GP First 2019 by GPRA Publications

GP FIRST 2019 edition

MAKE THE MOST OF MED SCHOOL TIPS FOR FIRST YEAR STUDENTS

HOW TO BECOME A GP GPSN: GET INVOLVED

Journey beyond your expectations

Nhulunbuy

Darwin Katherine

Northern Territory General Practice Education (NTGPE) provides supported general practice training in urban, remote and very remote parts of the Northern Territory (NT). General practice training in the NT is highly rewarding, challenging and unlike anywhere else. You will be exposed to diverse clinical and cultural opportunities in the most beautiful and vast landscapes. You will have the opportunity to make a real difference at the primary health care level for individuals, families and communities. Choose GP in the NT for a journey beyond your expectations. Find out more, visit ntgpe.org.

Tennant Creek

Alice Springs

FROM THE CHAIR

tarting medical school is an incredibly exciting time. There is so much to do, including picking up new interests, making more friends and attending events. At the same time, it is easy to be overwhelmed by the multitude of clubs and extra-curricular activities on offer.

With so much going on, it is challenging to choose which clubs to sign up for. However, there is one club which is distinctive â&#x20AC;&#x201C; a club which supports you academically throughout your journey, offers opportunities to upskill and provides events to network with other students and professional doctors. The General Practice Student Network (GPSN) is a mustjoin for any medical student. As a national network, we serve thousands of medical students across the whole of Australia. Whether you are just curious about specialties or have your mind set on general practice, GPSN will provide you with opportunities to go beyond your medical curriculum and step outside of lectures and tutorials to be exposed to the diversity and depth of General Practice. There is a GPSN club at each university which has tailored events to your medical program, ranging from trivia nights, clinical skills evenings and guest speakers. In 2019, we will also see the introduction of state-based events to facilitate collaboration and to allow you to meet other like-minded students attending other universities in your own state. In addition, the GPSN national working group provides

an opportunity for students to collaborate on projects across Australia focusing on rural, Indigenous and community health. Past projects included the Cultural Immersion Trip to Kakadu, the Rural Farm Stay at Warwick and the Homeless Health Community project in Sydney. With the restructuring of the working groups for 2019, we hope to continue these wonderful initiatives and integrate local club involvement in these projects. GPSN is supported by General Practice Registrars Australia (GPRA). As a member of the GPSN network, you will also have access to the resources and support of GPRA throughout your medical journey from student, to prevocational doctor, to GP registrar. For more information about GPSN, please visit our Facebook page and website which also provides contacts to your local club and national executive. Whether you are just starting out or are a senior medical student, I would encourage you to get involved with GPSN by participating in local club events or by joining the GPSN national working group. Looking back at my first-year self, it was certainly one of the best decisions that I made. Welcome to our network. We look forward to being with you on your journey, every step of the way.

Elizabeth Wong 2019 GPSN National Chair GP First 1

CONTENTS From the Chair 1 What is GPSN? 4

MAKE THE MOST OF YOUR FIRST YEAR Attention: first year students

Textbooks: a guide for first year students

Four tips for first years

Improve your study techniques

Staying human in medical school

GPSN: HOW TO GET INVOLVED Find your local club

Club highlights 16 What is the GPSN national working group?

Cultural Immersion Trip

Farm Stay Trip 22 Meet the 2019 GPSN National Executive Team

GP First

Published by General Practice Registrars Australia Ltd Level 1, 517 Flinders Lane Melbourne Vic 3000 p 03 9629 8878 e enquiries@gpra.org.au w gpra.org.au

All efforts have been made to ensure that material presented in this publication was correct at the time of printing and published in good faith. The publisher does not accept liability for the use of information within this publication. Owing to the rapidly changing nature of the industry, GPRA does not make any warranty or guarantee concerning the accuracy or reliability of this content. ÂŠ 2019 GPRA. This work is copyright. Apart from any use permitted under the Copyright Act 1968, no part may be reproduced by any process, nor may any other exclusive right be exercised, without the permission of General Practice Registrars Australia Ltd.

MAKE THE MOST OF MED SCHOOL Thriving in med school

Part-time worker, full-time student

Tips for international students

SCUBA to stethoscope 36 Changing the pace 38 A general practice placement in Woolgoolga

How to write and build a medical CV

Make the most of your GP rotation

Incredible India 48

Research as a medical student

Applying for scholarships and grants

A placement like no other

Why general practice? 57 A call to heal: how GPs can work together to change the world, by GPRA Patron Professor Michael Kidd AM 58

FROM UNI TO JUNIOR DOCTOR Life after medical school: surviving your internship year

From medical student to intern by Clinical Professor Leanne Rowe AM

Preparing for general practice training; join the Going Places Network

My Health Record by Dr Rob Hosking

ENTERING GENERAL PRACTICE Pathways into general practice

Extended skills in GP training

How does GP registrar employment work?

Be a rural GP by Dr Bob Vickers

Lectuerer, musician, boxer, DJ... Still specialising in life by Dr David Lam

78 GP First 3

he General Practice Students Network (GPSN) is a network run by students for students interested in general practice.

There are GPSN clubs at over 20 university campuses Australia-wide. Whether you are a final-year student planning your career or a first year student looking to learn more about life after medical school and interested in fun events, there is something in GPSN for everyone. Get involved, membership is free! Opportunities include: • local events at your GPSN club (for example, clinical skill sessions, study and exam sessions, career sessions, movie nights and social events) • national events (camps, conferences, seminars) • peer support • career development • networking opportunities.

WHAT IS GPSN?

GPSN is a network supported by General Practice Registrars Australia (GPRA). GPRA is an independent, not-for-profit organisation which supports medical students, prevocational doctors, GP registrars and early-career GP Fellows around Australia.

General Practice Registrars Australia (GPRA) Supports

General Practice Students Network (GPSN) A national network of medical students interested in general practice.

An elected body of GPSN students from across Australia. Together with the local club chairs and national working group chair, the National Executive forms the National Council.

or ts

GPSN National Executive

ts or

4 GP First

National working group Nation-wide work on projects important to furthering healthcare, for example, Close the Gap, homelessness, rural health and more. We create events, conferences, camps and more.

