a great experience because you work up a patient from the very beginning. I found the emergency department offers a great opportunity to round out your knowledge and skills whilst rapidly assessing and treating undifferentiated patients in a time-critical manner. “My second term was in Charters Towers, as I'm currently on the prevocational pathway for rural generalism. My time in Charters Towers was probably the best so far. I was rounding on patients myself, discussing management plans with my supervisors and with their feedback I would enact the plan. “The type of experience or exposure I had in Charters Towers is unheard of in a tertiary setting. In rural communities you're doing a lot more, which allows you to develop your clinical decision-making skills. I felt like my knowledge and skills were growing exponentially as I was making my own decisions but in a very supportive clinical environment where the senior doctors were always there to guide me. “My third term was my surgical term, in gynaecology. My clinical elective in sixth year was also in gynaecology at Townsville University Hospital. The only difference was now as an intern I was getting paid to do all the things I loved as a medical student. I was assisting in theatre, seeing patients in clinics and on some occasions witnessing the magic of childbirth. It felt like I just picked up from where I had left off as a medical student in sixth year. “I’m currently on paediatrics. This is just a short elective for five weeks, and every second week I'm rostered on to baby checks. So just this morning, I was examining babies and squeezing in a couple of cuddles here and there, which always warms my heart. “Essentially, at this stage, I'm trying to complete all the prerequisites for the rural generalist pathway. Next year, I'll be rotating through obstetrics, anaesthetics, emergency medicine as well as another rural term and a relieving term. Beyond that, I'll be planning to apply to one of the GP colleges, whether it's ACRRM or RACGP, and deciding on an advanced skill I would like to specialise in. “Ultimately I see myself in a rural community with women’s health as a part of my practice. I would love to be a part of a community, and I feel like in smaller hospitals, you're able to know everyone in the team. In Charters Towers, by my third week I knew everyone in the hospital; I knew who was on the wards, I knew who was in admin, and who was in the kitchen.”

10 October 2022

Reaching for balance with a passion outside medicine

Obstetrician and gynaecologist Dr Tiarna Ernst has a high-flying perspective on finding life balance, having trained in tandem as both a professional athlete and doctor. The 2011 James Cook University graduate, who grew up in Cape York, was drafted into the inaugural AFLW competition in 2016, winning a premiership with the Western Bulldogs in 2018 and continuing to play elite sport throughout her medical specialty training. “I knew for me, running out on to the football field was almost therapeutic and that I could switch off from the pressures associated with being a junior doctor,” Dr Ernst says. “I could just be a player and it didn't matter what I did outside of playing footy. I think that can be transferred into any area of interest; it doesn't need to be sport.” Dr Ernst will deliver the keynote closing address at the AMA Queensland Junior Doctor Conference, which is supported by NQRTH. She will talk about how to find purpose and passion outside of medicine. “My message for junior doctors to find something, whatever it is, outside of medicine that gives you balance in your life,” Dr Ernst says. “I think you need to find a passion. It doesn't need to be sport. It doesn't need to be physical. It could be analytical, it could be academic, but it needs to be something different outside of medicine. It needs to be something where you can switch off, you can forget that you're a doctor or a medical student, and just pour your energy into that thing. “I've got some colleagues who are very interested in music, others are interested in volunteering groups, climate change, things like that.”

5 October 2022

Leading leaps in genetic research from northern Australia

Townsville nephrologist Professor Andrew Mallett is internationally recognised for his work in identifying new approaches, understanding and treatments for genetic kidney disease. The Bowen-raised James Cook University graduate returned to North Queensland in late 2020 as director of clinical research at Townsville Hospital and Health Service, becoming the first JCU Medicine graduate to be appointed professor of medicine. Prof Mallett leads the KidGen Collaborative, a national clinical and research consortium championing novel diagnostic and research pathways for patients and families affected by inherited kidney disorders. His multidisciplinary renal genetics clinic model operates in 18 locations across Australia. “Kidney health is a national quandary,” Prof Mallett says. “It's a massive need. At a national level today, there are something like 1.7 million Australians affected by kidney disease, and about a million of them don't even know it. Kidney disease disproportionately affects those in Northern Australia and in rural and remote areas. Wherever you practise, you're contributing to the greater good, but to do it here where there's clearly such need, I think is really important.” Prof Mallett is one of a handful of nephrologists in the country who specialise in genetic forms of kidney disease. “When I was doing my renal advanced training in 2011 to 2013, there was no one in Australia in that subspecialty area,” he says. After completing a Churchill Fellowship in the United Kingdom, France and North America, he focused his career on heritable forms of kidney disease. “It's an area in which there's a great clinical and research connection,” he says. “By understanding how changes in our genes may cause or relate to the development of kidney disease, we've got a really good chance of understanding how these diseases individually work, and that may lead to better treatments in the future. “At the same time, there's a great personal connection to patients, because many are seeking a diagnosis. What is the cause of their kidney disease? What is the type of their kidney disease? Both when I was a renal advanced trainee and before that as a more junior physician trainee and medical student, most of the time we didn't have good answers. Everyone seemed so comfortable with that, and I really wasn't. “A lot of my research is focused on the development and application of new genomic technologies to help patients in a clinical context to get those answers. We now understand that at scale, and it's available in clinics right around the county.” A key achievement has been the Medicare listing of genomic testing of patients with heritable forms of kidney disease as of July 1 this year. “It’s something that was aspirational and unthinkable five years ago,” he says. “It's been great to contribute in a research way to realising things like that at the same time as doing the research that underpins driving major clinical and policy change.” Now a teacher of JCU medical students, Prof Mallett started at JCU in 2001 as a 17-year-old fresh from boarding school in Brisbane and a holiday job as an assistant nurse at Bowen Hospital. “I worked as an AIN (Assistant in Nursing) at Bowen Hospital practically every weekend from before I got into medical school and then for the first five years I was at medical school,” Prof Mallett says.

20 September 2022

Emergency Medicine Spotlight: Queensland's first Indigenous FACEM's mission in medicine

North Queensland born-and-raised JCU alumnus, Dr Tatum Bond, has become Queensland’s first Indigenous Fellow of the Australasian College for Emergency Medicine (FACEM). The achievement is the culmination of six years of specialist training in Rockhampton and Cairns, combined with a life-long passion to help Close the Gap in Indigenous health outcomes and increase the representation of Aboriginal and Torres Strait Islander doctors in medical specialities. Part of the Ngajanji people from the southern Atherton Tablelands, Dr Bond grew up in the Central Queensland town of Gladstone. Even as a child, she looked destined to be the first in her family to pursue a medical career. “I've always been fascinated by how the human body works. I was a big fan of those biology children's books and models,” Dr Bond says. “My mother tells a story of when I was about four or five, I was meant to be asleep but I was watching the TV from around the side of the wall. It was a 60 Minutes program about a baby who was born with their intestines on the outside of the body, and apparently, it was from then on that I’d say ‘I want to do medicine’.” Dr Bond says it was important for her to be close to family, so choosing to study medicine at JCU in Townsville was the logical choice. It was a decision that would hone her medical interests and her path into specialisation. “I'd never travelled outside of Queensland. So having something ‘close-ish’ to home was important to me. I really enjoyed JCU and thought it was a very well-run medical school. “The rural placements were where I had the most fun and learned the most. I went to Cooktown in my second year and absolutely loved it. I went to Thursday Island in my sixth year and was just really accepted as part of the team. These experiences led me down the rural generalist pathway after graduating, before ‘jumping ship’ to ED in 2014,” Dr Bond says. Now, as an ACEM Fellow, Dr Bond has returned to Cairns and works as an Emergency Consultant, dividing her week between Cairns Hospital and the Royal Flying Doctor Service.

20 September 2022

Homegrown paediatricians bring subspecialties to NQ

Paediatric rheumatologist Dr Courtney Samuel and paediatric and fetal cardiologist Dr Rosh Samuel.

19 September 2022

Community life enriches varied practice

Dr Craig Acton works across general practice, emergency medicine and obstetrics and gynaecology as a GP registrar in the southern Queensland rural town of St George. Moving between the local medical practice, St George Hospital and outreach services, each day is varied for the Townsville-born doctor, who was part of the second cohort of JCU medical graduates. Since moving to St George in late 2020, Dr Acton, wife Lucille and children Stella, 10, Hannah, 8, and Oscar, 6, have embraced community life in cattle and cotton country. “I enjoy being actively involved in the St George community, not only as a doctor but also by being involved in school, sporting clubs and community events with my family,” he says. “The team of doctors I work with at St George are very supportive senior clinicians who provide diverse experience as I undertake my training as a GP registrar.” Dr Acton did RACGP-approved, JCU-organised core hospital training terms in St George – an earlier stage of the training pathway not usually accommodated outside major regional centres. After gaining a degree in Medical Laboratory Science at JCU, Dr Acton completed his Bachelor of Medicine, Bachelor of Surgery in 2006. Spending his intern and first few postgraduate years at Nambour General Hospital, his interests gravitated towards general practice and obstetrics and gynaecology. “After completing my DRANZCOG (Diploma of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists) at Redcliffe Hospital, I was accepted into both the general practice and obstetrics and gynaecology training programs,” he says. “I chose to pursue a fellowship with RANZCOG, but after eight years of training I was unsuccessful in my final examination. Re-evaluating my career path, my ongoing interest in general practice led me to rural general practice where I can use my skills to provide a service to a small community. “GP was always of interest due to the variety of presentations. It also allows me to build relationships with patients and to provide them with holistic health care.” One of Dr Acton’s most memorable experiences as a doctor was his first unsupervised caesarean section: “It was a category one emergency due to foetal bradycardia. My consultant was off site at the time and arrived after I had delivered the baby. I remember my hands shaking as I closed the uterus and abdomen, and my consultant patting me on the back telling me I’d done a good job. Both baby and mother recovered well.” Dr Acton looks back fondly on his time at JCU, having maintained friendships long since graduation and been exposed to many valuable practical experiences in rural and low-resource environments. “My final JCU placement in Chennai, India, provided cultural immersion as well as insight into practice in a facility with minimal resources,” he says. “It was an experience I will never forget, and I am grateful to have had the opportunity.”

5 September 2022

Seeing hospital through a patient's lens

Dr Alisha Thomson has seen the health system from doctor, patient and management perspectives during her five years of treatment for ovarian cancer. Dr Thomson was a 27-year-old James Cook University graduate in her second year of medical practice when she was diagnosed with stage four ovarian cancer. Discovering a new passion amid the demands of treatment ultimately led her to change her medical specialty training path. “I was a psychiatry house officer at that point. After a significant period of sick leave, I was given the opportunity to work as a medical education registrar through a return-to-work program,” she said. “I went back to psych and then did some time as the medical admin reg and just really enjoyed the systems thinking and looking at the bigger picture. I loved psychiatry, and it took me years to finally switch, because it's hard to change lanes.” Now a medical administration registrar, Dr Thomson has endured four rounds of chemotherapy as well as radiation, surgery, and therapies such as monoclonal antibodies and breast cancer drugs. Her experiences as a cancer patient continue to inform her leadership role in improving systems and processes at Townsville Hospital and Health Service (THHS) and putting patients’ needs at the centre of decision making.

31 August 2022

Doctor finds opportunity in regions

Dr Alex Mitrichev is an advocate of medical training in regional Queensland. A former Russian navy doctor who emigrated to Australia 10 years ago, Dr Mitrichev worked at Cairns, Hervey Bay and Sunshine Coast hospitals before taking up a role as Principal House Officer (PHO) in orthopaedics at Townsville University Hospital. “In regional settings, you can plan your future much easier than in the bigger centres,” he says. “Townsville is a good combination of the tertiary hospital experience equal to the experience you’re potentially going to get from Brisbane or other big places, and also a lifestyle you probably will never achieve in the big city.” Dr Mitrichev and his wife, Iana, an architectural technician, have two young children and love the easy outdoor lifestyle their family has been able to enjoy in both Townsville and Cairns: “It's quick to get around, there are a lot of things to do, including for the family. People are nice, supportive, happy to help you if you have any questions. There is a lot of opportunity, especially for the kids.”

30 August 2022

Single-practice model delivers in the west

Things came full circle for GP supervisors Dr Clare and Dr David Walker this year when JCU graduates Dr Tom Currie and Dr Samantha Campbell returned to Longreach as rural generalist trainees. “It's the first time in our careers that we’ve mentored students who became junior doctors who have done their training at the bigger facilities and returned to work with us. It's really nice,” says Clare, a former Rural Doctors Association of Queensland president. “Samantha came to Longreach as a fourth-year and sixth-year student, while Tom was placed here in sixth year. They were both keen and engaged students whom we stayed in contact with the during their junior doctor and advanced skill training years.” The Walkers are helping to shape medical services in Central West Queensland, David as Executive Director of Medical Services for Central West Hospital and Health Service (CWHHS), and Clare as a board member. Operating under an innovative model of care called the CWHHS single-practice model, the hospital and health service employs salaried Senior Medical Officers who provide primary care at a privately owned GP clinic during the day and share the hospital after-hours call load. “It solved a couple of problems,” Clare says. “Medicare billings in general practice are just not fit-for-purpose in remote areas. You can’t attract and retain doctors for the salaries that they would earn through Medicare billing alone in most remote areas. There are a lot of areas in remote Queensland and, more broadly, a lot of remote areas across Australia where there are just no GPs anymore. So, if this is the model that works and we can recruit to it easily and allow the patients to have access to GPs, it’s certainly one of the models that should be looked at more broadly. “In this town, there’s that appreciation that even during a day when you’re at the general practice, looking after patients, you might have to leave with a minute’s notice to attend a delivery or respond to an emergency and then come back. You’re on call and you are providing the higher level of care that’s required in remote areas.”

25 August 2022

Paediatrics calling for junior doctor

Dr Eliza Kurth has been accepted on to the paediatric training program after spending her internship and junior house officer year training at Townsville University Hospital. Dr Kurth will start Basic Paediatric Training in Darwin in 2023 with the Royal Australasian College of Physicians on the Townsville University Hospital and The Royal Darwin Hospital rotation. She’s thrilled to be following her dream specialty. “I love the medicine, the bright little patients I get to care for, and the unique opportunity you have as a clinician to make a lasting impact on a child’s life,” the 2020 James Cook University graduate says. “I was originally drawn to a career in medicine due to its emphasis on human connection and the provision of care to those more vulnerable than yourself.” Dr Kurth has loved the training experience at TUH, and will return as a registrar in 2024. “I decided to stay local as I felt very connected to the local hospitals and communities that supported my medical training to date,” she says. “By training in a regional hospital, I feel that I was very well supported, had access to quality teaching, close consultant supervision, research opportunities and a tight-knit network of colleagues/friends that have shaped me as a junior doctor.” She says growing up in the small town in North Queensland of Kuranda was instrumental in her desire to pursue a career in regional and rural medicine. “In my spare time, I love to travel back home to go hiking, chase waterfalls and spend time with family,” she says. She returned to JCU to share her experiences with first-year students in one of the ‘Meet the Graduates’ sessions held for pre-clinical students. Junior doctors reflect on their time at medical school, share tips and tricks, and talk about placement experiences and the relevance of med modules in their day-to-day work. JCU students do at least 20 weeks of rural and remote placements during their six-year degree, which makes them work-ready from the start of internship. In sixth year, they become a valuable part of the medical workforce as student interns. “Hands down my favourite placement was my final-year rural internship at the Weipa Hospital,” Dr Kurth says. “This placement was perhaps the most pivotal in my transition from a medical student to a junior doctor. “I was independently reviewing patients in outpatient settings, helping manage patients in the emergency department and attending lots of outreach clinics in neighbouring communities (Napranum/Mapoon). I made some of my closest friends on that placement, and we spent many weekends adventuring in a 4WD, camping, fishing and learning about the local culture. “JCU provided me with all the tools and experiences required to navigate my first few years as a junior doctor. I’m incredibly grateful for my training so far, the invaluable lessons instilled in me, and the growing development of regional and rural medicine that I have an opportunity to take part in.” 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.

