Postcard from NT

Five years of medical school and five more years of working as a doctor has not taught me anything about being an air traffic controller. Yet, working as the District Medical Officer on call for East Arnhem Land, I wonder if I perhaps should have taken a course in aeronautical logistics.

East Woody Beach, Nhulunbuy

I'm working in Gove District Hospital in Nhulunbuy, Northern Territory on a 3 month GP registrar rotation. This area is a place of wonderful contrasts, of bumpy dirt roads that become impassable in the wet season, and a hot spot for little planes shuttling people in every direction. The hospital receives patients from the mining town where it is situated, several nearby Aboriginal communities, a number of bigger communities further away, and many small homeland regions. The budget for patient travel is enormous. It is often a logistical challenge to prioritise and arrange transport by phone, with minimal knowledge about how well equipped your caller is to handle an emergency. For acute medical problems, Careflight provides evacuation services. For less serious issues, the patient travel department scrounges seats on charter or commercial flights.

Working a shift as the District Medical Officer, many of these issues become important. Is it better to send the lady with unstable chest pain straight to Darwin with a nurse escort now, or wait a few hours for a team including a flight doctor to come? When the autopilot equipment on one plane breaks down, how will the young man with acute abdominal pain be brought in? Can the pilot fit in one more pickup before running out of allotted flying hours for the day? Is the broken down plane removed from the runway in that community yet?

Working here is a rich and challenging experience in many ways. Sometimes it seems a different world to down South, and as a GP registrar it is great to experience new things in training.

National Minimum Terms and Conditions Review

Generic handshake

GPRA is involved in a process of updating and reviewing the National Minimum Terms and Conditions for GP registrars in GP term 1 and 2. This is a really important process as it lays the basis for the minimum terms and conditions that GP registrars experience. The salaries recommended by NMTC are regularly indexed, but this year the whole document is up for review.

As current SGPT GP registrars or GP supervisors, you are engaged in working with the NMTC. We are really keen to hear your input or "wish list" about what should be upheld or changed in the NMTC. Have you come across anything you think should be different? Let us know at rlo.east@sgpt.com.au

Exam results

Getting results from GP training exams is often a time of celebrating, but sometimes it can be difficult. Congratulations to all who passed the recent RACGP OSCE's! No matter how you did, feel free to contact your SGPT RLO's (Andy or Letitia). We're always happy to have a talk, whether you want to share some good news or need some support.

The Future Series

Are you wondering what comes next after GP training? GPRA is running "The Future Series", an interactive online conference for registrars and newly-fellowed GPs. It involves a series of 16 excellent webinars presented by doctors who can give a first hand insight into business issues after GP training finishes.

There are four topic streams in the series:

• Successful negotiation
• Being the Contractor 
• Being the Boss (solo practice)
• Sharing the Profits (group practice)

Webinars are only $22 each or $110 for access to all sessions. You can attend for as many sessions as you like.

More Information: www.gpra.org.au/future-series

Register here: http://gprafutureseries2011.eventbrite.com

A digital habitat

SGPT is partnering with the University of Tasmania and GP Training Tasmania in an exciting new project investigating a "digital habitat", building on the existing "STARs" platform of resources. You can get involved too. Here's what Dr James Brown has to say:

We are running a project to develop a web based 'digital habitat' to support learning in General Practice. This 'habitat' will use the new wave of web tools.  Before the development stage we are investigating current use and perceptions of GP learners and teachers in using web based tools for education and collaboration.

This project is likely to incorporate what we have already done with the STARs platform.

We are using a questionnaire as part of the study. I would be most grateful if you could give approximately 10 minutes to do the questionnaire. The success of this study depends a great deal on your participation in this.

To participate, click on the link below: 

https://www.surveymonkey.com/s/VHGZ2KC

Postcard from NT

Andrew Roberts is working for 3 months in the remote communities of the Katherine West Region, NT. Read about his experiences in this "Postcard from NT"

“Remember to keep your feet clear of the pedals, and don’t touch the joystick. The exits are…well…right next to you.”

It was the first time I’d seen a flight safety demonstration that included such instructions, but then, I’d never flown on such a tiny mail plane before. We were flying from Katherine out to the remote Aboriginal community of Lajamanu, roughly 600km to the south west. All things considered, I was quite glad to have even made the flight. The pilot had apparently not been told that she had a passenger today and had left half an hour earlier than scheduled. A quick call out on the radio and she quite happily turned back to get me. I can’t imagine such service from good old Qantas!