University local GPSN clubs Events (academic, clinical and social), networking, peer-support, leadership and more! Events can be with students, your university or with other students in your state.

MAKE THE MOST OF YOUR FIRST YEAR

ongratulations on taking the first step on a pathway to a career in medicine. Starting medical school can be daunting, exciting and everything in between.

In this section, you will find plenty of tips, hints and advice on how to make the most of your first year at university.

ATTENTION: FIRST YEARS

tarting medical school can be a challenge, especially for those who have just left school. On the upside, your university years may be some of the best you will have — they will go by quickly.

Here are my best tips to help you in your first year.

Do not be afraid to attend an event alone When you go to a new place in university, you will start off not knowing anyone. Do not let this stop you from making new friends; remember, many people think that people are judging them if they attend an event alone — do not worry, no one is judging you! As long as you are being yourself and you are open and friendly, you will make new friends. Do not be afraid to approach people. Regardless of whether these people are the people that you will only have a conversation with or will turn out to be your best friends, you will learn something from their experience. Remember: everything starts with a simple “hello”.

Do not limit your social circle to a standard friendship group Always be open to meeting new friends. Do not stick to the first friend you made and think that they will be your closest friend throughout your entire degree. Sometimes it takes a while for people to realise whether they have similar interests or viewpoints. You may not have a great first impression of someone but may later develop a really good friendship with that person.

Understand the new definition of “friends” Being good friends in university is beyond having a lot to talk about. Sometimes it is about whether your schedules coincide or if you have time to spend with one another.

You may realise at some point in your degree that because you have a different timetable or study location as your friendship group, you may not be spending as much time with them as you would like. You may feel like you are not close to them anymore and can’t integrate into the conversations that they have. You want to spend more time with them but do not want it to come at the expense of your results. Do not feel bad! You need to realise that everybody has a different schedule in university and it is okay to miss out on social events to study. Although university life can seem as if it is about making friends, study should be your first priority. True friends will remain as friends even though you don’t see them as often.

The biggest mistake: “exams are a month away, I can always catch up later!” You will be inclined to skip lectures at the start of the semester, thinking that you can always catch up later. Do not make this mistake. Due to the great workload of medicine, you will soon find that you are missing out on the current sessions because you are still catching up on last week’s lectures. Before you know it, the semester is coming to an end. Remember that you need to go through a topic more than once to be able to understand and remember it well enough for the exam. You may find that you do not remember much from week one in week 12 and need to go over it again. The best way to deal with this is just make sure that you are present for all lectures and academic sessions. This way, you are at least hearing the content and it will increase your recall later on. All the effort that you put in during the semester will really matter in week 12.

MAKE THE MOST OF MEDICAL SCHOOL

o not be too focused on what will be in the exam. Instead, focus on learning how to be a good, knowledgeable doctor.

Getting everything right may seem really important during medical school — and it is important as you can not be a doctor if you don’t pass medical school — but medical school is the only place you will be guided and allowed to make mistakes. Everyone makes mistakes in medical school — in class, on the exam — allow yourself the freedom to make mistakes and learn from them. If you do not learn from the mistakes, you will still have to learn the information after you graduate, only without guidance and potentially putting patients at risk. Your medical school will also prepare many academic sessions that you may deem as “unimportant”, but remember that they are put it in your timetable for a reason. Everything that you are learning has been reviewed by a panel many times before it is placed in your timetable — listen, learn and do your best.

You may spend the whole time engaged in small talk with people and not actually having a conversation relevant to medicine. Remember — you may connect with someone influential or inspiring. This could also be the time you find out about different opportunities, such as research projects, placement opportunities or grants. Attend networking events if possible, particularly in your final few years when you may be looking for opportunities to add to your CV.

Pay attention during placements Placements may seem boring because you are not allowed to do a lot of “hands-on” work. Sometimes, it can feel as though you’re watching the clock, waiting for the day to end. Learn as much as possible by taking every opportunity as a learning experience; be curious, helpful and ask questions.

Attend networking events

Do research on your health service area before you show up so that you can understand a lot of the presenting symptoms.

Networking events may seem like they do not bring any benefit to medical school.

Take notice of the little things that your doctor does and develop good habits as a future doctor.

By Ying Min Teoh, GPSN Publications and Promotions Officer, studying at James Cook University (JCU). GP First 7

TEXTBOOKS: A FIRST YEAR’S GUIDE

he seemingly endless list of textbooks available for medical students is enough to make many reconsider their degree, but before you go rushing off to buy every single textbook, it is worth figuring out which textbooks are the most valuable. Remember, an extensive collection of textbooks may make you feel smarter, but they most likely will not be helpful to you in your first year of medical school. Instead, stick to the basics — a good anatomy textbook will be a loyal companion throughout your medical career. Choose wisely — you will be using these textbooks for a while and most do not come cheap. Your university will give you a textbook list. In the meantime, here are my recommendations.

Anatomy Gray’s Anatomy for Students (2nd ed) — a comprehensive and detailed textbook that has simple, written descriptions and lots of diagrams. It also provides clinical cases to demonstrate the relevance of anatomy in future practice Clinical Anatomy by Systems (Snell) — provides less depth but more clinical cases which may prove to be more interesting and relevant for some students Netter’s Atlas of Anatomy (Illustrated) or McMinn’s Atlas of Anatomy/Rohen’s Colour Atlas (Cadaveric) — an atlas comes in handy if you need help visualising anatomical locations and relations

Clinical Skills Clinical Examination (Talley & O’Connor) — a great investment in the long run and shows numerous examination procedures and signs and symptoms as well as underlying pathology. Perfect for OSCEs Clinical Examination (Epstein) — less comprehensive, but more straight forward; suitable for first year students

Histology Wheater’s Functional Histology — many histology images and provides explanations of the related anatomy, endocrinology, cellular biology, and some pathology. It will come in handy in helping cement concepts of histology Human Histology — another option

Immunology and Microbiology Mim’s Medical Microbiology — all your microbiology needs as well as some basic immunology 8 GP First

Immunology for Medical Students — another option

Neuroanatomy Neuroanatomy (Crossman) — holds a reputation of being complex; a good textbook that will help long term Essentials of the Human Brain (Nolte) — another option

Pathology Robbins Basic Pathology — connects the most basic science with clinical medicine and is sufficient for the first few years of medical school Robbins and Contran Pathological Basis of Disease — significantly thicker and wordier; caters to the budding pathologists

Pharmacology Rang and Dale’s Pharmacology — contains easy to understand pharmacological concepts and additional information about the pathophysiology of drugs

Physiology Guyton and Hall — a massive textbook that has incredible detail and logically sequenced chapters which come useful during revision Berne and Levy — also useful for revision By Daniel Liu, University of New South Wales GPSN Chair.