23 August 2022

Come for the training, stay for the lifestyle

With a broad scope of practice and unique and diverse cases, you’ll never be bored as a GP in regional and rural Queensland. But that certainly doesn’t mean it’s all work and no play. Our training region is classified as North Western Queensland, an adventurer’s playground offering a vivid mix of landscapes to explore – from glorious beaches and mountains, hinterlands, and spectacular rainforests, to wide savannah country, wilderness and the rugged Outback. It’s a vast and diverse region that covers 90% of the state and encompasses a population of over 1.6 million people. While all these communities can be classified as either regional, rural or remote, they offer vastly different lifestyle experiences. You could choose to experience rural medicine in tourist hot spots like the Cairns Coast or take the path less travelled amidst the untamed beauty of the North West. GP registrars can train in a variety of regions across North Western Queensland including Far North Queensland, North Queensland, Central Queensland and South Queensland. Dr Cindi Jackson is a GP Fellow and JCU Medical Educator in the Wide Bay region who discovered plenty to love about the lifestyle that comes with training in North Western Queensland. “I love living a two-minute drive from work. I love bringing my kids up in a pollution-free environment where there is a real sense of community. I like contributing as an important and respected member of our community. We know each other and we look out for each other. “And as an amateur photographer, I love the rural landscape, the space, the colours and the whole feel of the bush,” Dr Jackson says. Two-thirds of the 674 GPs who fellowed between Jan 2016 and June 2022 have stayed to practise in our region, like Dr Jackson. They can attest to a few of the many lifestyle benefits of pursuing your GP career in North Western Queensland: You’re in an environment that values work-life balance Registrars in our training region love the more relaxed pace of life that our regional, rural and remote communities are renowned for. It was a feature that drew dual ACRRM-RACGP registrar, Dr Rachel Yin Foo, to the Central West town of Winton. Choosing to do her advanced skills training in emergency medicine, Dr Yin Foo knew a community like Winton promised a better work-life balance. “I like the lifestyle of working in a small community, both as a GP and being on-call for the hospital. It allows for a more realistic social life than what a career in emergency medicine usually gives you. “There is a frequent social calendar in Winton and it’s well linked in with the other towns around it. There’s even an outback film festival held there,” Dr Yin Foo says. You can choose your own adventure If you like the great outdoors and are always up for an adventure, you’ll find what you’re looking for in North Western Queensland. During their downtime, you’ll find many of our registrars and GP fellows exploring the Great Barrier Reef, hiking ranges and gorges, or at the locals' best fishing spots. Dr Riley Savage is a rural generalist in the western Cape York town of Weipa. She moved back to the town two years ago and says she loves being able to provide the same adventurous lifestyle to her kids that she had during her rural upbringing. “I love the fact that our kids are growing up with the advantages of rural life that I had. We now spend every weekend we’re not working either camping or on the boat and have been swimming in more pristine creeks and waterfalls than I can count. We are totally spoilt by nature here,” Dr Savage says. Training rurally might even offer an adventure that is the fulfilment of a childhood dream, as it has for ACRRM registrar Dr Jay Short. He’s training on the beautiful Magnetic Island, off the coast of Townsville, and has jumped at the opportunity to work towards his pilot’s licence. “From the age of four, I used to run around with my arms out, pretending I was a Flying Doctor. Being able to put two passions together is pretty exciting,” Dr Short says. You get to experience real community While the landscapes vary wildly, a consistent feature of rural towns in North Western Queensland is a grateful community that will welcome you in as one of their own. Neighbours who pitch in when someone needs a hand, community events that everyone gets involved in, locals stopping for a chat when they see you in town. It all combines to create a special atmosphere that embeds GP registrars and their families into the community. Dr Nikki Harch is a recent ACRRM Fellow who trained in the Central Queensland town of Emerald and chose to stay on after fellowship, in large part due to the strong connections she developed with the community. “Over the past few years, I have been able to build relationships with my patients which just makes the work I do as a GP so much more rewarding. And because you've spent that time to build up the trust, it means that I am able to make a difference with things like vaccine hesitancy, for example. “I know my community and I trust my community, and I can definitely see the benefits of raising a family and growing my career here,” Dr Harch says. You can still have the best of both worlds When some people think of training in a rural or remote location they assume it means being isolated and cut off from the rest of the world. While some registrars will thrive on being in the furthest flung locations of our training region, many will discover a happy medium of life in a rural town that’s still - as the locals say - ‘a hop, skip and a jump from the big smoke’. RACGP registrar Dr Luke McIntosh has become a recognisable and popular figure in his training location of Mundubbera in Central Queensland and is experiencing the connection to a community of a rural GP. “Working and living in a smaller community, getting to meet everyone and feel like you’re a more valued part of the community was a big drawcard for me,” he says. “It becomes a lot easier to develop that rapport with patients when they see you down at the local show and things like that,” he says. “You still do get to go away for weekends and get to enjoy some of the highlights of the big cities but coming back to live and work in a town like this is so rewarding and it’s something that I’ve really valued,” Dr McIntosh says. You might discover your ‘Forever Home’ When you choose to work and train in North Western Queensland, you might find your new home, like Dr Catrina Arnold-Nott. She was working on Thursday Island when she visited the Atherton Tablelands for a short holiday with her family. One week later, they had bought a 120-acre farm and were preparing to move back to the Tablelands permanently. “It was a totally impulsive decision,” Dr Arnold-Nott says. “We had never talked about living in this part of the world. We had never talked about owning land. We had never, ever talked about being farmers!” “When we moved here, it was like finding home for the first time in my adult life. Up until then, I had thought where I had grown up was home and that I would probably end up back there one day. Then we moved here, and straight away I thought ‘My bones are going to be in the cemetery here’. I grew roots so quickly and so deeply,” Dr Arnold-Nott says.

23 August 2022

Rural generalists with, in and for their communities

From medical students to mentors leading primary health care in the small outback community of Barcaldine, rural generalist doctors Priscilla and Welwyn Aw-Yong exemplify the intent of JCU’s integrated training pathway. The pathway begins with the undergraduate medical degree and continues into medical specialty training, with each program sharing aspects designed to inspire a workforce willing to train and practise locally. A connection with community is forged early on, with undergraduates experiencing at least 20 weeks of rural and remote clinical placements, and continues through to postgraduate specialist training in general practice and rural generalism in the region. When the Aw-Yongs were deciding where to pursue their GP training, a second-year rural placement in Barcaldine during her undergraduate degree came straight to Priscilla’s mind. “I got a very positive impression of Barcaldine in the four-week placement, so that’s what we applied for,” Priscilla says. “Just seeing the way the practice was run and watching the doctors and how they work; they were relaxed and approachable to us students. I think that’s what drew us to Barcy.” The JCU graduates moved to Barcaldine in 2018 and quickly became embedded in the community and advanced in their training and careers. With plenty of training and development opportunities on offer in rural settings like Barcaldine, it wasn’t long before the students became teachers. Now a JCU GP medical educator, Priscilla works across the hospital and Barcaldine Medical Centre providing care to patients and training junior doctors on the JCU GP training pathway. Likewise, Welwyn has made the most of the advancement opportunities on offer for rural generalists. After fellowing through JCU with ACCRM in 2020, Welwyn now works as Acting Director of Medical Services at Barcaldine Hospital and Multipurpose Health Service in addition to his work at the local GP practice. The couple’s story is a familiar one in towns across JCU’s 11 GP training regions, where graduates have become integral to their communities’ health, providing continuity of care and stability. JCU is Australia’s only university delivering both undergraduate medical education and postgraduate general practice training. By selecting values-aligned students to undertake the undergraduate program, 70 per cent of whom are from rural and regional areas, JCU is increasing the likelihood of graduates choosing medical practice in those areas. Peer-reviewed research shows almost half of JCU’s first 10 cohorts of doctors are practising in regional, rural and remote Australia. Just as importantly as addressing workforce maldistribution, more than half of JCU’s postgraduate year 5-14 medical graduates have chosen to become general practitioners, rural generalists or generalist specialists. Of the 758 GP Fellows JCU has produced, approximately two-thirds have stayed on in the North Western Queensland training region. JCU’s training pathway is purposefully designed to produce doctors who are passionate about rural health. Broad scope of practice is a major drawcard for GP registrars who choose to train in rural Queensland. Rural GPs see a wide range of presentations, perform a range of procedures and provide other services to improve the overall health of rural and remote communities. Welwyn loves the diversity of his combination of roles. “Barcaldine is the type of place where you have to think on your feet. Sometimes there might not be anybody else; you can’t just refer them ‘down the road’,” he says. “You do all these investigations and emergency procedures yourself, particularly as you get into advanced skills training. You have this really broad scope of practice and that is very rewarding.” Priscilla, who completed internal medicine advanced skills training, says her aim as a medical educator is to build a strong relationship with GP registrars. “We’re sharing their successes, the light-bulb moments, and the challenges. On top of teaching, I see the role as providing mentoring and pastoral care elements as well. Living and working rurally, while rewarding, isn’t all rainbows and sunshine. We’re in it together.” "The broad scope of practice as a rural GP is complemented with a focus on building long-term relationships with patients. “One of the best things about being a rural generalist is that you care for your patients through a whole journey. When they’re well, having a check-up at the GP clinic, when they’re unwell, and often looking after their families, parents and children. That’s a big part of what I think is amazing about GP,” Priscilla says. Now in their fifth year at the hospital and general practice, the Aw-Yongs are helping provide the town with something it desperately needed in its access to a GP: stability. “When we arrived in Barcaldine, one of the first questions you get from patients is ‘How long are you going to stay here?’. Then it was ‘I’m surprised you’re still here’. It goes to show that communities like Barcy get used to doctors leaving,” Welwyn says. “I think our biggest need is having doctors willing to stay on a more permanent basis. We haven’t had many who left in our time here, which is good. It makes a big difference when your patients see you here for a longer time, putting down roots in the community.” By pursuing GP training in a rural setting, as the Aw-Yongs have done, doctors discover supportive and close-knit communities. “People work together and feel passionate about the town, and that draws you in,” Priscilla says. “Coming from big city backgrounds, we’ve been struck by how friendly everyone is here. People actually stop to say g’day here, even if you don’t know them. It’s very easy to meet people in Barcy.”

20 July 2022

How GP training in a rural setting makes you a better doctor

After more than half a decade of undergraduate medical education and years working in a hospital or health service setting, you’ve reached this point – applying for specialty training. As you weigh up your options, ask yourself, ‘what kind of doctor do I want to be?’. If you got into medicine because you love a challenge and you want to make a real difference, learn from current registrars and fellows about how undertaking the Australian General Practice Training (AGPT) program in North Western Queensland can shape you into an exceptional specialist. From the rugged Outback to the Tropical coastline, our diverse training region covers all of Queensland except for the South East, and offers a unique training experience. Registrars in our region all have their own story to tell, but there is a common thread tying them together: the scope of practice you get as a rural GP is unbeatable, and you’re more competent, confident, and fulfilled because of it. Just ask Dr Steve Salleras, a GP with 21 years’ experience practising in Far North Queensland and Medical Educator with James Cook University (JCU). “Guaranteed, rural and remote medicine will make you a better doctor,” Dr Salleras says. “You’ll learn resilience and self-efficacy at a level you cannot learn in an urban environment.” General practice specialty training commences through AGPT from PGY2 and it takes three years to complete full-time. It’s a shorter training pathway that’s available to you earlier than most other specialties, but don’t be fooled into thinking that makes it the ‘easy choice’. General practice is challenging, just as it is rewarding. “It’s a hard job,” Dr Salleras says. “Even now I don’t have ‘neat and compact’ days where everything is easy. But I didn’t become a doctor looking for easy. The challenging and unexpected aspects of rural medicine are part of why it is so satisfying. “As far as living a life of purpose, meaning, and connection, rural general practice ticks all those boxes in a big way,” Dr Salleras says. From what Dr Salleras has seen in his role training JCU GP registrars in Cairns and surrounds, the broad scope of practice and the challenges of limited resources are part of the formula for rapid skills development and knowledge. “As a rurally based GP registrar, you’re exposed to a range of cases, and you could be involved in the whole system in terms of service delivery. It brings a perspective and habits that can be really helpful in reducing barriers for your patients,” Dr Salleras says. Broaden your horizons with a broad scope of practice Are you considering general practice training because of the diversity of presentations and broad scope of practice? Not all GP training experiences are created equal. Rural practice offers more diversity and responsibility than you could probably expect in an urban setting. One young doctor who can attest to this is Dr Daniel Bakhsh, a JCU GP registrar from Melbourne who has recently taken up a training post in Tully, 140km south of Cairns. Only a few months into his GP-based training, Dr Bakhsh is already feeling like he is right where he needs to be. "In metropolitan and tertiary centres, GP registrars often feel more like referral centres for hospitals, and that your role is largely administrative in the context of a medical team. You don't really have the opportunity to grow and develop as a clinician,” Dr Bakhsh says.“Even as a relatively new rural-training registrar, I've already been able to undertake procedures, manage complex patients and make significant medical decisions for my patients, under the supportive guidance of my GP supervisor, who has a vested interest in the health and wellbeing of their community,” Dr Bakhsh says. For Dr Bakhsh, the experience he is receiving at the town’s only general practice can be summed up simply as ‘this is why I became a doctor’. “I'm engaging with medicine in a really meaningful way, and finally directly applying the skills and knowledge I've acquired over the past several years of training to better the health of my patients. It's incredibly gratifying,” Dr Daniel Bakhsh says. Experience the best of both worlds as a rural generalist Do you like to be in the middle of the action? Rural GP training gives you the opportunity for you to provide continuity of care while keeping your connection with a hospital. The Rural Generalist Pathway combines the provision of community-based GP services as well as hospital-based specialised services such as obstetrics, anaesthetics, and emergency medicine. As a Rural Generalist, you can call the shots and experience real variety. ACRRM Fellow and rural generalist Dr Emma Gillmore moved to North West Queensland in 2018 to complete GP training with JCU. She says Cloncurry offers a broad scope of practice and diverse patient caseload, which provides the perfect opportunity for junior doctors to fast-track their growth and competency. “There’s only a couple of us in town, so if you’re on call then whatever comes through the door, you’re the doctor who handles it. The other day, a patient needed a lateral canthotomy, which is a really rare procedure. Another doctor and I performed the procedure, and it’s not something we would get the opportunity to do in a larger tertiary hospital setting,” Dr Gillmore says. “You see a lot of patients with significant chronic diseases that you wouldn't necessarily see in city areas. You manage everything out here. You manage strokes, heart attacks, car accidents, paediatric issues, gout, arthritis. You’re the rural GP, it’s up to you," Dr Gillmore says. Working rural can advance your career With a less competitive training environment compared to larger settings, GP registrars, like Dr Shane Sadleir, have discovered plenty of opportunities for professional development in a rural setting. Just a year into training in Cooktown, he’s taken on a clinical lead role as Senior Medical Officer with the Torres and Cape Renal Unit at the hospital. “I’m really enjoying the role and the added responsibilities. You get a lot of diversity, and your day is so different and often quite exciting,” Dr Sadleir says. It’s a similar story for Dr Welwyn Aw-Yong in Barcaldine. The ACRRM Fellow completed his JCU GP training in 2020 alongside his wife Dr Priscilla Aw-Yong. They chose to stay in Barcaldine, and they’ve been embraced by the medical and broader communities. Welwyn is now the Acting Director of Medical Services at Barcaldine Hospital, in addition to his work at the nearby Barcaldine Medical Centre. “Barcaldine is the type of place where you have to think on your feet. Sometimes there might not be anybody else; you can’t just refer them ‘down the road’,” he says. “You do all these investigations and emergency procedures yourself, particularly as you get into advanced skills training. You have this really broad scope of practice and that is very rewarding.” Advanced skills training opens doors and contributes to healthier communities Another element of general practice training that can make you a better all-round doctor is advanced skills training. Advanced skills are focused on enhancing the procedural and clinical services GPs can provide in non-urban settings. For ACRRM registrars and registrars completing a Fellowship in Advanced Rural General Practice (FARGP) through RACGP, advanced skills training is a compulsory requirement. A wide range of Advanced Specialised Training (AST) for ACRRM registrars, or Advanced Rural Skills Training (ARST) for RACGP registrars, includes: Aboriginal and Torres Strait Islander Health Academic Practice Adult Internal Medicine Anaesthetics Emergency Medicine Mental Health Obstetrics and Gynaecology Paediatrics Palliative Care Population Health Remote Medicine Surgery Dr Erica West is a JCU GP registrar on the rural generalist pathway who chose to do advanced skills in paediatrics. “This advanced skill allows me to practise medicine in an acute setting as well as focusing on preventative health and health education to help grow stronger and healthier future generations,” Dr Erica West says. In a vast region with far-flung remote communities, the hospital and health services in Mount Isa play a crucial role in meeting the health needs of a population of approximately 32,000 people across 300,000 square kilometres. “I would encourage other GP registrars to go rural and do advanced skills, purely for the fact that you get a lot more experience in an area where you get to develop your interests and become very useful. It’s a lot of fun to get more involved in one area, but it doesn’t take away from any other areas that you get into in rural generalism,” Dr West says. So, are you up for the challenge? General practice training in North Queensland is challenging and rewarding, and it can help unlock your full potential as a doctor. Dr Salleras sums it all up in these terms: “In our world of medicine, it’s crucial we have people working at their maximum capacity. People have an enormous capacity, but they’re often underperforming because of the system they’re in. It causes burnout because it’s frustrating, not to mention an incredible waste of resources. “Compare that to rural medicine, where you will be stretched and tested in a way that grows your skills and competency. You’re much more likely to be using your full capacity in rural practice,” Dr Salleras says. The Australian General Practice Training (AGPT) program is opening its second recruitment intake for 2023, providing 1,500 Australian Government-funded places for registrars to attain a GP fellowship.