It was my first trip out to the remote community during my GP Registrar term, after a week of orientation and cultural education with Katherine West Health Board (KWHB). I was quite excited, if a little nervous. Lajamanu is a community of approximately 1000 mostly aboriginal people close to the NT/WA border in northern Australia.

The clinic is coordinated by KWHB, an Aboriginal Coorporation with whom I am placed for a 3 month GP term as part of an extended skills placement in Aboriginal Health. KWHB manage the health services to communities across a vast area of the Australian outback, roughly two thirds the size of Victoria.

The flight was hot, bumpy, slightly nauseating, and at times mildly terrifying, but the view was just amazing. The rivers and gorges, the hot, red dirt dotted with sparse vegetation, and the sheer remoteness made me realise how lucky I was to be visiting such a unique place. As we flew into the community, I realised how small it all actually was, when I saw that the runway poking out both ends of the town

We landed safely and I was dropped off at the clinic by the pilot. I was welcomed by the clinic coordinator who showed me around and I was surprised at how well-set up the clinic appeared. Four consulting rooms, a large waiting area and a 2 bed treatment room/emergency room seemed to provide everything we would be likely to need. I met the remote area nurses (RANs) that ran the place, and was struck by the dedication they showed living and working in such a remote place.

I happily took a wander around the town with one of the RANs and the clinic dog “Chopper”, so named due to her missing left ear. The temperature dropped nicely as we walked along the ‘main’ road, past the school, the store, the police station and the administration building. Happy kids ran through the streets, all huge smiles and runny noses. A bunch of teens played football in the setting sun. The many camp dogs gave us a wide berth, apparently due to Chopper being so fiercely protective of the clinic staff. I made a mental note to befriend this dog!

As I lay in bed that night, my head replayed the many and varied opinions on aboriginal health that I’d heard all my life. The simple solutions spouted by media, politicians and indeed lay people. “We should just cut off their welfare payments”. “If only someone would build them proper houses”. “Why don’t they just get up and get a job”.

Already, after only one afternoon, it was glaringly obvious just how simplistic such views really were.

OSCE preparation webinars

No doubt many of you are studying hard for the upcoming RACGP OSCE on 23rd October. GPRA is once again offering OSCE preparation webinars free to its members.

These webinars are an excellent resource to help know what to expect in the OSCE and provide some great tips for success. They are hosted online with a presenter who has recently sat the exam.

Find out more at http://www.gpra.org.au/osce-preparation-webinars
The webinars will be held on:
Thursday 29 September — 8:00pm
Monday 3 October — 8:30pm
Thursday 13 October — 8:00pm
Monday 17 October — 8:30pm

We're hiring

If you are interested in working as a Registrar Medical Educator or Registrar Liaison Officer in 2012, then get in touch with us now! We are really keen to hear from anyone who is interested in these roles. It is a great way to extend your training and learn much more about the GP training scene, both locally and nationally.

Drop us a line at rlo.east@sgpt.com.au to express interest.

Five Minutes in the Spotlight with... Julie Rogalsky

Julie recently joined SGPT as the Regional Manager of the Eastern region. What better way to get to get to know her than through five minutes of fame in the RLO rant spotlight?

Julie is a true local, "born and bred" in Gippsland. She was born in the now non-existent Traralgon Hospital and has had a number of varied roles in the area since. Before joining SGPT, Julie has had involvement with the Central West Gippsland Division of General Practice, Bass Coast Regional Health, the Victorian Department of Health and Latrobe Community Health Service. Julie lives in Gippsland with her partner Shaun and her two children Alannah and Connor. 

When joining SGPT, Julie did not realise how soon she would have to demonstrate her true committment to the role. "I've already had to put my life on the line for this job," says Julie. It was on the final descent of the return flight from the recent GPET convention in Canberra that a lightning bolt hit the plane. Julie recalls that Linda Kruger encouraged her by saying "I'll see you in the afterlife". All we can say is: you thought a lightning strike was bad? Try taking on the RLO rant tough questions of the month. Here's what Julie had to say.

At school I... was a goody two shoes, always doing the right thing.

At home I cook... risotto! And lots of kids stuff.

The last big belly laugh I had was... Bridesmaids (the movie). Great to watch with a group of friends.

My greatest fear is... dying in a plane with Linda Kruger.

The best thing about GP training is... the degree of involvement and interest from experienced GP's, ME's and supervisors. And, of course, working with the fantastic SGPT staff!