BUYING TEXTBOOKS Try the following options to save money: The campus bookstore — you will be able to order all of your books here brand-new. Some universities will also sell second-hand textbooks. Other students — many students will want to sell their old textbooks. Connect with them to see what they have to sell. Major online stores — websites, such as Book Depository or Amazon, can offer new or secondhand textbooks cheaper than the campus bookstore. Online second-hand sites — websites such as studentvip.com.au offer cheap second-hand textbooks; also visit Facebook Marketplace or Gumtree. Renting — websites such as jekkle.com.au allow you to rent a textbook. The campus library — borrow a textbook, particularly if you will only need it once or twice.

FOUR TIPS FOR FIRST YEARS

n your first day of medical school you are going to be bombarded by information on how the course works, what textbooks to buy, and how to study â&#x20AC;&#x201D; all while trying to navigate the campus.

Even though semester two was more academically challenging (courtesy of anatomy), I was more organised and engaged than in semester one. Of course, donâ&#x20AC;&#x2122;t overcommit yourself to social activities; be sure to leave enough time to do your assignments and study.

Meet new people

Get organised in your study early

Mingle with the other first year students and attempt to meet the people in your course.

No two people study alike, so it is up to you to discover how you learn best.

These individuals are going to be in your tutorials, lectures, In Case Learning sessions (ICLs) and on your placements. They will soon be your life-long friends and a wonderful support system; forging connections early on will make you feel more at home in this new phase.

For me, I find it helpful to attend lectures in-person, as I remember content better than listening to a recording.

Ensure you take advantage if second-year students generously offer their resources and knowledge. Medical students are a supportive group who enjoy their memes as well as their jocular acronyms.

Get involved in campus life During O-Week, you will see a plethora of societies, organisations, and events vying for your attention. At first, the array of activities dazzled me and I held a rather reserved attitude towards signing up. My rationale was that I did not know how rigorous the course was going to be, so I did not want to overcommit and find myself cursing my extracurriculars in the stressful days before exams. However, during the second semester of first year, I signed up for more groups and became involved with campus life. I saw how rich my university experience was compared to my first semester. Join in the activities that capture your interest.

I keep a physical folder for each semester (of both handwritten and typed notes) as well as having the lecturer notes annotated on my tablet. When it comes exam time you can feel secure in having all the material you need, and you will know where it is. My most successful study technique is to explain concepts to myself using a whiteboard and markers. Doing staggered past papers and practice questions can also give you more confidence. Do not leave your study to the last minute.

Take care of yourself During medical school get a good GP, surround yourself with supportive like-minded peers, ensure your professional wardrobe is up to scratch for your Clinical Skills Sessional Encounters (CSSEs), and have a lot of fun along the way. In no time at all you will be spouting clauses on confidentiality and demonstrating dorsiflexion like you were born a medical student. By Natalie Evans, Monash University Medical Student and Year 2 GPSN Monash Representative. GP First 9

IMPROVE YOUR STUDY TECHNIQUES

etting into medical school is a dream come true for most of us, but it comes with a fair share of challenges.

Being at medical school is more than just about lectures, deadlines and exams. It is the foundation of our journey as doctors. It is about our careers after graduating and our patients. Here are a few tips that may benefit you in developing a healthy routine and studying efficiently.

Prepare before attending a lecture Lectures play a huge role in your learning, especially in the early years of your degree. Pre-read the lecture materials and gain a basic understanding of the major concepts. If possible, start note-taking and writing down your questions ahead of time. Above all, pay attention during lectures and avoid distractions that come in many forms including phones, laptops, friends and ceilings. Sitting in the same lecture hall for hours can be tedious, especially when the lecturer is reading off the slides — every student has dozed off at least once. If you lose focus or find a particular section difficult, make sure to note when you stopped paying attention and fill in the gaps when you go back to the recording.

It is important to understand that we are all different and we all need to study differently. Know whether you study better alone or in a group, at the library or at home and by writing things down or reading it out loud or teaching others. Identify techniques that work for you. Make sure you process information thoroughly because beyond passing your exams. You will require this knowledge for placements and future medical practice.

Organise your study materials You need to know what to study before you start studying. It is important to organise all your study materials and make a list of topics you need to cover for your exams to ensure you don’t miss any. Then, prepare a timetable that allows you to cover all the topics at a good pace. Starting revision early will allow you to go through the content comfortably, so try not to leave all your revision to the last minute.

Your study environment matters

Also, ensure that your timetable is not insane. Avoid scheduling a lot of topics on any given day as this may lead to a build-up of unfinished topics and falling behind. This increases anxiety, guilt and stress.

Make sure you have a designated study space organised according to your needs.

Scheduling your breaks and nights off is essential to avoid missing out on your much-needed revival time.

Things to check include suitable lighting, a comfortable chair, removal of distracting objects and sufficient space.

Lastly, it is very satisfying to have a checklist — give yourself a tick at the end of studying each topic.

An organised environment saves you from wasting time and enhances your ability to focus.

Take study breaks

In saying that, some of us need that clutter around us to be able to work. Find out what works for you.

Review, don’t cram An extremely high volume of content is delivered at a rapid pace in medical school. In order to understand and retain all the content, you need to go over it repeatedly, unless you are blessed with a photographic memory. Remember that it’s not about studying all the time — it is about studying effectively. 10 GP First

Make sure you have adequate, scheduled breaks while studying. Your brain is not designed to work effectively for hours on end. As a rule of thumb, taking a 15 minute break after every 45 minutes of study will enhance your ability to work consistently. The exact timings can vary, so find a routine that works for you. During these breaks, avoid social media —get some fresh air or talk to people instead. Reward yourself during these breaks once you achieve your study goals.