7 July 2022

An Outback adventure just what the doctor ordered

Dr Christopher Akwuobi graduated from medical school in Nigeria eager for a challenge and passionate about helping people. He found what he was looking for, and much more, in the North-West Queensland town of Mount Isa. Arriving in Australia in 2020, Dr Akwuobi first completed a three-week medical observership at Mount Isa Medical Centre, then secured a position as a medical officer at Mount Isa Hospital. He says the Outback mining town ‘feels like home, just a little hotter’ and has provided a balance of interesting clinical work and excellent supervision; exactly the kind of medical experience that had brought him to Australia. “I chose Mount Isa because I've always known from my background in medicine that rural areas are where you’ll see the more challenging cases and get more hands-on experience,” Dr Akwuobi says. While rotating throughout the hospital’s departments, Dr Akwuobi found himself gravitating toward the emergency department (ED), an area he was already familiar with from over 10 years of work back home in Nigeria. “I’ve always been in the ED and general practice since graduating. Watching how an Australian emergency department is run was a very good experience. Right now I’m looking at doing specialty training in emergency medicine after I get my general registration,” Dr Akwuobi says. Mount Isa Hospital has been the perfect place for a doctor like Dr Akwuobi who is interested in training in emergency medicine. As a part of the North-West Hospital and Health Service (NWHHS), the hospital services NWHHS serves a population of approximately 32,000 people across 300,000 square kilometres. Dr Akwuobi has seen a diverse range of medical cases in emergency from young to elderly patients, including acute coronary syndrome, allergies and anaphylactic reactions, sepsis, orbital cellulitis, stroke, head injuries, lacerations and complex fractures, pneumothorax, GI bleeding, appendicitis, cholecystitis, diverticulitis, bowel obstructions, alcoholic liver disease, and a range of chronic health conditions. “Some of the things I have observed in Mount Isa were completely new to me. You see a lot of complex cases and chronic issues as well as a lot around Aboriginal and Torres Strait Islander health,” he says. The need for more doctors is an issue facing many of our regional and rural communities, and Mount Isa is no exception. Dr Akwuobi says he could see the strain on the town’s health services, particularly when it came to general practice. “If we don’t have enough GPs, it adds a burden on the emergency department as patients are presenting with issues that would be more suited to treatment in general practice. We try as much as we can to see all the patients, but with long wait times you might have patients leave rather than wait for treatment, which impacts health outcomes,” he says. The diverse and complex caseload Dr Akwuobi was seeing significantly grew his clinical skills and knowledge. Supporting him every step of his progression was what he says is the best medical supervision he’s ever worked under. “It’s not your typical supervisor-trainee relationship, it was more of a closer partnership,” Dr Akwuobi says. “We have consultants and senior medical officers available most of the time so if you were ever confused, you could always get someone to support you. They were also very helpful for me as an International Medical Graduate They're able to guide you, especially with Australian guidelines. Honestly, these are just some of the best doctors I've ever worked in my career. “There is a culture where people don’t say no to each other, as far as it is in their ability to help, everyone was really happy to support one another. You don't have any issues at all when it comes to relationships with colleagues. Because they're all very lovely. It was a very peaceful environment.” Dr Akwuobi says. “When you’re not working, there are all these things you can do. I have a neighbour who loves hiking so we can do all these adventures in the middle of nowhere! I got involved in a local football team. There’s definitely enough to balance your work and life.” Dr Akwuobi was in Mount Isa for 14 months before relocating to Hervey Bay to complete work-based assessment required for full registration in Australia. He remembers his time in Mount Isa incredibly fondly and is excited by the prospect of returning to the region. “I don't think I am interested in practising in the big cities after my rural experiences. I would be very happy if I had the chance to go back to the North-West. It’s all dependent on applying during the annual recruitment campaign and going through the process,” Dr Akwuobi says. Traditionally, Mount Isa might not have been considered the ‘place to be’ for medical training, but the sentiment is changing. Dr Akwuobi’s positive experience is shared by others, like Dr Sally Magoffin, and they’re encouraging more doctors in training to discover for themselves what the town has to offer. “It’s a very good place to do your medical specialty training, particularly when it comes to emergency medicine. I'll say it is one of the best medical communities I've worked in. The consultants, my colleagues, the whole allied health team; were all wonderful. The whole experience means a lot to me and has really helped my medical practice,” Dr Akwuobi says.

1 July 2022

Pieces fall into place during internship

Useful career planning resources > How to write your CV> How to write your cover letter> Interview tips and tricks> 7 reasons to train in northern Queensland > Clinical career structure

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.”

13 June 2022

Open to adventure

A temporary primary school teaching job was the launching pad for Dr Ineka Booth’s rural generalist career in the Aboriginal and Torres Strait Islander community of Palm Island (Bwgcolman). Dr Booth was training as an emergency registrar at The Tweed Hospital when her partner, Adrian, got the opportunity to do a six-week teaching contract on Palm Island in 2020. “He really loved it. He thought the community was amazing and that I would really enjoy working in this environment,” she says. “At that stage I was I was already thinking of making the switch to rural generalism training and looking at the possibility of doing a fellowship through ACRRM (Australian College of Rural and Remote Medicine). We decided to move here together and have both had fulltime jobs on the island for the past 14 months.” Her two and a half years of training with the Australasian College of Emergency Medicine (ACEM) have helped her gain accreditation for an advanced skill in emergency medicine. “It’s an amazing and unique experience to come to Palm Island as a registrar,” Dr Booth says. “There are a lot of examples of the challenges of remote medicine and the problems facing Indigenous people, but that makes the job interesting and rewarding. Sometimes, the little successes feel like big wins. In terms of my development as a registrar, it's been a really fantastic step and it has come at the right stage in my career, being able to have that broader scope of experience.” Dr Booth has been one of the Queensland Health doctors supporting the transition of the island’s GP services to the Palm Island Community Company (PICC). “As part of the overall Palm Island Action Plan, we were always planning to transition away from having a Queensland Health-run primary care practice,” she says. “It's been really lovely to see this transition because we have a strong emerging Aboriginal Community-Controlled Health Organisation (ACCHO) that's taking leadership and ownership of primary health care amongst other broader community services. “We've maintained a strong medical workforce at Joyce Palmer Health Service, the hospital here, and the idea is that over the next few years, they become complementary but separate services.” Remote medicine brings leadership roles For Dr Booth, the excitement of emergency medicine as a provisional Senior Medical Officer and the rewarding work of general practice are a perfect mix. “I’ve really enjoyed the broader scope of practice associated with rural and remote work, and the fact that I have some lovely continuity of care within the primary care centre and some clients I've made progress with over the last 12 months in terms of their chronic health conditions,” she says. “I like the fact that I can keep my skills up in emergency medicine and still get some good emergency cases. Remote medicine exposes you to leadership roles that you would never be exposed to in a bigger centre. “It has been nice to have the opportunity to step up into those leadership roles and start to think of health in a holistic way where it's not just about the patient in front of you, but it's about the cultural implications of what you're doing and how we're going to overcome the unique challenges that face us here on the island due to various things like remoteness.” She says excellent mentors on the island do a great job of initiating cultural education and giving feedback. “We have some fantastic Aboriginal Health Workers and Indigenous Liaison Officers who help us provide culturally appropriate care,” Dr Booth says. “The community has been incredibly welcoming to people who come here and show this place the respect it deserves.” Bettering population health Dr Booth studied medical sciences at Australian National University, with an exchange year at Stockholm University in Sweden, before completing medical school at Deakin University in Geelong. She also holds a University of Melbourne honours degree in autoimmune diseases. “I really wanted to secure my skills in emergency medicine before I exposed myself to this kind of role,” she says. “Going into the ACEM qualification, I wasn't entirely sure whether I'd end up completing it or going into rural medicine with an emergency skill. I'm quite happy now that I've had the exposure to a remote job that gives me the best of both worlds. “The learning curve has been steep but looking back on the last 14 months, it's really progressed me a lot in terms of my career and skills and understanding of Indigenous health, remote health and how to tackle health from more than just what’s in front of you, but from an entire population or community point of view.

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.

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

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.

10 May 2022

'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.

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

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.

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.”

14 April 2022

Finding your place in the medical world

When psychiatry registrar Dr Kiran Sharma arrived in Townsville from Canada, she was a locum radiation therapist contemplating a career change. “I had a few great mentors in radiation oncology who suggested I apply for medicine,” Dr Sharma says. Plan B had been to return to Canada to study law, but she instead took a detour after her travels and gained entry to James Cook University’s medical degree program. Now in her third year of psychiatry training at Townsville University Hospital, Dr Sharma has worked all of her junior doctor years and started a family in North Queensland since graduating in 2015. She is currently in a clinical and academic role educating medical students and junior doctors as the medical education registrar for psychiatry. “The sunny weather and casual lifestyle were appealing and have kept me here for 12 years,” Dr Sharma says. “James Cook University provided a broad base of medical knowledge with particular attention to tropical medicine, regional and remote areas and Indigenous populations, all of which has helped me relate to and help my patients.” Her career design has been a balance of family and work life, in a field where she can spend time to understand the issues her patients face and help them make positive changes for their mental wellbeing. “Every day is unique and challenging,” she says. Dr Sharma is one of the mentors in a peer support group Northern Queensland Regional Training Hubs (NQRTH) has set up to help international fee-paying students navigate the Intern Campaign and the complexities of having to apply both interstate and in Queensland. The peer mentor group connects current interns, who were last year’s graduating international fee-paying students, with current JCU international fee-paying students. Dr Sharma shares her experience and tips for international medical students: Reaching the pointy end “You have worked hard for six years studying medicine, whilst being far away from home and paying international tuition fees. During these years, you were given equal opportunities in medicine, but now at the pointy end of the journey, you realise that Intern allocations are citizenship based, and you will have to wait your turn for an internship, so now the panic is setting in! “The year I graduated from JCU medicine was a rare year where Townsville University Hospital was fully subscribed by domestic students, and I believe this has not occurred in the many years since. There were no public hospital internship allocations available for International Medical Students (IMSs) in the state initially. “It was horribly stressful. It was anxiety provoking. It was hard to keep perspective. I worked so hard alongside my classmates and paid my way, which involved working part-time and living frugally, and yet the divide between us remained and they would get a job and I would have to wait. It seemed unfair not to have a merit-based system. Making the most of opportunities “Fortunately, my patience paid off, and within a few months I was offered a Mater Hospital internship with most of my rotations in the public hospital and my ED rotation in Cairns. The year was amazing for learning, growth and professional development. “I was not disadvantaged in the slightest as an IMS. I earned the same amount as my peers and my experiences were no less valuable. Your experiences and opportunities will always be what you make of them. The support I received as a Mater intern was incredible because of the small intern cohort. Interviewing and career anxiety “Developing interview skills as a medical student helped me succeed in my future opportunities when successfully interviewing for internship, RMO campaign and my registrar training position with Mental Health Service Group and the Royal Australian and New Zealand College of Psychiatrists (RANZCP). “The divide is no longer there. I am now an Australian medical school graduate, working in North Queensland as a dual citizen. My opportunities are no different from those I studied with and the challenges I overcame made me stronger and more ambitious. “Being worried about waiting for your career to launch is normal and completely understandable. However, the odds of getting an internship as an IMG are in your favour. Did you know that most IMSs who want to remain in Australia are employed after their final year of medicine? “Things will work out for you more likely than not, and if you are fortunate, you will have the chance to pursue your dream specialty and give back to medical students and junior doctors who face similar stressors, just as I have." Kiran’s top tips for students “In the meantime, do not lose perspective and positivity. Worrying about things you have no control over will not change the outcome. Here are some tips for peace of mind: Keep healthy – exercise, get fresh air, eat well. Start to prioritise your mental and physical wellbeing while you do not have the pressures of internship. Practise what you will be preaching. Keep busy – idle time is more time to worry which will not help you. Use spare time to build your CV, work on research and maybe earn a publication or volunteer. When distinctions will be merit based you will be thankful you bolstered your CV. Consider what areas interest you and start developing your CV for that area. Think strategically about where you want to work. Working in a major centre might not be possible, so consider regional options, or private options. Have a list of first, second and third choices. Be prepared to think outside of your comfort zone. Rejection is not failure, it is an opportunity to reapply yourself. Movement before and after internship is common, so if you don’t get your first choice, there’ still time down the track to apply for future positions. Don’t lose your self-esteem. The IMS internship allocation process is just that, a process, and many of us before you have survived. Don’t lose sight of who you are and what you offer. Prioritise time with people who are supportive and positive. Speak to someone if stress or worries are affecting your mental wellbeing. It could be as informal as a coffee with a mate, or an appointment with your GP. Caring for your own mental health will help you be a good doctor. A network of medical training opportunities 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.

12 April 2022

Be there for Barcaldine: Drs Priscilla and Welwyn Aw-Yong

Be there for the community, be there for the teamwork, be there for Barcaldine. It won’t take long for you to feel right at home in Barcaldine. This small central-west Queensland town is bustling with community groups and friendly locals who welcome newcomers with open arms and chip in when someone needs a hand. The embodiment of this community spirit is initiatives like Artesian Original, a co-op craft store in the main street of town. The small store open two years ago and now features the crafter of 57 makers from Barcaldine, providing a community focal point, a creative and social outlet, and raising funds for local charities. Megan Otto, a jewellery maker with Artesian Originals says: “This is about doing something fun and showing that there is always something social to do in Barcaldine. It’s one of those towns where everyone will say hello to you. You can talk to anybody, you’re welcome anywhere, there’s always a lot going on, it’s just a lovely community. If you come here with an open mind and get involved, you’ll probably stay here for life!” Doctors who come to work and train in Barcaldine will find themselves embraced by the local community, as husband and wife rural generalists Dr Welwyn and Dr Priscilla Aw-Yong can attest. The JCU graduates moved to Barcaldine in 2017 and quickly became embedded in the community and advanced in their training and careers.

8 April 2022

Be there for Mundubbera and Monto: Dr Htoo Aung

Be there for professional and personal growth, be there for the doctor-patient relationships. Be there for rural Queensland towns like Mundubbera and Monto. There’s more than meets the eye to the Queensland central-west town of Mundubbera. What might seem like your ordinary rural town is bursting with industry and opportunity. The ‘salad bowl’ of Queensland is famous for its harvest of citrus, grapes, and a range of other fruit. This plentiful growing region also offers the opportunity for growth of a different kind. Junior doctors who choose to pursue a career in general practice are discovering that the region is a great place to be for both professional and personal development. Dr Htoo Aung sought out a training placement in the region because he knew how valuable the experience would be to his progression as a GP. After spending the past two years as a Public Health Officer at Bundaberg Hospital, Dr Htoo commenced JCU GP training in 2022, making the move to Monto, a small town an hour north of Mundubbera. “I am really interested in rural medicine. This hospital [Monto] is a bit further from a regional centre so it means I am doing a lot more myself here,” Dr Htoo says. “It’s exposing me to a lot of different procedures, experiences and patient cases. We can manage a lot of things on our own here so that’s why I decided to come here and I am really enjoying it so far,” Dr Aung says. “When I started here, I didn’t know exactly what I would be doing. Given my past experience, I felt more comfortable in the hospital at first. But my supervisor at the GP clinic has been really supportive and I’ve started seeing patients here and understanding the GP practice system.” On top of being well supported by the hospital and clinic teams, GP registrars who come to train in the region will quickly find themselves embraced by the wider community. The locals are acutely aware of the GP shortage and welcome JCU GP registrars with gratitude and open arms. Local Graham Rowles Jr understands the difficulties in accessing health services in towns like Mundubbera. The son of long-term local GP Dr Graham Rowles Snr, Graham himself has worked as a pharmacist for over 30 years before taking on the family citrus business, Margram Orchards. "Doctors, pharmacists, most roles in primary health care; it is a challenge getting them out here,” Graham says. “There's definitely an impact on the health of these little communities. Having worked as a pharmacist in both metropolitan and rural settings, I definitely encourage health professionals to go rural. You get to know your patients, socially and medically, and you really become part of the community."