GPET Convention 2011 - Highlights

The recent GPET convention in Canberra was a chance to hear about the future directions of GP registrar training as well as reflecting on the past. The main themes of the event were partnerships in Indigenous Health training, assessment of competence and quality and academic capacity. Some interesting and progressive ideas about assessment methods were raised by Ron Epstein (listen to the keynote address here). Of note, 22% of the academic papers at the GPET convention were presented by registrars, which is a fantastic increase from 0% a few years ago.

The GPRA also held its AGM and advisory council meeting after the convention. As your RLOs it was good to be able to represent local issues here in the various policies and ideas that are developing.

My reflection is that GP training in Australia is certainly an exciting area, with many inspiring people who are keen to see registrars become excellent General Practitioners in the future.

Five Minutes in the Spotlight with... Thevarajan Nakkeeran (Keeran)

Keeran is currently a GP registrar in Korumburra Medical Centre. We recently turned the RLO Rant spotlight in his direction to find out more about his story.

Keeran and Cynthia at a recent GP Workshop dinner

Keeran is originally from Sri Lanka, and grew up in a rural area. He studied medicine in Sri Lanka and worked there as a junior doctor. He and his wife Cynthia were married 13 years ago, and moved to New Zealand a few years later. Keeran's older brother was living in New Zealand at the time and working as an engineer. Keeran spent a number of years working with his older brother and was not practicing as doctor. However, he finally agreed with his wife's gentle prodding to continue his medical career. He got through the hurdle of the AMC exam, then worked in Gosford and Bendigo before heading in the Gippsland direction. He lives with his wife in Korumburra, and they are enjoying connecting with the local community as well as other Sri Lankan friends around Gippsland. Here's what Keeran had to say when asked some tough questions:

My parents always told me... don't lie a lot! In fact, this is what my mum said last time she rang me.
When I was a child I wanted to... be a GP! I had a great role model of a family doctor when I was growing up.
My happiest moments were... when we got married.
My earliest memory is... the happy day when I flew for the first time. It was to India.
The best thing about GP training is... a rewarding job.

Thanks Keeran!

Your working hours - are they safe?

What is the impact on the working hours of a GP registrar on fatigue, stress, patient care, and safety? GPRA recently released a discussion paper about safe working hours. Some of these issues are particularly relevant to rural GP registrars.

“The opportunity to acquire the advanced procedural and emergency skills that are provided in rural and remote training practices is highly regarded by most registrars,” says Dr Emily Farrell, GPRA Policy Director, “However, we need transparency in work hour expectation, and fatigue mitigation strategies, to ensure registrars are not deterred from continuing to work in rural and remote areas."

Read the full media release at the GPRA website, and the discussion paper at www.gpra.org.au/position-papers.

You may also be aware that the Australian Medical Association is conduction their annual survey of the working hours of junior doctors, which includes GP registrars for the first time this year. Please also consider participating in this survey. You can complete the audit by visiting http://safehours.ama.com.au.

A social night in East Gippsland

Recently the East Gippsland Cluster Group had a pleasant dinner at Miriam's Restaurant in Lakes Entrance to make connections and catch up on the GP training gossip. See some photos on the SGPT RLO Facebook page (and don't forget to "Like" it while you are there!).

We're encouraging each cluster group to organise a social dinner as well. Please contact Letitia or Andy (rlo.east@sgpt.com.au) to find out how to do this.

Academic Post at Gippsland Regional Clinical School

Does the idea of an academic registrar post interest you? Dr Daryl Pedler from the Gippsland Regional Clinical School based in Traralgon had this to say:

A/Prof Daryl Pedler

"We are very keen to attract an Academic Registrar here next year and envisage that the Registrar would have a combined teaching and research role.  While the exact time commitment and aspects of the role are negotiable, ideally we would be seeking a 0.5 appointment, which would allow the Registrar to continue in general practice for the balance of their working week.  The proposed teaching role would be into both the GP program (Year 4C) and also into our Year 3B program (i.e. those students undertaking their first clinical year and who are seeking to develop their basic clinical skills and knowledge).  We can also offer the Registrar support in developing research skills in a range of contexts; our particular interests lie in (medical) education, population health and clinically-related research and we would welcome their involvement in an activity related to one of these areas."

Academic Posts - what, why, and who

Do you enjoy finding out more about what interests you? Are you motivated by research? Does education excite you? You should consider an Academic Post! Now is the time to think about it for 2012, as applications close on 20th September.