Use practice questions and sit mock-exams

minds work in unison and not against each other.

Try testing yourself with questions from past or practice exams and Multiple Choice Question (MCQ) banks at regular intervals as well as at the end of each topic to discover any gaps in your knowledge.

Sleep, diet, exercise and good mental health play a big part in success.

Aiming to do at least 50 MCQs a week throughout the year is an achievable goal that will help build your knowledge consistently, identify knowledge gaps, develop critical thinking and monitor progress. Sitting mock exams can help train your time management skills and ability to think under pressure.

Everyone studies differently Everyone studies differently and uses various study techniques. The use of visual aids and flowcharts can help condense information and facilitate last-minute revision. This method is beneficial to remember management protocols, antibiotics and other topics. Using flash cards to note down salient points from each topic can help retain information and produce quick revision material for later use. Some also find it useful to write their own MCQs to test their areas of weakness. These questions can be shared to facilitate group study by raising points for discussion.

Variation is vital Variation is vital to help your brain function effectively Keep varying your study technique and location to stimulate your brain and avoid falling into an aimless and ineffective routine.

Look after your physical health We all neglect self-care during exams and medical school, but it is extremely important to make sure our bodies and

Do not underestimate the power of a good night of sleep. Your brain desperately needs that time off to process everything and recover. It is vital to go to bed and wake up at a set time every day, despite changes in your routine. Always allow yourself a minimum of eight hours sleep without guilt. Studying until 3am does not mean you are more knowledgeable. It might mean that you are not managing your time well. Make sure you stay hydrated and have a healthy diet with plenty of fruits, veggies and nuts. Although we all have varying exercise capacities and needs, try to do something active every day.

Take care of your mental health Despite help being more readily available to us now, a lot of us still don’t ask for it or don’t know when to ask. Do not leave it until it is too late. Universities offer counselling services and your GP is well equipped to assist you. Understand that it is okay not to be okay. If you are in a crisis situation, call Lifeline at 13 11 14. University is full of opportunities, but try not to take on so many things that you don’t have any time for yourself and risk burnout. If you are struggling with studies, ask for academic help from your mentors and fellow students, earlier rather than later. We hope you find some of these tips helpful as you continue your medical journey. We wish you all the best for everything. Keep calm and stay positive. By Bridget Joseph Xavier and Akshaya Ajit. GP First 11

STAYING HUMAN IN MEDICAL SCHOOL

rom across Australia four doctors come down South for compulsory skills training. They have deliberately chosen the same course at the same time and the same place, flying in from all corners to maximise the opportunity to catch up and support one another in their continued learning. They have a friendship that was conceived in medical school and nurtured with all the right ingredients — copious hours spent studying together, robust debates, shared values, insight into one another’s flaws and strengths, loyalty, honesty and a lot of late night karaoke.

Value relationships The first lesson we can learn from these doctors is to value the relationships you make on your journey and embrace the opportunities for those relationships to establish and flourish in medical school. The time in medical school enables great access to a range of activities, committees and placements that stretch and develop you as a human being. Enjoying time with your peers and nurturing those relationships, as well as those outside of medical school provide a foundation that can support you throughout your career. Having the right people with you on your journey helps you ride out the challenges and share the disappointments and highs, and provides encouragement and the gift of contributing the same for others.

Self-awareness The second strategy is nurturing your self-awareness. This is essentially a lifelong process of self-discovery, observing your responses, reactions, noticing your responses to circumstances and people and seeing how these change over time and with different experiences you have. This is important in knowing your personal signs of stress and overload.

Self-care The third lesson is self-care informed by self-awareness. Establishing a discipline of prioritising your care for self is vital. This will ensure that you remain as effective as possible in your studies and in your later career. The more you recognise your own signs of becoming overwhelmed, the quicker you can respond to re-balance yourself. This will enable a faster bounce back after times of greater stress, such as during exams, or through difficult work situations. 12 GP First

Rest, nutrition, physical activity, relationships, fun and interests outside of medicine are all important in keeping you balanced.

You are the future of general practice A final important point is to ensure that you have your own independent GP. If you don’t have one, find one who is right for you. From the perspective of the community, and your future patients, we need great doctors who are well rounded human beings, who can relate to us as individuals with all of our complexity and diversity and who understand themselves and who can better understand us. Congratulations, thank you and best wishes for your journey. By Stephanie May (above), who is the founder of Doctor’s Wellness, a social enterprise contributing to a shift in normalising wellness in the medical workforce and society. Doctor’s Wellness tailors programs for health services and member organisations around Australia facilitating opportunities for doctors to practice self-care, self-reflection and stay connected with colleagues. Connect with Stephanie at www.doctorswellness.org

GPSN: HOW TO GET INVOLVED

y now you may have settled into medical school â&#x20AC;&#x201D; perhaps you have even pushed past the milestone of your first year.

This is a great time to learn more about GPSN. Getting involved in GPSN can enrich your university experience and help you start on the right track to a career in general practice. In this section, you can read about who makes up the GPSN network, what GPSN does and how you can get involved.

The Healius Institute is a unique resource committed to providing world-class learning and administrative support. As your partner in lifelong learning we: • Introduce Medical Students and Healthcare Professionals to an outstanding career in General Practice. • Empower Registrars through knowledge enabling them to thrive in their chosen career path. • Support experienced GPs and their ongoing development by upskilling them in their areas of special interest. • Encourage our Supervisors to pursue their passion for teaching by providing dedicated administrative and educational support.

For more information on how the Institute can support your educational journey, visit phcinstitute.com.au

institute

GPSN LOCAL CLUBS At each university, the local GPSN club holds events which promote general practice as a vocation, educate students about GP training programs, as well as fostering an appreciation and understanding of primary healthcare.

The interests of the student members at each different university are unique. Local GPSN clubs organise events that meet the interests of their student membership and ensure active engagement with primary healthcare throughout medical school.

Local GPSN club events vary from campus to campus, but can include:

How to join:

• academic events (study and exam skills) • clinical skills events (suturing, surgical knots, using medical instruments) • social events (movie nights, trivia nights) • networking events (career nights, GP training pathway information sessions).