5 April 2022

Be there for Emerald: Dr Natalia Anderson

Be there for the opportunities, be there for the locals. Be there for rural Queensland towns like Emerald. Emerald, the ‘jewel in the crown’ of Queensland’s central-west. For decades, many have flocked to the outback region in search of precious gems. Now, there’s a new opportunity that’s attracting attention, and it’s contributing to the growing population and a vibrant community. Emerald is fast becoming recognised for its outstanding health facilities and training opportunities. For junior doctors like Dr Natalia Anderson, the town has been the perfect place to pursue a career in general practice. “You've got supervisors and bosses who want you to excel and will get you really involved doing procedural skills,” the second-year JCU GP Registrar says. “It motivates you to stay here because it is such a supportive environment to learn and develop as a doctor. “It’s not competitive between registrars like it can be in metropolitan hospitals. No one is left behind in terms of meeting your training requirements and getting your procedural skills time. “I think the social side of life in Emerald has been another bonus in terms of making us want to stay here. You work together and you socialise together. It helps increase the morale and the ability to work well and efficiently.” The opportunities Emerald offers have extended to Natalia’s partner, Grant, who made the move to Emerald for Natalia’s training. In doing so, Grant was able to achieve his dream of opening his own business as an exercise physiologist. “As health professionals, you can feel that the community is very keen to keep us here,” Dr Anderson says. “We’ve seen this in how people have supported Grant’s exercise physiology business. He’ll be based at the Emerald Medical Group Practice where I’ll be starting the GP side of my training. This opportunity has helped go a long way in getting us to seriously think about setting down roots here in Emerald.” The community in and around Emerald are all about finding opportunities and making the most of them. Tyler Brown returned to the region to carry on the family business, Rubyvale Gem Gallery, with his brother Mitch. They’re expanding his father’s gem business with a brewery and holiday accommodation.

5 April 2022

7 Reasons to do your medical training in North Queensland

Doctors are discovering for themselves why medical training in North Queensland offers a rewarding experience like no other. The opportunities in the North are as unique and varied as the beautiful landscapes. Here are seven standout reasons we hear time and again from medical students and junior doctors on why they decided to pursue training in North Queensland. 1. Make a difference to communities that need you If you chose to become a doctor to make a difference, then North Queensland is the place for you. With a shortage of GPs and specialist services in northern Queensland, the region’s healthcare needs are underserved and it’s impacting the health of these communities. Dr Hannah Bennett decided to pursue specialty pain medicine training in Townsville after seeing the need for services in her role as a rural generalist in Ingham. “I became much more aware of the lack of pain services outside metropolitan areas and decided to do my fellowship,” Dr Bennett says. “Our pain service in Townsville is the only one outside of the southeast corner of Queensland. “There's a severe lack of specialist pain services not just for rural and remote Queensland – First Nations people are underrepresented in referrals and that's not because they don't have persistent or chronic pain, it's just that they don't have access to services that are safe and culturally appropriate.” By being where the need is, you will be playing a significant role in improving the health of rural and remote, and Aboriginal and Torres Strait Islander communities.

28 March 2022

Be There for Cloncurry: Dr Emma Gillmore

Be there for the scope of practice, be there for the continuity of care, be there for Queensland towns like Cloncurry. The small northwest town of Cloncurry stretches just a few kilometres along the Barkly Highway, an hour and a half out from Mount Isa. But don’t let its size fool you. Cloncurry is a growing and diverse community with some of the friendliest locals you’ll meet in your life. Cloncurry is also a place where junior doctors are discovering a rich and rewarding career as general practitioners. Dr Emma Gillmore, GP and Senior Medical Officer moved to Cloncurry in 2020 with her husband and two young daughters to commence GP training through James Cook University’s program for registrars. “There's a really strong community spirit in Cloncurry. I think there’s a palpable difference being in Cloncurry compared to a lot of other places. There is a really strong sense of unity,” Dr Gillmore says. From a clinical perspective, Dr Gillmore says Cloncurry offers a broad scope of practice and diverse patient caseload, which provides the perfect opportunity for junior doctors to fast-track their growth and competency. “You see a lot of patients with significant chronic diseases that you wouldn't necessarily see in city areas. You manage everything out here. You manage strokes, heart attacks, car accidents, paediatric issues, gout, arthritis. You’re the rural GP, it’s up to you." “There’s only a couple of us in town, so if you’re on call then whatever comes through the door you’re the doctor who handles it. The other day, a patient needed a lateral canthotomy, which is a really rare procedure. Another doctor and I performed the procedure, and it’s not something we would get the opportunity to do in a larger tertiary hospital setting,” Dr Gillmore says. With plenty of long-term locals in Cloncurry, GPs have the opportunity to build strong doctor-patient relationships. It’s a facet of general practice that contributes to better health outcomes for patients and can also be incredibly rewarding for doctors, as Dr Gillmore has found. “As a GP in Cloncurry, you manage every breadth and every facet of people’s health, both their mental and physical health. It is very rewarding to be part of your patients’ journey through life and health care. “You’re seeing a patient through pregnancy, then you’re caring for the child as well. That’s the whole point of rural generalism, that if you stay here long enough you get to be part of the generations of these families, which to me is amazing,” Dr Gillmore says. Auxiliary Lieutenant Andrew Hobbs from the Queensland Fire and Emergency Service moved to Cloncurry six years ago to pursue career opportunities. He’s seen and felt the impact of a doctor shortage in the region and summed up what it would mean to have more junior doctors choose to work and train in Cloncurry. “We're a long way away from the metropolitan coast. The ability to have more doctors come out to be trained up here would be a big thing for Cloncurry. We're all one big community and to get a range of professionals out here training and practising their craft is important for developing the bush,” Lt Hobbs says. “It's a great opportunity to do something different and get to know some great people. If you're new to town and you don't know anyone, head down to the pub and park yourself at the bar; you'll have some friends in no time!”

21 March 2022

Be There for Rural Queensland

Dotted right across Northern Queensland are rural towns with a lot to offer. Communities of friendly locals who always have time to stop for a chat, who rally around one another when someone needs a hand. Enterprising businesses, dedicated volunteering initiatives, and vibrant social scenes. In early 2022, James Cook University’s GP Training program travelled to five of these towns in the region to gather stories in the communities that will welcome new General Practioner registrars in 2023. Featuring Cloncurry, Barcaldine, Emerald, Yeppoon and Mundubbera, the ‘Be There. For Them’ campaign gives future GPs a glimpse into life in these vibrant communities. From farmers and graziers to entrepreneurs, librarians, bakers, and young families. We’ve showcased diverse communities that are facing a common problem: access to high-quality healthcare close to home. There is a critical GP shortage in remote, rural, and regional areas across Queensland that is impacting the health outcomes of these communities. There are 3.8 doctors per 1,000 people in Australia’s cities, a figure which drops drastically to 2.3 per 1,000 in rural and remote areas. As Australia’s only university training a fit-for-purpose health workforce, from undergraduate medical studies through to general practice, JCU is entirely committed to the region. This commitment is echoed by a rural and remote healthcare network who provide and support valuable health services from the Torres Strait to the Sunshine Coast, who are all about training doctors to meet health needs in underserved communities. As we travelled across rural Queensland, locals would frequently share stories of how far they have to travel to see a doctor, of waiting times up to a month, and how the longevity of GPs staying in town can sometimes be measured in months, rather than years. Some of the community members summed up the need and what more doctors would mean for their town:

17 March 2022

Indigenous doctor's Cape ENT surgery dream

Torres Strait Islander doctor Lisa Waia first glimpsed herself as an ear, nose and throat surgeon during a James Cook University medical placement on Cape York Peninsula. After seeing an ENT surgeon and his registrar in action on a Deadly Ears outreach to Cooktown and Hope Vale, she returned full of dreams of becoming a surgeon who could make an impact on chronic ear disease in far northern Aboriginal and Torres Strait Islander communities. The dream has crumpled many times under the weight of stereotypes and self-doubt, but it’s becoming a reality for the Townsville University Hospital principal house officer and 2016 JCU graduate. “My cousin brother and I both graduated from high school in the same year. We were the first out of our family to finish high school,” Dr Waia says. “I went on to university and was the first of my family to finish up with a bachelor's degree, which was really exciting.” Dr Waia says it was a struggle to find her place during her junior doctor years. “I don't come from medicine. I don't come from a line of doctors. I don't even come from a line of professionals,” she says. “Boys and men in my family are labourers and the women are usually stay-at-home mums or work casual jobs here and there. Coming into a profession like medicine was daunting. “I've had my fair share of having imposter syndrome as my baseline and then having snide comments come my way that medical students who are Indigenous don't have to pass their exams or they have a really low pass mark or they let anyone into med school, which is not true. “We've done the degree; it's definitely not easy. But it just compounds that imposter syndrome, which is really upsetting. Then, getting into the workforce, you come across systematic barriers and challenges that our people face. It gets a bit exhausting after a while being someone who's trying to be the voice of our people, which is in no way my responsibility, every time someone makes a negative comment or voices a stereotype. “When I come across someone who's got a negative mindset or stereotype about my people or my culture, I go back to the basics and talk through it because I don't think they understand quite how many horrific things have happened, and the intergenerational cycles of trauma that are in place.”

8 March 2022

Breaking through barriers

Iranian-born Dr Rozita Parnian feels a sense of pride when she sees a female surgeon leading the way at work. “It’s really empowering. I feel proud even though I'm not in her team,” says Dr Parnian, who migrated to Australia with her two older brothers in 2012, seeking asylum. Seeing strong, capable women with family responsibilities make their way in male-dominated medical specialties allows Dr Parnian to picture the same future for herself one day. “In Iran, men are always 100 steps above women. That's true for any kind of situation. It doesn't matter whether it's education, the workplace, trying to get any kind of legal rights,” she says. “You have equal rights and equal access to everything here in Australia. I think sometimes people take it for granted. Although it’s been hard, I still feel happy and feel lucky to be here.” Dr Parnian started her internship at Townsville University Hospital in January. That she would graduate from James Cook University with a Bachelor of Medicine, Bachelor of Surgery in 2021 was almost unimaginable to her 10 years earlier as a Brisbane high school student struggling with language barriers. “I thought, ‘I know a bit of English and it's not going to be a problem’. I knew some English in terms of American English. But then when I came to Australia, it was so different because people were talking in a different kind of accent,” she says. “I wanted to become a doctor since I was a child and then, all of a sudden, I was here in Australia and I wasn't even able to talk in the language, let alone study medicine. I found myself in a position that my dreams had shattered so I had a difficult time during the first year, trying to accept the reality that it would be hard for me to get into medicine. But then I thought maybe just start from zero, study English and try to do my best to get into medicine. “I had subjects that didn't require much English, like maths, physics, chemistry and accounting. I did well in all of them and got the OP I needed. But it was hard in a different system and a totally different environment.” As a temporary visa holder, Dr Parnian was considered a full fee-paying international student. With scholarships from James Cook University and AMA Queensland, and her brothers working to help support her financially, she completed the six-year JCU medical degree. “It was the JCU and AMA scholarships that helped me to be able to continue,” she says. “It has been tough throughout the whole 10 years that I've been here but I'm just hoping that now that I am a doctor, I can support my family a little bit. Now it's my turn. “I've got a few other goals in mind in terms of helping others in my situation to get empowered and do their best to not give up, and not to just sit and wait. If I had sat and waited for the government to decide on my refugee visa, it's 10 years now already.” After a decade of refugee visa applications, she remains on a temporary visa and now plans to apply for a skilled migrant visa. Settling into the busy general surgery rotation, Dr Parnian is looking forward to being involved in the peer support group Northern Queensland Regional Training Hubs (NQRTH) has set up to link international medical students at JCU with current interns who graduated as international fee-paying students. “I'm really happy to help anybody who needs help,” she says. “I try to be friendly so people don't feel shy to approach.” NQRTH Program Manager Andrea Muller said the peer support group was established to help the many international fee-paying students who found it stressful to navigate the Intern Campaign and the complexities of having to apply both interstate and in Queensland. “Often these students have little to no family support network in Australia so the process is stressful and an emotional time for them while completing their final year of medical school,” Ms Muller says. “They need to prepare competitive CVs and then attend interviews with multiple hospitals. By connecting current interns, who were last year’s graduating international fee-paying students, with current international fee-paying students, we are providing these doctors and students with a chance to connect, share their stories and reassure them that in the end, they will receive an intern position.” NQRTH has hosted an Intern information session and will be providing further sessions including CV Preparation and Interview Tips and Tricks as well as various sessions about wellbeing and resilience. Dr Parnian says reaching for small goals paved the way to her big goals of getting into and finishing medical school. “It was a challenge. A lot of the times, I thought, ‘I can't do this, it's a lot of pressure and a lot of responsibility and it's so hard.’ It's important that you believe in your dreams and abilities. If you have some goals and a purpose in life, and if you put a little bit of effort every day into it to reach your goal, then eventually you’ll get there.” Rural placements in Charters Towers and Sarina during medical school gave Dr Parnian a taste of country hospitality, while her final-year term in Mareeba made her a more confident intern. “Being a sixth-year medical student in a rural setting, they treat you as a junior doctor, so I was able to practise a lot of internship jobs,” she says. “I feel like that rural placement made me very confident and prepared for internship. People in rural and remote areas are real. Their friendship and their kindness are different. You feel it. “I wanted to stay in Townsville because I feel like this city has given me a lot of things and it was my turn to give it back to the community. I wanted to start here to be able to give the kindness that I received from the community to the same community." "I haven't decided what I want to become next because I want to have my options open. As I progress through internship and experience working in different departments, then I can have a better idea of what fits best for me.” The theme of International Women’s Day 2022 is Break the Bias: “Imagine a gender equal world. A world free of bias, stereotypes and discrimination. A world that's diverse, equitable, and inclusive. A world where difference is valued and celebrated. Together we can forge women's equality. Collectively we can all #BreakTheBias.” James Cook University is proud to support the Northern Queensland Regional Training Hubs program. We are a medical training network integrating private and public hospitals and health services, GP clinics and James Cook University. We collaborate to provide doctors in training with unique medical training opportunities from intern to fellowship in Northern Queensland while enjoying the lifestyle that only this part of Australia can offer.

