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.”
The med school experience
Dr Gill, who grew up on a banana farm near Cardwell, was based in Townsville for the clinical years (4-6) of her JCU medical degree and rates those years as the best part of the degree. Looking back, she appreciates the preclinical years (1-3) as a time when students build the foundations of their clinical knowledge and start developing the communication and teamwork skills that will be essential to their careers as doctors.
“First year can feel like drinking from of a fire hose; there’s a lot of information coming at you. But then in second year you’re starting to put it altogether. You’re developing a lot of new clinical skills and learning about the systems. The rural placement in second year was probably one of the highlights of my time in medical school. Going back to Ingham, where I went to high school, I felt like I was able to give back to the community even as a medical student, taking histories, drawing blood, and suturing.”
During her Bachelor of Medicine, Bachelor of Surgery degree, Dr Gill completed a third-year placement in the small American town of Harvey, North Dakota, as winner of the Lynn Kratcha Memorial Rural Bursary, as well as placements in Babinda in fourth year and Tully in sixth year. “The knowledge and skills I developed whilst on rural placement, I continually apply to my day-to-day work as an intern. Your experiences from rural placements become indispensable throughout your career.”
“See one, do one and teach one”
Harjyot’s top 3 tips for med students
1 Embrace teamwork
“Medicine today relies on the collaboration between doctors, nurses and allied health professionals so becoming a great team player early on is going to help you throughout your career. For example, in theatre, every day you're working in a team with the anaesthetist, nurses and orderly. On your medical wards, you’re in a big team with your consultant, registrar, resident as well as nursing staff and allied health professionals. In ED when there's a resus call, you’re once again a part of a team with a key role. In general practice, you're working with other GPs and nursing staff.
‘Learning how to collaborate towards a common goal, being open minded, delegating tasks based on others’ strengths and being receptive to feedback are skills which can be developed in a team setting and will aid in the provision of quality healthcare for your patients.”
“Don't feel like you need to study everything yourself because that's just not possible. No doctor, or any healthcare professional for that matter, ever works alone. So, if you can establish a study group early on, this will help you throughout medical school and beyond. Knowing your role within a team, how to best perform this role to ensure the success of the team, and how to support your teammates are incredibly vital skills.”
2 Work on communication
“Communication is the cornerstone of healthcare and it’s not just about communicating with your patients, but also with other health professionals. There are many examples that I could think of where communication is so important, and it's usually when there's a breakdown in communication that things go wrong, or errors happen. I find myself practising my communication skills every day when I call for consults, protocol scans with radiology and, most importantly, when I’m in a rural setting requesting retrieval of a sick patient via RSQ (Retrieval Services Queensland). Therefore, knowing how to communicate effectively is essential for safe and timely care of your patients.
“You can have all the knowledge in the back of your mind, but at the end of the day, the patient wants to know that you care for them, and if you can communicate that with empathy and compassion, this will make a world of difference to your patient's healthcare journey.
“In doing so, it also makes caring for your patients a more rewarding experience. When I interact with my patients, I find myself, educating them on their health, motivating them to make lifestyle changes and empathetically breaking bad news. As a medical student you can learn so much simply through observing doctors on placement as well as practising counselling/communication with your peers in study group.”
3 Make the most of your placements
“When on placement, take initiative and be proactive, because your doctors and supervisors will notice this and want to get you involved. This usually leads to a greater placement experience and further development of your knowledge and skills.
“This can also open many more doors for us. As a medical student, I was offered the opportunity to be involved in audits and research projects when I demonstrated my interest and willingness to learn. You might even be lucky to find a mentor who can guide you throughout your career.
“Placements can also present you with the opportunity to figure out what type of doctor you want to become. That's not just specialty wise – whether you want to pursue general practice, surgery, or medicine – but also the type of doctor you want to be when it comes to caring for your patients. You can pick up on the good things that others are doing and make it a part of your practice. You can also observe the not so good things and be mindful of those in the future.
“At the end of the day your patients are your greatest teachers. Of course, there’s so much you can learn from your lecturers and in the classroom, but ultimately at the bedside is where your learning will happen. That's where you will consolidate your knowledge, practise your history taking, clinical examination and procedural skills. It's not on mannequins or in clinical simulations, it’s at the bedside so I hope you make the most of it because it is truly a privilege to attend placement and be involved in the care of people at their most vulnerable.”
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.
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.