1. Join GPSN at your university campus, OR 2. Become a member of GPSN online and contact your club chair to let them know you'd like to be involved with your local university club. Join online at gpsn.org.au/join Find your university club at gpsn.org.au/clubs

FIND YOUR LOCAL GPSN CLUB • University of Adelaide — adelaide@gpsn.org.au • Australian National University — anu@gpsn.org.au • Bond University — bond@gpsn.org.au • Curtin University — curtin@gpsn.org.au • Deakin University— deakin@gpsn.org.au • Flinders University— flinders@gpsn.org.au • Flinders University NT Medical Program — ntmp@gpsn.org.au • Griffith University— griffith@gpsn.org.au • James Cook University— jcu@gpsn.org.au • Macquarie University— macquarie@gpsn.org.au • Monash University— monash@gpsn.org.au • University of Melbourne— umelb@gpsn.org.au • University of Newcastle— newcastle@gpsn.org.au

• University of New England— newengland@gpsn.org.au • University of New South Wales— unsw@gpsn.org.au • University of Notre Dame Fremantle — notredame@gpsn.org.au • University of Notre Dame Sydney— undsyd@gpsn.org.au • University of Queensland— uq@gpsn.org.au • University of Sydney — usyd@gpsn.org.au • University of Tasmania — utas@gpsn.org.au • University of Western Australia — uwa@gpsn.org.au • University of Western Sydney — uws@gpsn.org.au • University of Wollongong— wollongong@gpsn.org.au GP First 15

CLUB HIGHLIGHTS Each year, GPSN local clubs run events for members. In 2018, GPSN was busy as two new clubs joined the network. All around Australia clubs at each medical school have worked hard to put together many quality events — from BBQs to trivia, surgical and procedural skills to career information nights. Here is a snapshot of our events last year, and what to expect in the year to come.

Northern Territory GPSN Flinders NT

GPSN Flinders NT ran their first teddy bear hospital in 2018. This was a fantastic event which saw medical students teach kids about healthy eating, how to call an ambulance, washing hands and how to use stethoscopes. Thank you to Northern Territory General Practice Education (NTGPE) for supporting this event. We hope to run the event again in 2019.

South Australia

University of Adelaide and Flinders University GPSN University of Adelaide ran a specialty speed dating night. This event was a huge hit as it provided great insights into many specialties that can also be combined with general practice. This event tied in well with GPSN Flinders’ career night, reminding students that your local doctor is not “just a GP”.

Victoria

Deakin University, Monash University and University of Melbourne GPSN Deakin’s free community health checks at the Relay for Life event in Geelong were a big hit; relay participants were lining up to get their blood pressure taken by students. Similarly, GPSN Monash University expanded their events to include even more participants and put on two new academic events to bring their yearly total to seven events. GPSN at the University of Melbourne ran both a suturing and dermatology workshop, upskilling students in a common area of general practice but often difficult to gain experience.

Tasmania

University of Tasmania University of Tasmania GPSN ran a palliative care workshop for their members – something which is barely touched upon in medical school but very important. 16 GP First

New South Wales and Australian Capital Territory

Australian National University, Macquarie University, University of Newcastle, University of New England, University of New South Wales, University of Notre Dame Sydney, Sydney University, Western Sydney University and University of Wollongong. With nine medical schools located in NSW and ACT, there are a host of GPSN events to detail — here is just a taste. GPSN Australian National University supported the Close the Gap campaign and University of New England provided tips to first years about surviving medical school. University of Notre Dame Sydney hosted mock OSCEs. There were also career pathways nights at University of New South Wales, University of Sydney and Western Sydney University. An example of inter-club cooperation was seen between the newest GPSN club at Macquarie University (MQU), and Western Sydney University (WSU). WSU showed MQU the warmest welcome as they invited GPSN members down to Campbelltown for a ‘Clinical Skills Night’. The night featured clinical procedural skills essential to general practice.

Western Australia

Curtin University, University of Notre Dame Fremantle and University of Western Australia GPSN UWA and GPSN Notre Dame Fremantle collaborated with their welcome event: a mental health and stress management workshop. A new local GPSN club was established at Curtin Medical School — none of this would have been possible without the support of the 2018 GPSN National Executive. Curtin GPSN’s first event, the Welcome Night and Information Evening, hosted guest speakers from Western Australian General Practice Education and Training (WAGPET). Many GPs came to share their insights.

Queensland

Bond University, Griffith University, James Cook University and University of Queensland. GPSN University of Queensland enjoyed a GP Careers Night and tickets to their Basic Surgical Skills Workshop sold out in 20 minutes. Griffith University GPSN’s “Red Flag” seminars were a hit, featuring sessions on cardiology, haematology, neurology and gastroenterology. Griffith and Bond University hosted their first ever inter-university GPSN social event. Bond University held multiple OSCE practice nights, and a clinical skills night featuring techniques on suturing, ophthalmoscopy, otoscopy and dermatoscopy. James Cook University GPSN hosted a suturing skills night and a “Red Flag” event for eye health.

GP First 17

WHAT IS THE GPSN NATIONAL WORKING GROUP? The GPSN national working group is a student-inspired, student-run group for GPSN members who are interested in improving healthcare. The group is made up of GPSN members from across Australia. The group is self-directed, selecting their own projects to work on, with the support of the GPSN National Council and GPRA. Past project have included national events, research papers, local and national initiatives, pilot programs and more. Working group national initiatives provide opportunities to experience and pursue roles in policymaking, research, community involvement and public health. You are invited to get involved in 2019! If you are interested in joining the GPSN national working group or would like more information on upcoming projects, email wgo@gpsn.org.au

JOIN THE WORKING GROUP GP First 19

GPSN CULTURAL IMMERSION TRIP AN INITIATIVE OF THE GPSN NATIONAL WORKING GROUP

he Cultural Immersion Experience Camp is an annual opportunity for medical students interested in general practice to experience in Indigenous healthcare and Indigenous culture first-hand.