7 February 2022

Purpose from grief

Dr Luke McIntosh’s path to general practice started as a first-year medical student grieving the loss of his mum, Leanne, to breast cancer. Throughout the illness, it was a supportive GP in their Geelong hometown who made all the difference to Mrs McIntosh and her family in the last years of her life. “Dr Ward really did inspire me because he displayed all the characteristics of an absolutely fantastic GP,” says Dr McIntosh, who was in Year 12 when the diagnosis was made. “All the way to the very end when Mum passed away, he provided so much support, not only to Mum as the patient but to the family. It just made a very difficult situation a lot more tolerable. From that day I aspired to become a GP and to live up to the example that he set. That’s what’s driving me still to this day.” A community mindset Dr McIntosh threw himself wholeheartedly into community life after arriving in Mundubbera as a GP registrar in February 2020. Mundubbera is a town of about 1,200 people in the North Burnett region of Wide Bay. “Everyone has been so welcoming and have been encouraging me to get involved in the community. Before I arrived, I was already signed up to the local touch football team and the squash competition,” he says. Whether it’s providing first aid at touch footy, helping the local retirement home association or speaking at events such as Australia’s Biggest Morning Tea, Dr McIntosh is active in community life. He’s also taken a proactive role in community mental health, working with the local suicide prevention group, and teaming up with the local school principal and school nurses to plan sessions on resilience and mental health for students. “Mental health in rural communities is quite a challenging topic,” he says. “It is something that for a long time has been overlooked, but we are seeing a lot more focus on it and a lot more funding from the state and federal governments, which is really exciting. Still, we’re having issues with accessing face-to-face services, so I’m very happy to be able to use my background in mental health training to provide some of that support in my role as a GP. We’ve been able to use telehealth psychology services, and that’s been helpful for our community. Thankfully, our town has a local Suicide Prevention Network and they’re doing good things on the ground and providing support to families affected by suicide or providing support to people who have issues with mental health and are contemplating suicide.” Dr McIntosh discovered his passion for mental health while doing his junior doctor training in Bundaberg. He was loving the regional lifestyle and the rural towns he visited as a registrar completing his Advanced Skills Training in mental health. “I got to visit all the local communities, including Mundubbera, and I thoroughly enjoyed that work and meeting the people out in these towns, seeing the small hospitals and working with the GP,” he says. “When the end of the year came up and there was a job option in Mundubbera, I jumped straight on it.” Broad experience He works at the private general practice and the small rural hospital, which includes an emergency department, a general medical ward and a nursing home. He’s completing his RACGP Fellowship along with a Fellowship in Advanced Rural General Practice (FARGP). “Being here as a registrar, I get such a broad exposure to a number of clinical scenarios,” he says of working in a rural town. That has really prepared me well for not only the exams, but just in general it builds my confidence in becoming a good GP. “It’s not always easy to get certain imaging scans or access to specialists so you really do have to break down the medical presentations to their basic features and go back to solid clinical reasoning and medical judgment to try to help the patients as best you can. You can’t always have access to instantaneous results with a CT scan or MRI. Even blood tests take a lot longer to come back. Although that has its challenges at times, it’s really enjoyable and it allows you to think through the presentations. I think a good GP is someone who can sit down with a patient, listen to their story and work with the patient to achieve the best possible health outcomes. I would like to think that my experience in mental health and the skills I have learned in effective communication are helping me achieve this goal and is helping the patients in my community.” Supportive network Dr McIntosh says JCU GP Training’s Wide Bay office is a source of support for the area’s rural registrars, helping to build a professional network. “Early on in COVID when everyone was worried, they were calling to check in and make sure everything was all right,” he says. “We’re really lucky that we have a good telehealth model for the rural registrars so even though I’m at least a few hours away from the nearest registrar, each week we can still catch up on Zoom. You do feel like you’ve got a bit of a community of registrars that you can bounce ideas off and learn things from. That’s really important because it can become a bit isolating out in the rural communities. Having that regular catch-up facilitated by JCU really helps smooth the process and transition into the rural town. We learned a lot through those workshops and half-day releases, and it really did prepare me well for the exam. They constantly got you thinking about clinical presentations and rational use of medications and pathology and imaging.” Rewarding work “Working and living in a smaller community, getting to meet everyone and feel like you’re a more valued part of the community was a big drawcard for me,” he says. “It becomes a lot easier to develop that rapport with patients when they see you down at the local show and they see you at the local Anzac Day Parade and things like that. You still do get to go away for weekends and get to enjoy some of the highlights of the big cities but coming back to live and work in a town like this is so rewarding and it’s something that I’ve really valued.”

7 February 2022

JCU Grad flying the NQ flag in prestigious national training opportunity

A born and raised North Queensland doctor has defied the odds to make her way into advanced training in one of the country’s most competitive medical specialisations. Dr Helen Buschel is one of just two trainees across Australia and New Zealand accepted in the 2022 intake for paediatric surgery training, commencing Monday 7 February through the Royal Australasian College of Surgeons (RACS). Hailing from Cairns, Dr Buschel graduated from James Cook University (JCU) in 2016 and completed her internship and junior years at Townsville University Hospital and Cairns Hospital. Her training pathway bucks the trend of the typically metropolitan pathway for doctors aspiring to become paediatric surgeons. “The perception is that you can’t get onto a specialist surgical training pathway without spending some time in a city,” Dr Buschel says. “The fact that I’ve done it purely from working in North Queensland shows you do get a lot of training opportunities here. “Paediatric surgery felt like a distant dream. It’s what I always wanted to do, but I didn't think I had a chance because it’s so competitive. “When I got the acceptance letter I thought it was a mistake. I had to get a colleague to confirm what it said, then I called mum and she didn’t believe it either!” Dr Buschel has spent the past five years preparing for the application process which has included extensive clinical training, rotations in remote communities like Palm Island, research, and a Master’s degree. She also attributes a part of her success to the close relationship she has been able to build with senior clinicians, consultants, and supervisors. “I had never experienced paediatric surgery until my first rotation as an intern. I absolutely loved it and the whole team were really supportive of me. “I am very passionate about training in North Queensland. If I hadn't have gone to Townsville there is no way I'd be doing what I am today,” Dr Buschel said. Helping facilitate training opportunities for passionate junior doctors like Dr Helen Buschel is JCU’s Northern Queensland Regional Training Hubs (NQRTH). NQRTH was formed in partnership with public and private hospitals, health services and GP clinics in the northern Queensland region to help support the Australian Government’s Integrated Rural Training Pipeline for Medicine (IRTP) under the Health Workforce Program.

4 February 2022

Rural generalist to pain specialist: easing the load

Some of the most rewarding career moves happen by accident, as Dr Hannah Bennett can attest. Dr Bennett, a 2012 graduate of James Cook University, had returned to Townsville after several years working as a rural generalist in Ingham and was looking to expand her skills in primary care. She had met North Queensland Persistent Pain Management Service Director Dr Matthew Bryant, also a former rural GP, while doing her advanced skill in anaesthetics. “I came in with the idea to do it temporarily and ended up really enjoying it,” says the pain medicine consultant, who earned the Barbara Walker Prize in 2020 for achieving the highest mark in Australia for the fellowship exam. “I became much more aware of the lack of pain services outside metropolitan areas and decided to do my fellowship. Our pain service in Townsville is the only one outside of the southeast corner of Queensland. There's a severe lack of specialist pain services not just for rural and remote Queensland – First Nations people are underrepresented in referrals and that's not because they don't have persistent or chronic pain, it's just that they don't have access to services that are safe and culturally appropriate. “We're trying to change that. We run a clinic at TAIHS (Townsville Aboriginal and Islander Health Service) and I go to Palm Island for a day every few months to do a pain clinic. We do a lot of outreach to Mackay, Cairns and Mount Isa, and look after patients as far away as Thursday Island. About the specialty “Pain management encompasses a lot of things. A big chunk of our work is managing patients with persistent or chronic pain, but we also assist complex acute pain patients, people who are experiencing pain from cancer or cancer treatments, in palliative care and other things like that. “Persistent pain is a huge problem Australia wide. About one in five Australians experiences chronic pain. A majority of those are managed in primary care by GPs and allied health professionals, but there is a subset whose function and quality of life are so significantly impaired, they are unable to be managed in the primary care setting and need involvement from a specialist pain management service. “We're not a purely medical service, we're a multidisciplinary clinic and we very much rely on that. We have our psychologists, psychiatrists, physios, OTs, pharmacists, nurses and doctors. Most of our patients will have involvement with, if not all, at least a couple of different disciplines as part of their management and journey through the service. Pathways to pain medicine specialisation “I did my intern year and RMO year here in Townsville and got to do some of the rotations that are prioritised for rural generalism, so I had good exposure to obstetrics, paediatrics and anaesthetics. I did a rural relieving term and worked in Weipa and Sarina as part of my second year. “In my next year, I did my advanced skills training in anaesthetics. They were re-establishing maternity and birthing services in Ingham and recruiting GPs, anaesthetists and GP obstetricians, so I completed my GP training through the hospital and one of the Ingham practices. We moved back to Townsville when I was having a baby. “Pain medicine is a bit of an interesting specialty in that you have to have what's called a primary specialty or fellowship, so you can't just go from med school and do an internship in pain medicine. Traditionally, the pain medicine faculty sits under the Australian and New Zealand College of Anaesthetists, but you don't have to be an anaesthetist to do pain medicine – you could be a GP, a rehab physician, a palliative care physician, an emergency physician. It is quite intensive in terms of some of the underlying pain neuroscience and physiology and pharmacology stuff that you need to know from an exam point of view, but it is still heavily practically based in terms of patient management and communication. “It's a mix between outpatient and clinic-based work, providing pain education to patients and the community in general, trying to upskill and teach other primary care providers, an interventional aspect where we do procedures and other injections to manage pain, and providing inpatient services. So, it's varied in terms of the things that you do day to day. Making lives better “Low back pain, for example, is the leading cause globally of disability in the world. That used to be just high-income countries, but it's even becoming more of an issue in middle and lower-income countries. We know that pain is more of a problem as people get older, and we've got an ageing population. About 80 per cent of people in aged care facilities experience chronic pain. “Persistent pain causes lots of loss of work and financial stress and impact on people's day-to-day lives and so you can make a massive difference to people. Their function and their quality of life are what we're focusing on. The reality is that for many patients we aren't able to take away all of their pain, but we can manage it a lot better. We can get them back to doing the things that they want to do and need to do. You see people living a rewarding, fulfilling life despite their pain, as opposed to being really impaired. Professional learning networks “North Queensland Persistent Pain Management Service has set up a Persistent Pain ECHO Network to engage with primary care providers. Project ECHO is an international program that creates a community of practice locally with a hub and spoke model. Allied health professionals, GPs, anyone who’s interested, log in, we do a brief presentation on a topic and then someone brings a case forward for discussion. It gets input from people in the community as well as the expert panel about how we can better manage that patient. It's designed not just to be about helping individual patients but about improving the capacity within primary care to manage other patients. Breadth of experience “The best thing about training in a North Queensland regional setting is the broad range of patients in terms of age, pain type and condition. We get to see a lot and do a lot. Aboriginal and Torres Strait Islander pain management is a big focus of ours and that's also not something you necessarily get in a bigger centre. Flexibility and support “Townsville is a very supportive training environment. I had maternity leave in the middle of my training and there was the capacity to train part-time or full-time. You can complete all your training in Townsville because it’s rated as a level one facility. There's a core training stage, which is the first 12 months, and the practice development stage, which is the second 12 months. You can do your whole two years here, so you don't have to move until you can complete that. There are lots of different ways you can make that work. Balance and lifestyle “I work weekdays – no after-hours, no weekends. As a consultant, I'm normally on call for a two-week block every few months, but it's just being available for phone advice as the anaesthetic registrar covers most of the overnight things. “I’ve loved Townsville from when I moved here from Brisbane for uni. It’s not as busy and fast paced. I love being 15 minutes from everywhere that I need to be. I like that I can walk from my place down to the beach. We do a lot of camping and fishing and swimming and boating out to the islands. There's so much on your doorstep here. It's just an easy life. We bought a house in an area with a good school and it's a great place to raise a family.” James Cook University is proud to support the Northern Queensland Regional Training Hubs program. We are a medical training network integrating private and public hospitals and health services, GP clinics and James Cook University. We collaborate to provide doctors in training with unique medical training opportunities from intern to fellowship in Northern Queensland while enjoying the lifestyle that only this part of Australia can offer.

31 January 2022

New beginnings in the Far North

If you want to know what regional GP training opportunities mean for rural and remote communities, just look to Weipa. This small mining town in Far North Queensland has an expanding dialysis unit, a new Ear, Nose and Throat (ENT) outreach program, and very soon will have a dedicated maternity service delivering babies in town for the first time in almost two decades. It’s a health movement that’s changing lives, and it’s largely driven by GP registrars. Heavily involved in these exciting new developments is Dr Will Horwood. Inspired to pursue rural medicine from his parents work as GPs in Papua New Guinea, he arrived in 2015 with his young family, completed his fellowship with James Cook University (JCU), and is now a Medical Educator and supervisor at Weipa Integrated Health Service. “There has been a real clarity of purpose with the JCU GP Training Program,” Dr Horwood says. “The priority is addressing real needs and improving services to regional and rural and remote communities. For me working in such a remote place, it's been nice to nice to be part of this broader mission.” Birth of a new era: The Weipa Maternity Project In the past 12 months, the community has seen the development and approval of the Weipa Maternity Project. Funding from Queensland Health will increase the number of doctors in Weipa to enable birthing services in town and offer primary care services to surrounding areas. Dr Horwood is currently involved in the preparation phase of the project and understands what dedicated maternity facilities will mean for the women of Weipa. “The impact of having these maternity services up here is going to be really profound for a lot of women and their families. It will mean they won’t have to leave town at 36 weeks of their pregnancy, where they’d be hundreds of kilometres away from their families and support networks,” Dr Horwood says. Hearing the need: The launch of Ear, Nose and Throat Specialists The Ear, Nose and Throat (ENT) Project, championed by JCU GP Registrar Dr Steve Johnston, launched in late 2020 in response to the impact of ear disease across the region. The outreach clinics provide treatment and education to communities all through the Cape to Cooktown and surrounds. “We’ve seen kids with chronic ear infections develop hearing loss because they didn’t get the appropriate treatment. This affects their educational outcomes, which means their whole life is impacted. We’re hopeful the ENT Outreach Program will make a really big difference to these kids, their families, and the wider community here,” Dr Horwood says. Addressing the rise of chronic kidney disease Kidney conditions are a major concern for Aboriginal and Torres Strait Island communities, and according to Dr Horwood the problem is only going to get bigger without preventative and early-stage care. Under the medical leadership of Dr Andrea Miller, Weipa’s Chronic Kidney Disease Prevention Program is now in its third year. The program was recently strengthened further with the addition of dialysis services. “This program is not only targeted at delaying, if not preventing, the need for dialysis, but also making the process easier for those who do have to start dialysis as it will limit the need for patients to travel,” Dr Horwood says. Hands-on training With exciting health service developments and hands-on experience, Dr Horwood is naturally a big advocate for the GP Training opportunities in Weipa. “Training here is valuable experience for any doctor, but as a GP, it gives you such a solid grounding in everything from primary care through to serious acute emergency medicine." “If you want to feel like you’re genuinely contributing to local health services, then Weipa is a great place to come. We honestly couldn’t do without our GP registrars.” Dr Horwood says. “There are a lot of good people here who make this a great place to live. It’s a beautiful part of the world and we love exploring. We’ve always felt so welcome in Weipa. We came here with one child, and now we’ve had another three, and we’ve just really enjoyed it here,” Dr Horwood says.

24 January 2022

What to consider when switching specialisations

With so much time and energy involved in pursuing a medical speciality, it may feel like switching specialisations is a bad idea. But as Dr Alyssa Ormond discovered when she was four years into intensive care training, switching could be the decision that reinvigorates your love of medicine. Originally from Cairns, Dr Ormond completed her undergraduate and postgraduate studies in Brisbane and Adelaide. Following internship and a year as a Resident Medical Officer (RMO) at Flinders Medical Centre, she decided to commence a Fellowship with the College of Intensive Care Medicine. While she loved it initially, four years as an ICU registrar had her questioning whether she was on the right path. “With time, intensive care lost its shine for me, and multiple factors contributed to my first dance with burn-out. I just felt worn out from something I was meant to enjoy doing,” Dr Ormond says. In search of a change of scenery, Dr Ormond moved to Darwin and dipped her toe into emergency medicine. It was there that her love of medicine was reinvigorated. She thrived on the fast-paced environment, the doctor-patient interaction and being part of an enthusiastic team of consultants. “It reminded me of what I am here for as a doctor and lured me to the ‘dark side’, which is what many in ICU call Emergency. So I joined the Australasian College for Emergency Medicine (ACEM) and continued dual training when I moved back to Cairns in 2018. I’m now pursuing emergency and have my ICU training on deferment,” Dr Alyssa says. As well as thoroughly enjoying her new specialisation, Dr Ormond is glad to have made the switch from a city hospital to the regional setting of the Cairns and Hinterland Hospital and Health Service. “To be honest, I would hate to go back to working in a metropolitan area. From my experience, there’s more of a medicine hierarchy in the capital cities. Up here, everyone cares about each other a little bit more. I also think you get a wider breadth of medicine here. The diversity of cases and the supportive environment have made for a very positive training experience. I look forward to coming to work now!” If you’re unsure about what specialisation to choose or are thinking of switching, Dr Ormond has some tips for you based on her experience… Figure out what you love Some people have a very clear vision from early on, but many others just don’t know what they want to do. I speak to junior doctors all the time who say they’re still unsure, and that’s ok! I would advocate for everyone to use their rotations as proactive opportunities to determine their interests. Medicine takes up so much of your life, you want to be happy with what you’re doing. Prepare your letter of recommendation If you’re switching specialisations, you’ll need to consider which supervisors or colleagues you could approach for a letter of recommendation. I had a letter from three of the emergency physicians from my time in Darwin who endorsed my entry to ACEM. The letters basically stated that I was reliable and that they enjoyed working with me! Make a submission for recognition of prior learning I was four out of five years into intensive care before I switched, but I don’t view those years as wasted time! There’s a lot of crossover between the colleges so you can apply for recognition of prior learning. It’s judged case-by-case and they’ll credit your previous experience to the new fellowship where it’s deemed relevant. Everything you’ve done adds to your experience as a doctor. Tailor your RMO years Since some colleges won’t accept you until you’re at least PGY3 or PGY4, use your time as a Resident Medical Officer (RMO) to prepare for the future. Investigate the requirements and recommendations of the college you’re interested in and tailor your rotations to reflect the trajectory you would like to take. Ask yourself, ‘what have I got to lose?’ From my experience, I would say if you’re thinking about switching, just do it! If you’re in one college, you don’t have to leave it to apply for another. If you’re successful, you can take a deferment to try the new specialisation. I'm lucky that my specialisations have similarities and crossover of rotations so if I do an anaesthetic rotation that counts in both specialisations, so that can fast-track the training. But you don’t have to give up one completely to try another! From internship to fellowship, there are plenty of exciting training opportunities on offer in northern Queensland. NQRTH connects medical professionals with these training pathways to address the shortage of doctors in regional, rural, and remote communities. Find out more.

