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.
Discovering a love for Emergency Medicine in Far North Queensland
After graduating from JCU in 2011 and completing PGY1-4 in Rockhampton, Dr Bond followed her love for rural medicine and the country lifestyle into the Rural Generalist Pathway. But as her training in the Central Queensland hub of Rockhampton progressed, she realised her interests were gravitating towards the Emergency Department more than the GP clinic.
“I loved the pace and the energy of ED. I really enjoyed the larger team there and the fact that you had a lot more people to bounce ideas off in that setting,” Dr Bond says.
So in 2014, Dr Bond ‘jumped ship’ and commenced training with the Australasian College for Emergency Medicine (ACEM), first continuing in Rockhampton before moving back to Cairns in 2016. Both locations provided the perfect training ground for Dr Bond’s growth as an emergency physician, with a variety of presentations, a range of patient demographics and a supportive team environment.
“You have some really special relationships, not just among the doctors but the entire health care team of allied health, nursing staff and admin. There’s less of a divide, less hierarchy, and more of a common goal,” Dr Bond says.
Emergency medicine has provided plenty of the purpose and impact that Dr Bond was looking for in her medical career.
“I know that I make a difference in most of my patients' lives when they present to the emergency department. You're there for a patient on potentially the worst day of their life. To be able to help, and even just make them feel more comfortable, is a really rewarding part of my job.
“Doing it up here in North Queensland, where there is just such a diverse range of presentations and the patients are stoic and appreciative is really special,” Dr Bond says.
Two ways to help close the gap in Indigenous health and training opportunities
Driving Dr Bond’s passion for Emergency Medicine is a personal commitment to helping Close the Gap in Aboriginal and Torres Strait Island health outcomes, and she’s leading the way as an Indigenous doctor on the frontline of patient care.
“ED is the front door into the hospital for most patients,” Dr Bond says. “It's really important that we can be culturally safe and that we as Indigenous doctors can encourage our peers and colleagues to be culturally safe as well.
“We need to be making hospitals safer for our Indigenous patients because they have much higher burdens of disease and shorter life expectancies. If we can improve their experience in the health system, we're doing a lot better in terms of health outcomes,” Dr Bond says.
Currently, there are seven Indigenous FACEMs in Australia, with Dr Bond the first to Fellow in Queensland. According to ACEM, there are 19 trainees as at June 2022 who identify as Aboriginal and/or Torres Strait Islander.
“The numbers have increased significantly in the last few years, but they're still so low. Now is the time to be pushing other specialty colleges, not just emergency medicine. Every Indigenous junior doctor or medical student needs to know that they can pursue whatever specialty they want. They have the ability to train and to learn and there's support, scholarships and mentorship available,” Dr Bond says,
Dr Bond has been heavily involved in the Australian Indigenous Doctors Associations (AIDA) since her second year of medical school. She is also involved with ACEM as a member of a steering group committee, working on the second draft of an ACEM Reconciliation Action plan.
“Increasing the Indigenous workforce in medical specialties is a really high priority for us. We want more people. The only way we're ever going to change things and to help Close the Gap is by getting more Indigenous doctors into these specialty pathways.”
“I’ve had plenty of patients who have really valued being treated by an Indigenous doctor. I think that makes a huge difference for patients to know that it's their mob, and they feel safer. You come away from those interactions with a big smile, when you're allowed to call someone Aunty and you get to know them, it’s really lovely,” Dr Bond says.
The journey to Fellowship and overcoming setbacks…
While it has been a rewarding journey for Dr Bond, Emergency Medicine training has provided its fair share of setbacks, like failing exams, that have pushed back her completion date and left her questioning the path forward.
“I failed the written exam by three marks and the OSCE [Objective Structured Clinical Exam] by 1 to 5%. Tiny amounts between passing and failing, and it felt devastating.”
“It’s something that we don't talk about, and it's something I think we need to talk about. The pass rates are sort of around 60 to 70%. We need to be open about the fact that the majority of us will fail at some point. And that's nothing to be ashamed of,” Dr Bond says.
Fortunately for Dr Bond, during these setbacks she had something to lean on; supportive colleagues around her and a great hospital community.
“After failing, I went to my friends, my bosses that I worked with, and the overwhelming response was ‘This is just an exam. It’s not a reflection of who you are as a doctor, we would love for you to treat us any day of the week’.”
Dr Bond pressed on for another two years, fellowing in May this year. As it turns out, the delayed completion of her Fellowship has been a blessing in disguise.
“I didn't know what my reaction would be when I got that result, but when I read it I just burst into tears because the relief was just that extreme.”
“Failing meant my training was extended, but because of that, I’ve just walked straight into this job from being a registrar. I think that it was meant to be because if I had passed six months earlier, I would have been without a job for six months,” Dr Tatum says.
The need for more Emergency Medicine specialists in northern Queensland
As the largest major hospital in Far North Queensland, Cairns Hospital plays an active and important role in the treatment of emergency cases across a vast region. Beyond the Cairns population of 160,000, communities right up to the Torres Strait Islands, and as far west as Georgetown will turn to the Cairns Hospital ED in acute and critical cases.
“We’ve got a huge area that we’re covering from here in Cairns,” Dr Bond says. “Some of our patients are coming in from little tiny towns of 500 people. So they're coming into the ‘big smoke’ and they're terrified and they don't know anybody or anything about the town. Being able to assist them through that journey is one of the things that I enjoy the most,” Dr Bond says.
In terms of the demand for ED doctors in the Far North, Dr Tatum says to prospective trainees not to listen to a persisting rumour that the specialty training pathway is oversubscribed in Cairns.
“We’re not oversubscribed here, we’re actually short and that’s across the board of our roster. So don’t listen to the rumours that there are no places here. I would say nine times out of 10 If you want to come here, we're willing to help facilitate that. We'd love to show you what medicine is like up in North Queensland,” Dr Bond says.
What kind of doctor would be suited to Emergency Medicine?
According to Dr Tatum, working in Emergency has been exactly the kind of experience you might expect; fast-paced and ever-changing. For her, it’s the perfect environment to match her medical interests and temperament.
“You don't know what you've got coming through the door on any given day. My attention span doesn't last more than about four hours, so an ED setting works for me.
“If you're someone who enjoys triaging, procedures, and problem-solving, then ED is definitely for you. It's a high-stress environment, but there's always people to bounce ideas off which is great,” Dr Bond says.
NQRTH connects medical students, interns 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. NQRTH is facilitated by James Cook University, which partners 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.