The Cultural Immersion Experience Camp is an initiative of the GPSN national working group. Applicants are selected for their demonstrated interest and engagement in Indigenous health, remote medicine and general practice. The 2018 camp selected six GPSN applicants to travel to a remote Aboriginal community in the Northern Territory, Kakadu. This trip was thanks to the support of Northern Territory General Practice Education (NTGPE). Scholarships were available for students unable to afford flight costs. “It was an honour to see sacred sites and such aweinspiring parts of our country with the traditional owners,” said attendee Helena. “Everyone has a role to play and choices to make that can help play a role in closing the gap of healthcare inequalities,” she said. The traditional owners of the land warmly welcomed the attendees, which included GPSN members, NTGPE GP registrars and cultural educators to Kakadu National Park. The days were hot, active, jam-packed and provided invaluable knowledge to inform the future medical career of each attendee. The team camped, cooked and fished by the river at Billabong Safari Camp. Day trips were taken around Kakadu National Park and Arnhem Land. Attendees visited remote health centres and saw firsthand the environment where remote and rural medicine is practised and delivered to the local community. Attendees visited places of significance to the local Aboriginal communities. Here, attendees ate bush tucker, dyed and wove their own jewellery and played the yadaki (didgeridoo). Stories were shared between attendees and the local guides, giving a unique perspective into Australian Indigenous culture and history. “On behalf of GPSN, thank you to Mandy and her family for welcoming us and sharing your land and stories, NTGPE for their ongoing financial and practical support, GPRA for travel assistance and everyone else involved in this incredible experience,” said GPSN National Working Group Officer Keshini Visvanathan. “We look forward to the 2019 Cultural Immersion Trip and strongly encourage all GPSN members to apply,” she said. Applications for the next Cultural Immersion Trip will open early 2019. Check the GPSN national eNewsletter for for information. By Helena Rann, 2019 GPSN National Working Group Officer and 2018 Secretary of GPSN Monash Univeristy. GP First 21

FARM STAY TRIP AN INITIATIVE OF THE GPSN NATIONAL WORKING GROUP

n a big city lecture theatre, it can be next to impossible to teach medical students about rural healthcare. Hands-on experience is essential for students to truly experience rural healthcare and to develop a passion for rural general practice.

Noticing this gap in education, the GPSN national working group organised the inaugural Farm Stay experience in 2018. The aim of this experience was to give medical students across Australia hands-on, real-life experience in rural and agricultural medicine. Students from medical schools across Australia applied for a place on the trip. They were chosen for their commitment to rural health. The first annual Farm Stay experience was held at Cherrabah Resort, Warwick, Queensland. This event was in affiliation with Towards Rural and Outback Health Professionals in Queensland (TROHPIQ), and was sponsored by Darling Downs and West Moreton Primary Health Network. The activities commenced on a Saturday morning with speakers who provided well-rounded perspectives on practising medicine in a rural setting. Southern Downs Region Mayor Tracey Dobie shared a fascinating overview of the region from an agricultural, tourism and community perspective. Attendees also listened to Ben, from My Health Record, who discussed the impact of technology on medicine and how these advances could dramatically shape the future of general practice. Dr Blair Koppen, the medical superintendent at Warwick hospital, detailed intricacies of an adventure-filled career as a rural generalist. Dr James Telfer of Stanthorpe Hospital provided details on how to best prepare to become a rural GP. In the afternoon, attendees put their minds to the test as they engaged in trauma emergency and bush medicine scenarios learning valuable skills, such as how to construct plaster casts. During the weekend, attendees took the chance to explore the breathtaking 5,000 acres of the Cherrabah Resort, filled with horses, sheep, donkeys and goats. Activities included horse riding, clay target shooting and quad biking. Attendees also enjoyed the abundance of home-grown produce and a buffet selection at every meal. This trip brought all attendees together â&#x20AC;&#x201D; despite many the competitive board games played â&#x20AC;&#x201D; and created friendships that will endure. The GPSN National Executive and working group hope this is the start of an exciting annual Farm Stay event. Please keep an eye out on the GPSN eNewsletter for application information. By Emma Chan, 2018 Rural Working Group Chair and Keshini Visvanathan, 2019 GPSN National Working Group Officer. GP First 23

A NATIONAL EXECUTIVE FOR A NATIONAL NETWORK

The GPSN National Executive is a representative body made up of GPSN members from medical schools across Australia.

The main role of the National Executive is to provide leadership and direction to the network and is led by National Senior Executive team, which comprises of the National Chair, National Vice-Chair and National Secretary. Together with the GPSN local club chairs and national working group representatives, the National Executive Team form the GPSN National Council. The National Council meet in-person yearly to discuss and plan GPSN activities and strategy, and to share ideas for the future. Throughout the year, they meet regularly by video conferencing. Major annual projects for the networkâ&#x20AC;&#x2122;s leadership include: national events, state-based events, camps, 24 GP First

promotions, and the publication of this magazine. Appointments to the National Executive are year-long terms. All GPSN members can apply for a position. Applications to the National Executive usually open around October each year. Applicants are asked to submit a CV and a statement addressing their skills, passions and experience. The National Executive consider all applications and choose the successful candidate by vote. The National Executive is a great way for medical students interested in general practice to gain practical experience in governance, policy, and leadership. As GPSN is supported by GPRA, the national peak body for GP registrars, the National Executive is well supported in their roles. Being a member on the National Executive gives GPSN members the chance to shape the future of healthcare.

Elizabeth Wong, National Chair chair@gpsn.org.au I decided to become involved with my local GPSN club because it seemed different to all the societies at my university. Unlike other stand-alone clubs, GPSN is a national network, where local clubs interact with other universities regularly. GPSN is a great way to meet new people not only within your university but across all medical schools in Australia. General practice is extremely diverse and gives you the opportunity to subspecialise. The wide variety of patients you see every day keeps every day on the job interesting. What I love about GPSN is the people — their friendliness, supportiveness and passion.

Angus McCormack, National Vice-Chair vc@gpsn.org.au I love GPSN because of the members’ passion and drive to continually enrich the experience of Australian medical students and ultimately improve the quality of general practice — one of the most varied, important, and exciting medical specialties. Joining GPSN is a fantastic way to meet and network with like-minded people at both a local and national level and involve oneself in a wide range of projects — there is something for everyone! Since I first became involved in my first year, I have thoroughly enjoyed GPSN and I would recommend it to anyone with an interest in general practice, Indigenous health, rural health, or research.