19 January 2022

Rural generalist dream

Michael Pitt was a 30-year-old dad managing a cattle property near Springsure in Central Queensland when the rural generalist path captured his interest. “My whole reason for getting into medicine was to be a rural generalist,” Dr Pitt says. “I had heard about it on the radio before I’d even applied to study medicine and I thought, ‘That sounds like exactly what I want to do.’ I still have that exact same goal as when I started.” Dr Pitt received the RDAQ JCU GP Training Prize in Rural Medicine in 2020 and is starting AGPT training with JCU after completing his internship at Rockhampton Hospital. “I grew up in rural Queensland on a cattle property between Capella and Dysart. After school I went and studied at Gatton College and I graduated with a Bachelor of Agricultural Science,” he says. “I worked on the land for nearly 10 years before going back and applying for medicine at JCU.” The 'old guy' Dr Pitt and his wife, Katie, moved to Townsville with their three young children, Abby, Tylah and Lachlan, for his JCU Medicine degree. “I did feel like I stuck out like a sore thumb to start with. I called everyone in the class kids because they were so junior to me, they seemed like kids,” he says. “At first they wouldn’t even speak to me because I was the old guy. But to watch them grow and then actually become friends with them, that’s probably the most enjoyable part of it all.” As a John Flynn Scholar, Dr Pitt did eight weeks of placement in the central Queensland town of Theodore. The John Flynn Placement Program, matching university students with doctors in rural locations for training, will be defunded in February 2022. “It was an honour to be part of the John Flynn program because you weren’t doing it because you had to do a rural medical placement to fulfil the course requirement, you were doing it because you were part of something else,” Dr Pitt says. “It gives you rural medical exposure, but it also shows you what it’s like to be an integral part of the rural community. They get you involved with more than just the medicine. I absolutely loved Theodore. It was great to be part of the community, great to be part of the GP practice. To see (JCU GP Supervisor and Senior Fellow) Dr Bruce Chater, who’d been at Theodore for 35 years at that stage, and how the community responded to him and the practice that he built, was really a great experience. I learned a lot about rural medicine and learned a lot about the community.” Dr Pitt’s fourth-year placement was in Longreach: “It was a completely different model to Theodore but was still in the true sense, rural generalist practice where the doctors are shared between the GP clinic for most of the week, but then they’ll do a few days in ED or on the hospital wards.” Family and community Dr Pitt was able to do all of his final-year placement in Mareeba, his family moving with him, and Katie working as a nurse at the Mareeba hospital. “They (his family) were there as part of the community as well. Katie was a very well-respected member of the nursing team at the hospital, and the kids made many friends as part of the school community. As medical students, we got to do a hell of a lot as sixth-years at Mareeba, probably more than what students back in Townsville were able to do. It was a great experience on all fronts,” he says. Dr Pitt feels he can have a huge impact as a rural generalist, and has received tremendous support from Rockhampton Hospital consultants in giving him more exposure to cases that will ultimately benefit him as a rural doctor. “As a rural generalist we’re not just there to be the doctor and go home. People in rural communities really appreciate the rural doctor because they are the jack of all trades. Patients can come into the hospital with a broken arm but then be able to come and see you in the GP clinic, so it’s a whole of life medicine, really,” he says. “It’s being able to do a bit of everything. You’re actually able to fix real issues that are affecting people here and now, delivering antenatal care right through to end of life care and everything in between. That’s what drew me to rural generalism in the first place.” Completing six years of medicine while raising a young family – Abby, Tylah and Lachlan are now aged 11, 8 and 7 respectively – with Katie’s nursing work as their source of income was challenging. “Kids are very resilient, so they’ve been great through this whole process of med school and internship,” Dr Pitt says. “It’s definitely a juggling act and there are obviously sacrifices that go with that – we just try not to sacrifice the kids’ experience as much as possible.” The whole family loved their time in north Queensland and are keen to return one day “We’re still trying to work out where is going to be best for us as a family, but at this stage north is looking promising,” Dr Pitt says.

12 January 2022

Finding the right skills and the right home in Emerald

For Dr Nichole (Nikki) Harch, growing up in the central Queensland town of Biloela would have a profound impact on her future direction as a JCU GP trained Rural Generalist. Now based in the Central Queensland regional town of Emerald and working as an ACCRM fellowed doctor in the combined role of GP, hospital-based Rural Generalist, and mental health clinician, Nikki’s love for a rural generalist medical practice continues to grow. “I was in my last year of high school and about halfway through the year, there was a bit of an uproar in the town as three of our doctors were all retiring at around the same time. The town really banded together to try and figure out how they were going to replace these doctors. And watching the way that my community rallied around this issue actually had a great effect on my decision to study medicine. “Seeing the importance that the town placed on having enough doctors just gave me a massive boost that this is what I wanted to do. I always wanted to contribute somehow to my community, and it seemed like studying medicine was going to be the best way to do it.” “It wasn't until I was on one of my JCU undergraduate medical student rural placements that I became aware of what the rural generalist pathway could actually offer as a career choice for doctors. Seeing these doctors working in a whole range of different scopes made the rural generalism pathway really hit home for me and that’s when I knew that that's what I wanted to be doing.” After graduating, Nikki undertook a four-year scholarship program with Queensland Health, with her final rotation taking her to Emerald where she continues to practice. “I actually did my intern year and first year of residency at Redlands Hospital which is located on the outskirts of Brisbane, which was my one and only experience of being somewhere urban. After that, I travelled up to Rockhampton where I undertook 12 months of Advanced Skills Training in mental health. My final rotation was in Emerald and I have been there ever since. “In addition to my role as a GP for the Emerald Medical Group, I work for the hospital on the emergency ward and also run a mental health clinic. I also conduct weekly outreach primary health care clinics to the surrounding community of Capella which has a population of around 1000. “As a Rural Generalist I have to be prepared for whatever walks through the door and be able to adjust to that. It takes a particular mindset to do that flip and switch; you need to be a bit of a chameleon. So, it makes an enormous difference to my mindset to be surrounded by like-minded colleagues. You end up being in a pretty tight knit group, because they're the ones that you can trust to pick up the slack if anything unexpected happens. Fortunately, we have a great community of medical professionals here in Emerald.” Part of Nikki’s mission in her current combined role as a mental health clinician is to tackle the fallout and prevention of mental health issues, including taking the stigma out of talking about suicide. “Mental health is an area of healthcare need in rural communities that just continues to grow. Although mental health can often be managed in primary care settings, unfortunately we're now seeing more and more acute cases that resemble something of a mental health crisis in these types of communities. “Emerald itself has had some horrific fallout from mental health issues, particularly around youth and adolescent suicides which is just devastating for the whole community, in ways that I can’t really even begin to describe.” “People shouldn't be scared to admit that they've had a suicidal thought; but they do need to be aware of when these thoughts become stuck that you can't push away, that it’s really important to get the right help. The first step is to take away some of the stigma associated with having the thought in the first place. If the work I do as a GP and mental health clinician can make people's journey a little bit easier or help them access the further support that they might need, then I’m certainly very happy to be doing that.” However, due to the current shortage of GPs in remote, regional towns such as Emerald, some patients can have difficult accessing the immediate mental health help and support when they need it the most. “Emerald does have a few psychologists and counselors based here, but they each have a waitlist of between three to six months. And although we are seeing more and more telehealth services being offered, for some people they are still needing that human interaction, particularly in the area of mental health. So for these people, having a GP they can access forms a vital step in their mental health recovery plan. But even my waitlist as a GP can be anywhere between six to twelve weeks, which is just too long. We have a dire need of attracting more GPs to rural and regional towns such as Emerald.” In addition to the many lifestyle benefits that can be found living in regional communities such as Emerald, Nikki also says a factor in her decision to stay was the opportunity to work with some of the ‘greats’ of Rural Generalism, including GP obstetrician, medical educator and JCU GP Training Senior Fellow, Dr Ewen McPhee. “I wanted to be able to work in primary care as well as in a hospital setting and knew that Emerald was a place with a fantastic reputation for achieving that. It has also been the most amazing privilege to be working among supervisors such as Dr Ewen McPhee and Dr Eugene Wong (former Director of Medical Services for the Central Queensland Hospital and Health Service). I've been incredibly lucky to be surrounded by amazing doctors who have who have walked the walk and who lead by example.” “As a registrar in training, I also appreciated being surrounded by others who have done the path to ACCRM fellowship before me, and who understand what is required. It’s also been great that through the GP practice here [Emerald Medical Group], we have supported education time which we are able to take as half day releases, plus the medical educators here on-site who are passionate about what they do which just makes all the difference.” Currently expecting her first child, Nikki says she is looking forward to putting roots down and raising her family while staying in Emerald for the long-term. “Over the past few years I have been able to build relationships with my patients which just makes the work I do as a GP so much more rewarding. And because you've spent that time to build up the trust, it means that I am able to make a difference with things like things like vaccine hesitancy, for example. Another great aspect to my work as a GP is that Emerald Medical Group is a nonprofit medical centre with the profits going towards increasing health supports and services to the local community. “I know my community and I trust my community, and I can definitely see the benefits of raising a family and growing my career here. As a recent ACCRM fellow, I have already had the opportunity to be involved with ACCRM’s Registrar Committee and start building my knowledge as a potential GP supervisor and medical educator. I am also a member of the Queensland Rural Generalist Training Advisory Group, and help out with the clinical skills teaching of the many undergraduate medical students we regularly have on placement here. “Working as a Rural Generalist in Emerald has really expanded my scope, in both a clinical and non-clinical setting, which I’m sure will help set me up for other exciting opportunities down the track.”

15 December 2021

Home is where the need is for rural GP

The further Dr Bronte Donaldson has progressed through her medical training with JCU and the GP training program, the more determined she has become to return to her hometown of Mount Isa. “I loved Mount Isa, but I didn’t go into medicine thinking I would go back there,” Dr Donaldson said. “Now, when I finish my training and get more experience under my belt, I want to go home to contribute to what my community needs, which involves a good, stable GP workforce.” After completing her internship and Junior House Officer year in Mount Isa, Dr Bronte has gone an hour and half down the road to Cloncurry for her GP training in the local general practice and hospital. “I love the diversity of the job. You’re doing all sorts of things that city GPs would usually refer to the hospital or a specialist. Out here you don’t have that option. Either a patient must travel 10 hours to see someone, or we do it ourselves. It’s a great challenge, but with the training I have, and continue to receive, I feel very prepared,” Dr Donaldson says. JCU GP Training’s Enhanced Rural Training Environment Program (ERTEP) was launched in 2020 to support recruitment and retention of GP registrars in areas of rural workforce need. “Given our location, it’s very expensive to get to training courses and on an early-career GP wage, it’s not possible,” Dr Donaldson says. “Thanks to the ERTEP support for my flights, I’m planning on doing an ultrasound course to upskill and help me feel more equipped clinically out here.” After further training in Cloncurry, Dr Donaldson plans to head back to Mount Isa, where her family lives. Based on her experience with the training opportunities and support on offer in Cloncurry, she strongly encourages others to consider pursuing their career as a GP in the outback. “Rural and remote medicine, although challenging, is the most rewarding thing you can do. It’s getting a range of experiences you wouldn’t get anywhere else. It’s helping communities that really need you. Your patients are so appreciative, and the people you work with become your family.”

29 November 2021

An opportunity to practise at the top of their scope

For Rural Generalist doctors Chris and Kirsty Symmons, Longreach has provided a great environment in which to complete their JCU GP Training and stay for the long term. “We said we would give it two years to start with, but it’s been such a great place to finish off our registrar training that we have decided to stay,” says Kirsty. “It’s now our fifth year here and we’ve decided to start a family with no immediate plans to leave. We both came here wanting an opportunity to develop our Rural Generalist skills while still doing GP work. Chris has his advanced skills in anaesthetics, and I have mine in obstetrics, so we both wanted to be in a smaller community where we could continue to use these skills in the hospital setting while also developing our skills in general practice. We both did our undergraduate medical training with JCU with a whole range of rural placements which prepared us well for this kind of experience.” Both doctors say it has been the opportunity to work ‘at the top of your scope’ that was one of the biggest attractions for them to stay. “In Longreach, we have the opportunity to work in a wide range of health settings,” says Chris. “In addition to our GP work, we both work at the hospital in Longreach which is the largest hospital in the central west district. The nearest referral hospital is at Rockhampton and that is an eight-hour drive away with no commercial flights. Because we’re so far away, we have to be able to look after whatever comes in the door. The upside is that it forces us to work at the top of our scope, both in the hospital and community. It also forces us to work as a team.” For Kirsty, Longreach has provided ample opportunities to practise and further develop her obstetric advanced skill training. “I did one year of obstetric training before I came out here and have enjoyed using those skills in the rural context,” she says. “Being so remote here means you have to be prepared to manage a wide range of pregnancy situations. I work very much as part of a team to provide antenatal care while liaising with tertiary teams including obstetric medicine, maternofoetal medicine and perinatal mental health. There have also been times when high-risk women have declined relocation to a larger centre for delivery. Working together as a team of midwives and doctors, many of the most complicated deliveries that I’ve managed have happened here in Longreach because there hasn’t been a specialist obstetrician to take over.” For Chris, being in Longreach means he can fully utilise his anaesthetic advanced skill training, as well as extend his GP procedural skills in a number of areas. “When I was a registrar doing my training in Longreach, I had some great mentorship from the senior GPs here who were used to doing a lot of skin cancer checks for patients, as many people here tend to live outdoor lifestyles. I gradually learnt more and more about the advanced procedures you can do in this area that are still within the realm of general practice.” “We’ve spoken to friends who are doing general practice in the city who refer even basic skin cancer excisions to specialist skin cancer doctors. Whereas being in Longreach has meant that I’ve been able to gradually increase my range of skills in this area, to the point where I’m now doing skin grafts and flaps, even on faces, which are procedures that most GPs would outsource.” An important ingredient in the expansion of skills is also the support and availability of telehealth specialists. “Because it can be so disruptive and expensive for patients to travel to larger centres for specialist review, we try to arrange appointments by telehealth wherever possible,” says Chris. “We have amazing specialist support out here with a good mix of public and private specialists who will either visit or do telehealth with you. As a result, we get exposed to a much larger scope of practice. Although having to cope with such a diversity of work in a remote posting like Longreach can be challenging at times, you are working as part of a tight team and help is only a phone call away.” Another valued feature of working and training at a remote and regional community is the strong continuity of care that exists between the GP clinic and the hospital. “We work across both the hospital and the general practice, which means we can see patients and admit them ourselves” says Chris. “We remain involved in their care at the hospital, discussing next steps when they get discharged back to general practice. This means that we are able to provide the best continuity of care that I’ve ever experienced.” For GP registrars looking for diversity in their role, Longreach is certainly able to deliver on that. “For our work in general practice, we provide a whole range of care including chronic disease management, general medicine, skin procedures, aged care, mental health, antenatal care and child health,” says Kirsty. “In addition to our GP and hospital-based work in emergency and in the wards, we also do outreach clinics to surrounding communities. I also used to do a lot of outreach to communities where there was no female GP. I have also been providing GP visits to the local nursing home since coming here as a registrar, which is something I have come to really enjoy. The opportunities to utilise a range of skills have provided us both with a unique and valuable training experience overall.” Chris now also combines his role with being a JCU GP training supervisor, while Kirsty is taking maternity leave. “I really enjoy supporting and encouraging the registrar’s journey in rural medicine, knowing that it can be hard and that there can be struggles at time, but wanting them ultimately to succeed,” says Chris. “I especially find it rewarding to care for and develop the next generation of rural doctors. The way we train here is a group practice model, rather than as a strict linear model. All of us here supervise the registrars and we all mentor each other and learn from each other’s different skill sets. It’s a mix of both formal and informal training. I know the huge difference it can make to know that you can just call on someone when you need support, no matter what the hour.” According to Chris, Longreach’s ultimate secret weapon for registrar training is its size and remoteness. “Very few towns of the size of Longreach have the range of services that Longreach does, and we’ve got them because we are so remote. And that is what makes Longreach such a good registrar training opportunity,” says Chris. “The hospital is just the right size; if it was any bigger than this you would end up being full-time at the hospital with not much opportunity to practise primary care. And if the hospital were any smaller than this, then you wouldn’t have a maternity service or the theatre service or some of the other inpatient services that we provide. To be honest, I think it would be almost impossible to find a more diverse job in medicine anywhere in Australia.”