An Academic Post is a great opportunity to get involved in research during your GP training. It is usually a part time position alongside clinical work. You can get involved with an existing research project, often attached to a University Clinical School, or research your own question, or even do a Cochrane-style systematic review. An Academic Post can count towards your training time if it is considered a "special skills" term. Find out more at http://www.agpt.com.au/TrainingPosts/Academictraining/

Dr Sandeep Bhagat completed an Academic Post with a research project attached to the School of Rural Health in Traralgon. Teaching of 3rd and 4th year medical students was a big part of this. According to Sandeep, "it is always a proud moment to meet a resident doctor who was once my student. There is a priceless sense of contribution towards a colleague's professional life." Sandeep identified flexibility with work hours, training in how to approach research and future university teaching opportunities as the best things about an Academic Post. "Please do consider an academic post," he said.

Dr Stuart Anderson has also completed an Academic Post in Gippsland. "My Academic Post involved a research project into the clinical exposures available to medical students doing their terms in East Gippsland," he said. "It was also coupled with a teaching role for those students and a role in developing some emergency skills training for local GPs, nurses and students." Stuart found that an Academic Post enabled him to have some flexibility with his time, as he was also the then getGP RLO and the Vice-Chair of GPRA. Stuart said he enjoyed the post because "it enabled me to develop my skills in teaching over the course of the year, and the flexibility of the job meant I was able to achieve quite a bit of medico-political work on the days when not much was going on academically and vice-versa." His advice to anyone considering an academic post is to "Make sure it is about something you enjoy a lot, and something that you want to pursue in the future."


Current opportunities for Academic Posts in Gippsland include involvement with the Monash University School of Rural Health in Traralgon (contact Dr Daryl Pedler daryl.pedler@monash.edu) and with the East Gippsland Regional Clinical School (contact A/Prof David Campbell david.campbell@monash.edu)

More Than Money - A Negotiating Guide for GP Registrars

GPRA have just released a guide for GP registrars about negotiating a win-win contract with their practice for training terms. It's a great resource to refer to and provides a good balanced approach to help with the process. Get it hot off the press from the GPRA website at http://www.gpra.org.au/negotiating-contracts

Get Social at SGPT

image via spaciousplanet

Time to get social with your GP registrar colleagues! As your RLO's we are keen to encourage some more social events.  In the aftermath of the approaching RACGP exam some of you may be keen to emerge from your copies of Murtagh and do some mingling. There's an opportunity for each cluster group to get together for something fun. Let us know if you are keen to organise an event in your cluster group by emailing us.

Five Minutes in the Spotlight with... Ning Chuo

Ning was kind enough to spend five minutes basking in the glow of the RLO Rant spotlight. Here's what we discovered. 

Ning is currently a GP registrar working in Bairnsdale Medical Group. She is looking forward to an upcoming 6 months extended skills post in Sexual Health at the Melbourne Sexual Health Centre. Ning was born in Sibu, East Malaysia and lived in Brunei Darussalam after that. She moved to Australia in 2000 and studied at Melbourne University. She worked as a junior doctor in the Austin Hospital before seeing the light and moving to the green hills of Foster at the start of GP training. 

We asked Ning her thoughts about some tough questions:

My last meal would be: Fried Kuey Teow

When I was a child I wanted to become: a Japanese Manga comic artist. (Ning generously agreed to donate an original piece to the RLO Rant collection, displayed for you here). 

The hardest thing I've every done was: to hug my brother. He really isn't a very touchy-feely kind of guy.

The best thing about GP training is: knowing all the other GP registrars. 

I'm always being asked: "How do you like Bairnsdale?". The usual answer is "Great when I'm not on call!". The other question I always get asked is "Are you Chinese?"

SGPT Registrar Counselling Program

A new counselling program for SGPT registrars is now up and running. This means that you can now access a psychologist free of charge and confidentially. We all know that GP registrars face many stresses associated with the job and training program. Many of us are geographically isolated from our usual support networks, but would be reluctant to access counselling via a GP mental health plan. 

Negotiation Skills Workshop - Letitia

It was with great pleasure I presented the first negotiation skills presentation to be presented from a registrar point of view at the GPT1/2 workshop. The idea of this is to increase negotiation skills before the practice match which will take place over the next month. The discussion afterwards included the discussion about the East Gippsland requirement, getting some information to upcoming GPT1/2 registrars, and a confidential practice rating system so that registrars could use this information when choosing a practice. If you are interested in providing phone advice to registrars before their GPT1/2 terms we would value your assistance with this - please email us at rlo.east@sgpt.com.au

Hospital registrars - if you don’t know about the National Minimum Terms and Conditions for GP term 1 and 2, grab it from the GPRA website here.