Laura Roden, National Secretary ns@gpsn.org.au I first got involved in GPSN through my local club at the University of New South Wales because I was interested in finding out more about general practice. I stayed involved because GPSN not only answered my questions but gave me so many amazing opportunities to run fun events, make friends at medical schools all over Australia and participate in national opportunities! I cannot encourage you enough to get involved with GPSN through your university club or the GPSN national working group which runs a variety of amazing projects nationally.

GP First 25

Keshini Visvanathan, National Working Group Officer wgo@gpsn.org.au I believe access to quality, affordable primary healthcare is a basic human right. However, there remains much disparity across the world and in our own backyard — in particular, in Indigenous, rural, homeless and refugee communities. It is my hope that through GPSN, particularly the national working group, we can play our part to help rectify the disparity in Australia. The GPSN community allows me to surround myself with likeminded and passionate people who share the common goal of providing the whole community with a high standard of primary healthcare. Through GPSN, I hope to encourage the best and brightest medical students to pursue a career in general practice.

Helena Rann, National Working Group Officer wgo@gpsn.org.au I’m a medical student at Monash University currently taking an intermission in 2019. I’m very interested in general practice for a multitude of reasons — I especially love the integration within the community and the long-term relationships that are established with patients. My particular area of interest is women’s health. I joined Monash University GPSN in 2017 and the National Council (as Close the Gap Working Group Chair) in 2018. I love that there are so many pathways for a GP to explore and I hope to use the working groups to promote the options in general practice.

Christine Wang, Local Events Officer leo@gpsn.org.au My main motivation to get involved in GPSN — at both a local and national level — was the opportunity to become involved with great student-run initiatives promoting the heart and soul of general practice. The GPSN community is irrefutably unique in their inclusiveness, passion and sustainability in the changing climate of medicine. This is why I am so excited about all the new and exciting projects planned for 2019. After medical school, general practice is such a versatile career pathway to take and always offers a holistic model of care that I admire and aspire to provide as a future doctor.

Lucy Doan, National Events & Projects Officer neo@gpsn.org.au Having been interested in general practice as a future profession for a long time, I was ecstatic when I got selected as an executive member of my local GPSN club! I have been involved with my local GPSN club for the last two years. During this time, not only have I gained valuable experience in running events, I have increased my interest in general practice as a career. I love running events, meeting new people and working behind the scenes. This makes it a delight to be the GPSN National Events Officer and an honour to contribute to future GPSN events.

Aashish Chalasani, National Sponsorship Officer sponsorship@gpsn.org.au I joined GPSN because it is a national network which shapes the perspective of students on general practice. Through GPSN and the exposure the network provides to general practice, we learn to admire the specialty for its fast-paced nature. With a wide range of presentations across an infinite number of healthcare domains and we move away from the myth of being “just a GP.”

Ying Min Teoh, Promotions & Publications Officer publications@gpsn.org.au I decided to join GPSN because I’ve come to realise the importance of a GP as patient’s first-hand contact, especially in rural areas where a particular GP might be the only doctor in that area. The GPSN national working group runs activities that allow medical students to develop essential skills. I hope to be involved in organising activities that will make current medical students the best doctors of the future. Being a GP is challenging, and it is unquestionably a career I will consider in the future.

GP First 27

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MAKE THE MOST OF MED SCHOOL

ith all the coursework and exams in medical school, everything else can seem overwhelming.

In this section, read more about the various opportunities you can undertake to enrich your experience at medical school, foster your clinical interests, and set yourself up for your future as a doctor.

THRIVING IN MEDICAL SCHOOL

ongratulations! You have survived your final high school exams, endured UMAT, trekked across Australia to attend every interview possible and have finally received that offer to study medicine.

You take a day or a week to celebrate this wonderful achievement before realising that this is only the beginning to a long road ahead. Medicine provides a multitude of opportunities and career choices including academia, general practice, physician training or surgery. However, before any of that, doing well in medical school is essential to provide a firm foundation for future success. As a fifth-year medical student, I have noticed certain characteristics and habits of a successful medical student. Medical school is not always smooth sailing and hopefully these tips will help you through the next few years.

Stay focused and persistent Medical school can be overwhelming. You will now have lectures upon lectures of new knowledge which you need to master. In high school it was possible to cram all your content the night before the exam. This is not possible in medical school because of the sheer amount of knowledge you are required to know. Study consistently and revise your lectures as soon as possible since subsequent lectures often build upon previous lectures. We always hear the phrase “study hard”. But what does this really mean? Does “studying hard” entail reading entire textbooks cover to cover or learning every reaction in the citric acid cycle? For some people, this may be effective but for a large majority, this is counter-intuitive and will increase anxiety levels.

Collaborate in teams The field of medicine encompasses life-long learning in groups, on the wards in the medical team, during academic conferences and in case discussions with colleagues. The high school system is rather rigid, in that many students studied alone, poring over readings and taking notes of everything. It is almost impossible to do anything alone in medicine. You will work with nurses, occupational therapists, physiotherapists, social workers and many, many more professionals. While you may be knowledgeable in a certain aspect of patient care, others in your team will have expertise in a different aspect that allows both of you to learn from each other. The same principle applies to study groups, where your peers will be an invaluable resource in providing you with feedback on your weaknesses while you use your strengths to support your peers. Your lecturer appears only a few times a semester but your peers will be there with you every day. Not only are peers incredibly helpful academically, but studying in groups also means that you feel well supported and can be constantly reminded that you are not alone.

Be humble Undoubtedly, you performed extremely well in high school, perhaps even achieving dux of your school. In medical school, you will be in a cohort with other very bright people. While it is good to challenge yourself to be the best, there are people around you with more skills and knowledge. It is these people who you will also learn to rely upon.

For some, that means listening to podcasts. For others, that might be drawing pictures and diagrams of everything.

Furthermore, many of your families have made immense sacrifices to financially support you through medical school. Maintain thankfulness that you have been privileged enough to embark on this journey and gratitude towards those around you who have had to make sacrifices for you along the way.

Make studying a priority because, one day, a seemingly trivial fact that you learnt during medical school may save a patient’s life.

Similarly, many patients forgo their own privacy and personal space to facilitate your learning and they deserve your utmost respect.

It is extremely important for you to identify how you learn and then stay focused and just do it efficiently.

30 GP First

Look beyond the books

empathy that their doctor shows.