17 November 2021

Junior doctor earns acclaim for vascular research

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), which is located at Townsville University Hospital (TUH) and James Cook University (JCU). “The support and research infrastructure available at QRC-PVD, JCU, have been instrumental in my PhD,” Dr Singh won a $5000 prize for best research paper at the Australian and New Zealand Society of Vascular Surgery conference. The study, ‘Association of Chronic Venous Disease with Major Adverse Cardiovascular Events’, shows that people with more severe venous disease are at higher risk of having a cardiovascular event such as a heart attack or stroke. He is part of a team investigating biomechanical engineering techniques to better predict abdominal aortic aneurysm (AAA) rupture, which is estimated to be responsible for 200,000 deaths a year worldwide. The research, published in the British Journal of Surgery and Journal of the American Heart Association, has earned him a spot as one of five finalists chosen to present at the Royal Australasian College of Surgeons Queensland state conference in competition for the Neville Davis Prize. “When an AAA grows up to a certain size, it has a higher risk of rupture and bleeding, potentially causing death,” Dr Singh says. “The current method of estimating the risk of rupture is by measuring the aortic diameter. This measurement is used to help decide when to perform surgical repair. However, some small AAAs will rupture before they reach the current threshold for repair and some large AAAs remain stable without repair. This suggests that diameter is an imperfect prognostic measure, so we're looking at using biomechanical engineering techniques, which can perhaps better predict the risk of rupture of aneurysms.” World-class program Dr Singh said Professor Golledge had been instrumental in his PhD. Professor Golledge, recently elected as a Fellow of the Australian Academy of Health and Medical Sciences in recognition of his exceptional contribution, leads a translational research program that is innovative in treatment approaches to vascular disease. “There’s ample opportunity to collaborate with other researchers nationally and internationally,” Dr Singh said of the Townsville-based PhD program. He said Townsville University Hospital’s supportive environment and the breadth of clinical opportunities were 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. Research that matters Dr Singh was awarded a $250,000 Queensland Government research fellowship and a total of $90,000 in Townsville Hospital and Health Service Study Education Research Trust Account (SERTA) Grants for his aneurysm study and another recently published investigation highlighting the in North Queensland and the need to reduce and prevent amputations. “It’s evident in literature that people with diabetes are at higher risk of having lower limb major amputations,“ Dr Singh says. “Our study compared the amputation rates between Aboriginal and Torres Strait Islander peoples and non-Indigenous people over 15 years.” “The findings were that Aboriginal and Torres Strait Islander peoples had a higher burden of major amputations secondary to diabetes. The other finding from that paper was that the burden of amputations in our region seems not to be reducing, in contrast to some of the other populations in Australia.” James Cook University is proud to support The Northern Queensland Regional Training Hubs program. We are a medical training network integrating private and public hospitals and health services, GP clinics and James Cook University. We collaborate to provide doctors in training with unique medical training opportunities from intern to fellowship in Northern Queensland while enjoying the lifestyle that only this part of Australia can offer.

27 October 2021

Upskilling doctors at the coalface of remote community health

Rural generalists in the Cape and Torres will be enhancing health services available to remote communities after receiving specialty training grants from the North Queensland Regional Training Hubs (NQRTH), an initiative of James Cook University (JCU). The Cape and Torres 2021 grants will deliver funding for five medical supervisors and general practitioner registrars in Thursday Island and Cooktown to undertake training for additional skills or knowledge beyond the scope of mandatory training. This year $33,000 was distributed to six successful applications for training across a range of activities such as ultrasounds and emergency medicine. NQRTH Regional Training Hubs manager for Cairns and the Cape and Torres, Robyn Dupuis, has led the grants program since its inception in 2018 and said it’s about filling gaps in health services for remote regions. “By upskilling our rural generalists, who are on the ground day in and day out, we're helping them to meet the community's needs in between the visits from the outreach specialists, providing care sooner and saving patients from having to travel to Cairns or bigger cities,” Ms Dupuis said. The health needs of communities in rural, regional and remote areas of northern Queensland are currently underserved. There is a disproportionately high number of GPs and specialists concentrated in the capital cities with a corresponding impact on doctor shortages in regional, rural and remote areas. The grants initiative is helping address the lack of specialty training in the region by supporting rural generalists to meet the health needs in the far north. “There’s a ripple effect that comes from expanding our doctors’ knowledge. By undertaking additional training, our supervisors and registrars can provide more comprehensive care to patients, they’re better able to diagnose conditions, and they can share this knowledge and train others in these skills as well. NQRTH was formed by JCU in partnership with the public and private hospitals and health services and GP clinics in the northern Queensland region to help support the Australian Government’s Integrated Rural Training Pipeline for Medicine (IRTP) under the Health Workforce Program. “One of our goals at NQRTH is to help get more opportunities into our remote communities, like the Cape which is primarily staffed by rural generalists,” Ms Dupuis said. “We must support these doctors to have the skills to the best of their ability and at the top of their scope of practice.” To receive the grant, applicants were required to live and work in rural Queensland and demonstrate that the proposed activity addressed a specific learning need that would be met by training and professional development not available locally. One of the successful grant recipients was specialist medical practitioner and JCU GP Fellow, Dr Clare Applegarth, based on Thursday Island. She will receive funding to undertake a national certificate in reproductive and sexual health and a training course on intrauterine device (IUD) insertion. “Women’s health is a significant issue for the region, and there are very few doctors who are qualified to insert these contraceptive devices. When I go to the outer islands I have to tell women to come back when a GP with the relevant skills returns, which could be weeks away,” Dr Applegarth said. “Thanks to the NQRTH grant, I will be able to upskill to help identify issues earlier, educate patients, and offer more comprehensive family planning services to communities in the region,” she said.

26 October 2021

Cloncurry calling rural generalist trainee

Rural generalist trainee Dr Megan Bates was sold on life in North West Queensland even before she started her internship this year at Mount Isa Hospital. Dr Bates grew up in rural Victoria, travelled Australia working in shearing sheds, abattoirs and pubs, and ran a general store for several years in a remote Northern Territory community before starting a Bachelor of Medicine, Bachelor of Surgery at JCU. Life-changing placements in Cloncurry during her medical degree sparked a dream of returning there as a rural generalist. As she nears the end of her intern year, Dr Bates talks about the experience: On interning in the Isa “Mount Isa is a wonderful place. It's been a fantastic internship so far. I've thoroughly enjoyed it. We're well protected and we have excellent mentors. The entire team is just very welcoming and it's a great community as well.” On the appeal of rural generalism “I'm very much a person who likes the idea of being a jack of all trades. There's not one thing I'm not interested in. That's been my issue all along – I love a little bit of everything and I'm constantly changing my mind. Most of all, I love general practice. Finding a job that suits that ability to do general practice and that grassroots medicine and then manage your same patients in a hospital environment is a perfect mix for me and that's what I love about it.” On her slice of paradise “The plan is to finish my internship and PGY2 (postgraduate year 2) in Mount Isa and then transition back to Cloncurry, which is where I want to carve out my own slice of paradise. I had a couple of formative placements in Cloncurry in fourth-year and then I did an entire year there in sixth-year, which was just wonderful. I've always been attracted to living in remote Australia and I did a lot of that before I was ever in medicine. There's just something about being out in the bush that I really love. Cloncurry is that perfect mix of small-town general practice with hospital work. I think it lends itself to a very healthy career. On family “My son, Julian, came with me on my sixth-year placement and I put him in school for the year in Cloncurry, which was fantastic. He made some friends and was able to feel connected to the town and a part of the community. He’s 13 now and in boarding school at Charters Towers. I wanted him to feel connected to where I knew I wanted to live and for us to raise a family.” Did you know? In Queensland in 2021, JCU medical graduates made up 42 per cent of rural generalist trainees and fellows.* (*Source: Queensland Rural Generalist Pathway)

19 October 2021

Spirit of the NQRTH on display in cycling adventure

Since its launch in 2007, the QSuper Cardiac Challenge has become a much-loved institution in Far North Queensland. In late September, nearly 300 cyclists rode 333km from Cairns to Cooktown. But as the Northern Queensland Regional Training Hubs (NQRTH) Doxycyclists will tell you, the three-day adventure was about so much more than cycling. Intern at Cairns and Hinterland Hospital and Health Service (CHHHS), Dr Matthias Wust, began the Doxycyclists riding group in 2019. He has championed the team’s involvement in the QSuper Cardiac Challenge which in total raised over $520,000 this year and $4 million to date for the Far North Queensland Hospital Foundation and cardiac care services for the surrounding communities. “The whole challenge was an absolutely fantastic experience,” Matthias said. “It’s the most fun you can have on a bicycle. It was a wonderful group of people all working together to make a difference in their community.” NQRTH were proud to be the principal sponsor of the Doxycyclists, providing the funding for team jerseys and assistance at fundraising events, and during the challenge itself. “NQRTH are the team. This could not have happened without the work and financial support from NQRTH. The wonderful jerseys we were able to wear are due to NQRTH. The team raised over $21,000 which was supported and facilitated by NQRTH, providing contacts and man and women power,” Matthias said. After a team of three in the 2020 Challenge, Matthias put the word out to grow the team and received an overwhelming response. 19 junior doctors, JCU medical students and friends from the Cairns community joined Matthias for the three-day challenge. “This year we had 17 on the team doing the ride for the first time. Seeing all these people discover and enjoy the Cardiac Challenge for the first time was a real highlight for me. So much effort went into the lead up of the event, I was so happy to see the team enjoying the ride.” For both NQRTH and the Doxycyclists, involvement was about so much more than the ride itself. As well as contributing to vital services at the Cairns and Hinterland Hospital and Health Service, involvement in initiatives like the Cardiac Challenge build a sense of community and promote training and networking opportunities for junior doctors and medical students. “Events like this are a brilliant networking opportunity for our students and doctors. The Challenge has a large group of experienced doctors, nurses, and allied health staff from the hospital. Friendships made on the ride carry into the work environment very easily. Its yet another reason why practicing medicine in a regional centre is the best way to live,” Matthias said. “It exemplifies the social and lifestyle opportunities and how they can complement careers in medicine. It’s a beautiful part of the world with some genuine rural Australian communities who are some of the most accommodating and positive people I’ve ever met.” It's a sentiment shared by fellow intern at CHHHS, Dr George Lindley-Jones. He took part in the ride and shared some of his thoughts about the ride and how the involvement with NQRTH was a perfect fit for the team. “The whole experience has been incredible. I love how the ethos of NQRTH aligns so well with the Cardiac Challenge. We’re riding through a lot of these small towns, experiencing the bush of Australia, and for us as medical students and doctors hopefully it’s inspiring people to come work out here in the future.” The Doxycyclists are certainly not going to be resting on their laurels. Matthias is hoping to expand the club to include a racing team, greater participation in other local charity rides, and an even bigger team for the 2022 Cardiac Challenge. “We’re going to go bigger and better in 2022! We will smash our 2021 $20,000 fundraising goal and make a huge contribution to the hospital we work in,” Matthias said.

13 September 2021

Exploring the nitty-gritty of psychiatry training at Mackay Base Hospital

For psychiatry registrar, Dr Beau Harman, choosing Mackay as a training destination to pursue his interest in mental health was a decision that reaped many benefits. â€œI was always interested in mental health pretty much from the get-go,â€ says Dr Harman. â€œI had heard good things about the mental heal

7 September 2021

Bringing hope to breast cancer patients as a surgeon in Mackay

For interns considering a career in surgery, Dr Schimmer says she has never looked back on her decision to specialise in the field. "I get to be involved with the patientâ€™s journey of breast cancer which can be an extremely emotional process for patients."

30 August 2021

Going the distance for regional health services in the Far North

Patients and healthcare professionals are painfully aware of how far you may have to travel for access to treatment when you’re living in Far North Queensland. The NQRTH Doxycyclists, a group of James Cook University medical students and junior doctors, are preparing to go the distance themselves to help bring health services to the region, and they’re doing it by bicycle. The Doxycyclists began mid last year as a group of medical students who started riding together as a way of socialising while staying active during the pandemic. It quickly evolved into so much more. For the second year running, they’re preparing to take on the QSuper Cardiac Challenge, cycling 330km from Cairns to Cooktown to raise funds for cardiac care equipment through the Far North Queensland Hospital Foundation. Matthias Wust is a JCU graduate and intern at Cairns and Hinterland Hospital and Health Service. He’s been an integral member of the group since it commenced and is excited by what it’s become. “We’re passionate about contributing to our community in a positive and impactful way. Not only is the Cardiac Challenge a great way to contribute to cardiac services in the region where we live and work, the ride itself is brilliant. It’s one of the best supported and organised charity rides through some of the most picturesque landscapes in the country,” Matthias said. North Queensland Regional Training Hubs (NQRTH) is proud to sponsor the team as they undertake this big challenge for an important cause. Matthias says the funding has allowed the Doxycyclists to get printed jerseys for 30 riders to train and ride in for the next two years. “From the beginning, NQRTH has been in our corner helping to make this happen – they’ve been instrumental in turning the dream into a reality. Their role in supporting medical students and junior doctors in this adventure is a perfect illustration of their attitude and the role they play in the region,” Matthias said. NQRTH is dedicated to promoting the range of medical training opportunities – from internship to fellowship - available in northern Queensland with the aim of addressing the shortage of doctors in the region. “Servicing rural and regional Queensland is a passion shared by the group. Many of us grew up in these centres, and we want to give back to our home communities. Add to that, the opportunities personally and professionally to a junior doctor up here are outstanding,” Matthias said. It’s an attitude that has extended from the hospital to the road, instilled in the Doxycyclists strong focus on building connections and exploring the region. “The team is about fostering relationships within the junior doctor ranks and medical students by organising regular rides. The lifestyle available to doctors working in this part of the world is fantastic. There is a rich culture of active, outdoor pursuits. This ride is a prime example of what regional Queensland has to offer,” Matthias said. So far, the team have raised over $10,000. You can sponsor the NQRTH Doxycyclists and help fund improved cardiac services for Far North Queensland. Visit https://bit.ly/3iKl11C to find out more.