Research project - Who wants to do GP training?

We need YOU to help answer the question: ‘Who wants to do GP training?’

Australia-wide, Victorian universities have captured the smallest proportion of medical graduates for general practice training. Why is this so?

Changing values within our society may affect the uptake of general practice training but one could argue this impact would be Australia-wide. Other influences for choosing general practice might be the academic, cultural and social influence of medical schools, and exposure to general practice during hospital training.

GPET has commissioned a small research project, led by the Department of General Practice at the University of Melbourne, to examine why registrars do or do not choose general practice training. The study will include data collection from Australian medical schools to determine exposure to general practice in their curriculum for medical students, as well as also focus groups or interviews with general practice and non-general practice registrars about the reasons for their choice of specialty training.

We are very keen to hear your views, and would interview you at a time and place convenient to you.

Please feel free to contact A/Prof. Meredith Temple-Smith, Department of General Practice, University of Melbourne, for further information: m.temple-smith@unimelb.edu.au or +61 3 8344 3371. Alternatively, if you would like to register to participate in the research, please contact Rebecca Gracey: rgracey@unimelb.edu.au or +61 3 903 45107

Research Week - July 15-22

Are you interested in research? GPET is hosting an online conference about research in General Practice. It's a great chance to learn about research, hear some fantastic speakers and interact with your peers. And because it's online, you can even attend in your pyjamas! Did we mention it's free?

Negotiation - Two sides of the coin

There has been some recent interest on the issues involved with GP registrars negotiating a contract with their practice. Some have said that registrars seem to have the upper hand in negotiation and ask for too much. However, the experience of many registrars would suggest that negotiating a contract for a GP term is a challenge for which there is little advice or training available.

Check out a recent Australian Doctor article that provides a debate about this issue with views from Dr Wicky Wong (GPRA Chair) and Dr Jon Emery (NGPSA Chair).

"Negotiation is about finding mutually beneficial outcomes." - Dr Wicky Wong

"Whatever the solution, this is a problem that needs resolution." - Dr Jon Emery

We have recently held a session for GPT1/2 registrars about how to negotiate a win-win contract with your practice, and we hope this becomes a regular session for years to come.

Watch this space - the GPRA are set to release a helpful guide to navigating the maze of contract negotiation.

Five Minutes in the Spotlight with Vin Rajeswaran

Vin is a GP term 1 registrar currently working in Bairnsdale. He lives there with his wife Tahlia and their 2 children. Vin grew up in Dindigul, a town in South India near Chennai. After completing his medical training in India, he moved to England for 2 years and then to Australia in 2006. Apart from medicine, he enjoys veggie gardening and cooking incredibly spicy food. Vin was put under the "RLO rant" spotlight recently - here's what he had to say:

My earliest memory is... being left by my father at the hospital where my mother was doing night shift as an obstetrician. He couldn't cope overnight!
My happiest moment was... when by two children were born.
At home I... cook - a LOT!
It's not fashionable but I love... farming.
The best thing about GP training is... having more time to spend with my family.
In five years I hope... to have built my dream house on my dream block of land.
What I don't find amusing is... people making generalisations about whole cultures.

The RACGP Online Exam

You may have heard that the RACGP written exam from now on will be a computer-based "online" exam. If you are interested in knowing more about what this involves, the following video may help:

We have had the opportunity to test drive the online exam and were very impressed with how slick it seems. To find out more, head to the RACGP online exam page.

Let the ranting begin!

There’s an old African proverb that says: If you want to go quickly go alone. If you want to go far, go together. We need to go far, quickly.*

This saying doesn't have anything to do with this blog, but a great blog needs a great opening line, and now this one does.

Welcome!

This blog is for registrars, supervisors, staff and interested onlookers in the Southern GP Training family in Gippsland. It is brought to you by your trusty Registrar Liaison Officers, who at the moment are Letitia Clark and Andy Linton. It will be a source of information, news, exam tips, registrar stories, and hopefully, fun. We'll send out this information in the monthly "RLO Rant" but if you want to get it while it's hot off the press, read it here first. You can also subscribe to our Twitter feed @SGPT_RLOEast.

Enjoy.