4 August 2021

Going all-in on life as a rural GP

Some people get a taste for country living and want another bite. After just one week holidaying in the beautiful Atherton Tablelands, GP Dr Catriona Arnold-Nott came straight back for the full meal. In a recent interview, she shares how satisfying and enriching the life of a rural GP can be… So firstly Catriona, set the scene for us on how you came to be living in the Tablelands. We hear you went ‘all-in’ on country living straight away? It sounds crazy. We never planned to live here! We were living on Thursday Island and came through the area on a holiday with our three young children. A week later, we had bought ourselves a 120-acre farm! It was a totally impulsive decision. We had never talked about living in this part of the world. We had never talked about owning land. We had never, ever talked about being farmers! When we moved here, it was like finding home for the first time in my adult life. Up until then, I had thought where I had grown up was home and that I would probably end up back there one day. Then we moved here, and straight away I thought ‘My bones are going to be in the cemetery here’. I grew roots so quickly and so deeply. It sounds like it was love at first sight for the region! You’ve been in the town for 10 years now. How would you describe your role as GP in the community? I think most people think GPs are just doctors so our role is to provide medical care to patients. It’s entirely true, of course, we do do that. But what I’ve learned from being here 10 years is that my role is much more than medical care. My role is counsellor, support and general advice, community engagement. We're community members, but we are always identified as the doctors as well. When I walk into our local shops, people say, ‘Hey, Doc, how you going?’. I think that's the pivotal bit about being a doctor in the community. Although we are fully enmeshed as community members in all these other different aspects, to the people around us we’re the doctors. It's not about respect and it's not about being on a pedestal, it's about our role and the fact that people know they can come to us and we will always try to help them, no matter what it's about. How does being a GP in a regional setting like the Tablelands compare to the big smoke? Well, I certainly don't want to diss my city colleagues, because they do very important and challenging jobs. But working as a rural GP, I think we do have to think on our feet a little more. I know we're only an hour and a half or two hours away from the nearest tertiary hospital, but many of our patients don't want to drive that far. That means I do much more procedural work than I would if I was in a city. When I see a tricky skin cancer, I say to the patient, ‘well, you know, we should send you down to a surgeon to get this chopped off’. They say to me ‘Catriona, you do it for me, I trust you’. My skills grow and I get better at doing that sort of stuff. I feel more confident to offer those kinds of services to our patients here locally, so they don't have to travel. What gets you out of bed every morning and excited to do this job? You know, I cannot imagine a job I could possibly enjoy more. I love relationships and I love people. I get to sit all day long and hear people’s stories, and then I get to walk those stories with people. I walk the journey of life with people from so many different backgrounds, from every age, every culture, every socioeconomic group. I hear stories and I am part of their stories. Those relationships for me are so strong. That’s what makes me love my job. I think I had a sense of it before I settled here, but I’d never worked anywhere for more than four years before we moved here. There is a real depth gained from being in this place for over a decade now. I'm looking after pregnant women who were childhood friends of my kids. This experience of walking through life with my patients is incredibly enriching.

3 August 2021

Taking a passion for rural health to hallowed halls of Harvard

For Dr Helena Franco, growing up in Brisbane and completing her undergraduate training on the Gold Coast made pursuing her career in the city the straightforward choice. But a short GP work experience placement in high school gave her a taste of regional medicine and left a lasting impression.

6 July 2021

An adventure in emergency medicine

For working mum and Emergency Medicine registrar Dr Farah Aziz, having a work-life balance was a critical factor for choosing where to complete her medical training. And according to Dr Aziz, she found it at Mount Isa in North-west Queensland.

1 July 2021

Making a difference in families' lives

A dual trainee with the Royal Australasian College of Physicians (RACP), Dr Williamson is completing her advanced training in general paediatrics as well as neonatal and perinatal medicine.

7 June 2021

A global journey from Kenya to Mackay for international intern

Originally hailing from Kenya, relocating to Canada and then to North Queensland, JCU medical graduate Dr Shivam Khanna has undertaken a journey across the globe in his quest to become a rural generalist doctor. “I grew up in Nairobi, Kenya and then went to pursue an undergraduate degree in sciences in Canada. About midway through my degree I realised that I actually wanted to do medicine. I really enjoyed studying human physiology and anatomy and I’ve wanted to help people. “Having grown up in Kenya, I had a particular interest in rural and tropical medicine so I did some research on where best to study this and James Cook University came up, so I applied to study there and the rest is history!” For the first year of his internship, Dr Khanna moved to the rural town of Mackay, located on the Coral Sea coast in North Queensland’s Whitsundays Region. “I chose go to Mackay for my final two years of medical school as I'd heard great things about the hospital there. I wanted an environment where there were small teams and where medical students could get really involved in patient care. And then I decided to stay on and do my internship there as well.” Located at Mackay Base Hospital for two years of his internship, Dr Khanna has since completed rotation in anaesthetics, orthopaedics, general medicine and general practice (GP).“They’ve all been very different rotations with diverse presentations of patients. But for all of my rotations, I was part of a small team consisting of either a consultant, registrar, or resident doctor and myself. So you are able to get lots of hands-on experience and in the process learn a lot about how medicine is actually practiced. “Anaesthetics was a really good rotation to start off with, as you learn a lot of practical skills such as airway management and cannulation skills, which set me up well for the rest of my internship in general medicine. “Being in anaesthetics also meant my job was pretty much on the frontline, in that you need to observe if anything goes wrong with the patient and to manage that. Although of course you also need to be able to recognize your limitations and when to escalate a situation to a supervisor, registrar or consultant. “It’s a very well-supported rotation as there's a consultant with you most of the time right next to you, giving advice, and you're learning from their experiences. So it’s a very safe environment for you to take that next step and challenge yourself.” Reflecting back on his internship experiences at Mackay Hospital, Dr Khanna says it was the uniquely regional nature of the hospital that had a positive and dramatic impact on his learning journey. “Being in a regional hospital means there are less sub-specialties and more opportunities for general medicine instead. Which means you have more opportunity to ‘step up’ as a junior doctor." “In a large hospital, for example, a case of pneumonia might go to a respiratory physician or the respiratory team, whereas in a regional hospital like Mackay you end up getting a good exposure to a whole variety of different presentations that would normally only be managed by sub-specialised teams.” The friendly workplace culture of the Mackay Hospital was also a standout feature. “You quickly get to know the nursing staff, the pharmacist, and the allied health team of speech pathologists, physiotherapists and occupational therapists. You get to learn how each other work as you build a relationship based around the patient’s care. “Everyone's really friendly because you work in such close proximity to each other. There’s never been a case where I've asked for help and it hasn't been available. I feel like the culture is such that people want to help you, and that you just have to ask for it.” Another important ingredient of the medical training in Mackay Dr Khanna experienced was the quality of supervision he received throughout his internship there. “I have found the supervisors in the Medical Education Unit to be extremely approachable. You're always being encouraged to learn more and to make the next step. You feel safe to practice what you can because you know that they are nearby and ready to help you. “You also have the opportunity to really get to know your consultant and your registrar and they also get to really know you which helps to set the foundation for trust. You are then able to gain better exposure and experience through that trust. “Working in a safe environment with this kind of support has benefited me greatly because I've been able to take that next step.” The supportive nature of supervision was also evident on ward-based rotations, such as orthopaedics. “For the orthopaedics rotation I was mostly involved in managing pre-operative and post-operative patients. So it's often managing their pain, managing their nausea, and managing any other comorbidities they might have. “But it’s also important to recognise any surgical complications that may arise and escalate those to your registrar or to the consultant. Fortunately, there is always someone available to help when you need it. It’s great knowing that someone has your back.”

5 May 2021

Life and medicine in the Burdekin

Fishing, family, cane fires and fast-paced clinical work: thatâ€™s what Dr Ben Lawry calls paradise. Dr Lawry is the medical superintendent at the Ayr Hospital and JCU GP supervisor. He made the decision to set down roots in the Burdekin early in his career.

28 April 2021

Cutting-edge technology for urology surgery at Cairns

While the surgical speciality of urology may not be an obvious choice for many junior doctors, for Dr Munad Khan it is one that offers both many challenges and rewards.

15 April 2021

Reflections on a 30-year orthopaedic career spent in the far north

For senior Orthopaedic surgeon at the Cairns Hospital, Dr Andrew Graham, the lure of working and living in tropical North Queensland proved too big to ignore and came as somewhat of a surprise.

22 March 2021

A Message from the Program Manager - Andrea Muller

2020 saw the event of COVID-19 and the impact that it had on students, medical staff and the whole of society. We saw the best of our front line health workers dealing with the uncertainty of what was to come, college examinations and the investigation of alternative work models. As students returned to the clinical setting there was even more participation and collaboration from doctors and academics across the region to ensure that our students received the necessary clinical training to pass their 5th and 6th years and graduate on time. The huge amount of effort and collaboration between JCU and the Northern Queensland Hospital and Health Services was outstanding. Doctor welfare has continued to be a talking point at all levels of the training continuum. COVID-19 may have exacerbated existing mental health conditions so it has been more important than ever to support each other and check-in on our colleagues and offer support. Due to the strong collaboration between everyone involved, we have grown as people and shown ourselves to be adaptable and resilient. 2021 is shaping up to be an exciting year ahead! We have collaborated with Queensland Health to host Queensland’s only 2022 Intern Campaign Webinar which will be promoted to graduating medical students around Australia. Students will learn about Queensland Health’s selection process and hear from current Interns and Workforce staff from Townsville University Hospital, Cairns Hospital and Mackay Hospital who will highlight the exceptional learning opportunities available in these facilities.

12 March 2021

Ari's intern year in Cairns

For Dr Ari Isman, his intern year in Cairns was a good year. â€œIt was very busy, but it gave me more than what I would have ever imagined. â€œEvery rotation was different, and I learnt so much from every single one of them. I had the opportunity to work in Mareeba."

11 March 2021

Gia's intern year in Mackay

For many future doctors, the idea of their intern year is nothing short of daunting. But for Dr Gia Cavalieri interning at Mackay and Proserpine hospitals in north Queensland was an overwhelmingly positive experience, one which has seen her grow and flourish as a doctor.

22 February 2021

A journey for opportunity and adventure

With a medical family and a thirst for adventure, it’s little wonder Dr Marie Tran found herself choosing to do her intern year in the north Queensland city of Mackay, with a rural rotation up the road in Bowen. “I’m from Montreal in Canada, but chose to study medicine at James Cook University in north Queensland. I’d met a lot of Australians doing their gap year in Canada and knew a lot of Canadians who went to Australia.” “We have two uncles who are doctors and two cousins in Australia who both graduated from medicine. They always told us that we had the personalities for the marathon that is medicine and a love of adventure. So they'd say why not study in Australia and have an adventure at the same time.” Dr Tran received another nudge in that direction when her older sister decided to follow their advice and enroll in medicine at JCU. “My sister is also a doctor. She is the year ahead of me and started the marathon a year before me and really liked it. I kind of do everything that she does.” Dr Tran said the decision to apply for an intern position in Mackay was something of a no brainer, having spent the last two years of her medical degree with the JCU Clinical School there. “I picked Mackay for my final years of study because my sister was there. She chose it because there were fewer students. This meant they got to do more and have more independence while still students,” Dr Tran said. “We were still in med school but we got to do similar jobs to the interns. It made the shift to the intern year much easier. I was more confident and had so much hands-on experience already.” But Dr Tran said even for those new to the region, interning in Mackay, with a rural placement in Bowen, is a great experience. “Everyone is extremely supportive and they understand our journey. They're always there to help if we need it.” She admits the broad clinical case-mix seen in regional and rural areas certainly adds to the experience. “It’s awesome to be in a rural area. There’s a different flow and you get to know the ‘frequent flyers’ better. There’s a lot more autonomy and responsibility. We’re also taught how to use the rescue services and there are a lot of emergency simulations as part of the training as well. In one of those simulations, the doctor had to insert a chest drain because of pneumothorax with guidance over the phone from the Critical Care Centre.” Diagnosing and treating tropical diseases is another bonus for the junior doctor. “As JCU is a tropical university, we learnt a lot about the common presentations in tropical areas, such as Q-fever, melioidosis, rheumatic heart disease, and Ross River virus. It was built into our curriculum and history taking from early on.” Dr Tran explained. “Some of our colleagues from the south come to us and say ‘wow, I just saw a case of rheumatic heart disease, I thought that never existed except in the textbooks’. And we’re like, ‘nope, up here it’s actually pretty common’.” It’s not only the work that has grabbed the former Montrealer, with the north Queensland lifestyle around Mackay and Bowen hitting the spot. “I get to go swimming every day. The beach is five minutes away and if I’m on a late shift I’ll go and swim in the morning before work. There are some great perks! “Bowen is the most stunning, beautiful area to work. There are hiking tracks that go to all the different beaches. You hike for an hour and finish up going for a swim. The water is so inviting it is like a magnet." “When people come to Horseshoe Bay you can see their eyes are just drawn to the water. There’s something magnetic about the blue and the green. It’s awesome, great for snorkelling and the reef is beautiful. “I understand why it is such a good tourist spot. I hear a lot of tourists out and about and then get to treat them as patients too.” While she’s loving life in north Queensland, Dr Tran said it’s also an important step toward her ultimate goal of working in critical care. A pathway she fell in love with while on rural placement as a medical student. “We had to transfer a patient by helicopter from Ayr and it was late at night. It was my first experience with the retrieval helicopter. In walks this doctor, and she’s little like me and she was wearing the flight suit with 'Doctor' on the back. I thought that’s what I want to be. I’ve been pursuing that path ever since.”

13 October 2020

A helping hand for mental health

Mental health was always going to be a significant problem during the COVID-19 pandemic, with fear, illness, and isolation proving a potent cocktail. Nowhere is this being experienced more acutely than amongst healthcare professionals on the front line of the battle. For many, it’s been months of intense psychological pressure and exhaustion as they help others, whilst fearing for their health and that of their families. For many, that’s being managed against a backdrop of isolation as a result of lockdowns and restrictions. Psychiatry registrar Dr Tahnee Bridson has long been aware of the impact of working in the medical profession on mental health, with many doctors suffering high levels of stress, anxiety, and depression long before anyone had ever heard of COVID-19. “We work in very stressful environments and the typical kind of personalities that we tend to have are quite perfectionist, and very driven and very hard on ourselves and this can lead to burnout,” Dr Bridson said. Last year Dr Bridson worked with mental health advocates, including former Australian of the Year Professor Pat McGorry, to organise a mental health week in Cairns. The aim, to raise awareness of mental issues in the wider community and to remind her medical colleagues of the need to look after their mental health and wellbeing. “We wanted everyone to think about their mental health and to know that it is okay to not be okay. We wanted people to feel they could put up their hand and say ‘I’m struggling and I need help’. People need to know that it is okay to be human, that no one has to be superhuman, and always putting on a brave face when things get tough. “We also felt it was really important for people to know where they could turn for help,” Dr Bridson said. The success of the project had organisers looking at ways to expand in 2020, when the world was plunged into the unknown of COVID-19. Dr Bridson said such a major, ongoing stressor was always going to take a heavy toll on the mental health of doctors and other healthcare professionals working on the front lines of the pandemic. To her, it seemed logical that they look at how their work from the previous year could form the basis of a support network for all health care professionals in need. Thus the Hand-n-Hand network was born. “It’s not a clinical treatment service, we are not going to act as their doctor or treating nurse, psychologist, or dietician. It is a pre-clinical service for people looking for peer-to-peer support to help through this time. It’s not just for doctors but all healthcare workers.” “The whole idea for the name was just something I came up with on Sunday afternoon while trying to think of something catchy to call us. It stands for ‘Helping Australian and New Zealand Nurses and Doctors’. I was kind of worried that it might sound a bit lame, but it’s caught on and everyone likes it.” Organisers started on social media, setting up on Facebook, Twitter, and Instagram, calling for those who wanted support and those keen to act as mentors or supporters to sign up. Within a day more than 400 healthcare professionals had asked to join. That number quickly quadrupled to 1600. Six months on and Hand-n-Hand is now a national peer support network, working in partnership with the Black Dog Institute through The Essential Network for Health Professionals (TEN). The psychiatrists, GPs, nurses and allied health professionals provide effective peer support and mentoring services. The organisation also has the interest and support of several medical colleges, including the Royal Australian and New Zealand College of Psychiatrists and the Royal Australian and New Zealand College of Obstetricians and Gynecologists. Members have also presented webinars and conducted radio interviews about the importance of mental health. The service has reported a significant increase in healthcare professionals seeking help in Victoria due to the second wave of the COVID-19. At the same time, it is also supporting people around the country and across the ditch in New Zealand. “There’s been a definite increase in the number of people asking for support. It started more with medical doctors, but it’s now expanded further into allied health and nursing as its gained traction,” Dr Bridson said. She believes by making Hand-n-Hand an informal, peer-related service, health professionals are less scared to ask for help. “There shouldn’t be any stigma attached to mental health but people worry that there will be. This just makes it a little easier for them to put up their hand and say ‘I think I need support’. The other really nice thing is we’ve had support within hospitals with department heads and bosses getting behind us. They’ve been quite keen, which is good. If it trickles down from the top, junior doctors and healthcare workers will be more likely to take it up.” Feedback has been overwhelmingly positive from both those seeking support as well as those offering it. Dr Bridson said the next step is to roll the program out to medical students, linking up with the Australian Medical Student’s Association. It’s hoped a pilot program will run for medical students at James Cook University in Townsville next year led by Professor Brett McDermott, one of the founding members of Hand-n-Hand. In the long run, Dr Bridson hopes the work of organisations such as Hand-n-Hand will help instigate change across the whole profession, from student level to the top. “Mental health and wellbeing need to be taken seriously in the workplace, especially in healthcare. While COVID has brought with it so many challenges, it has also allowed us to really raise these issues and hopefully get more ongoing long-term support for our colleagues.”

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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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