The greatest learning will not happen from textbooks but from patients and real-life experiences in clinics and in hospitals.

Look after yourself

A textbook will only provide information about pathology in isolation. In real-life, patients hardly present with a single pathology and are much more complex than just the presenting illness. The information you learn needs to be applied in a clinical setting to a real-life patient. Every doctor has encounters a patient that they will remember for a lifetime â&#x20AC;&#x201D; for positive or negative reasons. You must evaluate and reflect upon why each encounter created such an impression and what you can change or remember for future practice. Keeping a log of such interactions is also extremely useful.

Emotional intelligence is as important as IQ Even as a medical student, you will have innumerable opportunities to contribute to the community, make connections and develop new skills. This expands your friendships and equips you with skills like leadership and collaboration which will further your development as a person and a future practitioner. Real-life experience is integral to shaping the way you think and manage clinical cases. In addition, challenging scenarios like breaking bad news or counselling require years of practice in eliciting a patientâ&#x20AC;&#x2122;s main concerns and being able to prioritise treatment to accommodate these concerns. Even though you may have a completely different background to your patient, it is still essential to try to understand what they are experiencing and provide the best care for them. Patients will gauge a large part of the quality of their care not by how much their doctor knows, but by the level of

Although medicine may seem all-consuming at times, you are more than your future career. Allocate time in your schedule to nurture your relationships with friends, family and other loved ones. While watching cat videos and curling up in bed may seem like the perfect Friday night in, socialising with friends, especially those who do not study medicine, will keep you grounded. Maintain your physical health. Go for a jog, join a sports team or go to the gym. Maintaining hobbies, such as music or art, will also help you to maintain perspective, which is important for your mental health. In order to care for others, you need to care for yourself first. Recognise your weaknesses and do not be afraid to seek help. We are all fundamentally human and to be human means to make mistakes. If something does go wrong, try not to be too hard on yourself. Medical students are at a higher risk of developing mental illnesses, with a 2014 Australian Medical Association (AMA) report stating that one in five medical students reported suicide ideation in the previous 12 months and that one in two medical students will experience emotional burnout (ama.com.au/ausmed/ mental-health-when-medical-students-become-patients). Rather than allowing issues to escalate, seek professional help early or talk to your peers, some of whom will be going through the same challenges. Professional help can be provided by your regular GP or a counsellor at your university. Give yourself the chance to thrive and your medical experience will also thrive. Good luck and enjoy the years ahead. By Elizabeth Wong, GPSN National Chair. GP First 31

PART-TIME WORKER, FULL-TIME STUDENT BECOMING A MEDICAL STUDENT DOES NOT MEAN GIVING UP PAID WORK. HERE ARE THREE UNIQUE PERSPECTIVES ON STUDYING MEDICINE WHILE WORKING PART-TIME. Sunayana Raghuraman — physiotherapist Sunayana Raghuraman, Sunnie to most, is a first year medical student at Macquarie University. She works part-time as a physiotherapist, typically working eight to sixteen hours a week, depending on her university workload. According to Sunnie, part-time work is stressful, but there are many benefits, including getting a break from study and having increased financial security. “Part-time work has provided me with the opportunity to improve my communication with patients and has helped me work within a multidisciplinary team.”

doctors do by work shadowing, observing surgeries and working in a hospital environment.” “Pursuing medicine is going to give me the opportunity to make a meaningful change in the lives of numerous individuals, which is something I desired when deciding on my career path.” For Sunnie, general practice is an attractive option. “I thoroughly admire general practice as a specialty. It is one of the few specialties in medicine that requires an abundant breadth and depth of knowledge. This aspect of general practice intrigues me, as I enjoy variety and challenges.”

“Part-time work can seem stressful on top of an already stressful schedule. However, I have found that my time management and organisation skills have improved as a consequence,” Sunnie said. Balancing her work, social life and study is a juggling act which Sunnie is still learning to perfect. “Some strategies I have found useful include using calendar applications on my phone and computer to allocate time for all of my tasks throughout the week (university-related, work-related and social activities).” “By visualising my week, I am able to subsequently allocate blocks of time for study.” The skills Sunnie uses as a physiotherapist translate towards her future as a doctor. “As a physiotherapist, I have had multiple meaningful experiences with various patients and hospital staff members, which has made me even more enthusiastic about my future as a doctor.” “I am also able to work on my clinical reasoning skills and expand my knowledge of medical conditions and procedures, which is likely to help me in the future.” Studying medicine was something Sunnie was naturally drawn towards — she always had an affiliation towards the sciences. “During the course of my undergraduate degree and in my last year of high school, I had more exposure to what

32 GP First

“General practice is one of the few specialties in medicine that requires an abundant breadth and depth of knowledge.”

Ai Van Nguyen — retail pharmacy Ai Van Nguyen is a first year medical student at Macquarie University. He chose to study medicine to expand his scope of practice and help more people in the community. Ai Van’s part-time role is in retail pharmacy, working about nine hours each week. During university breaks, he works 38 hours a week – the same as a full-time worker. “Trying to juggle everything is definitely not an easy task,” Ai Van said. “I’m extremely lucky because I have a supportive working environment, where my employers are tremendously understanding of my workload and are happy to negotiate my working hours on a regular basis.”

Kelvin Koong — radiographer

Part-time work gives Ai Van a break from study, and allows him to apply the knowledge he is learning in medical school.

Kelvin Koong is a first year Doctor of Medicine student at Macquarie University. He works as a Radiographer at The Children’s Hospital at Westmead.

“I find work an escape from study... a time where I can take a quick breather yet still feel productive by using what I’ve learnt in medical school to help patients that come into my pharmacy.”

Typically, he will work 14 hours a week with on-call for one week every two months. Over the summer year break, he will be working 28 hours a week.

Like Sunnie, general practice is a career Ai Van is considering.

An understanding and flexible workplace has helped Kelvin maintain his busy schedule. “I am able to study a little bit at work when it is quiet. This has played a huge part in assisting with the balance between study and work,” Kelvin said. “I have prioritised study over certain social events. I focus on setting short-term study goals and ensure I have time for my social life while maintaining effective study.” There are many benefits to working part-time and studying medicine, beyond the comfort of savings in the bank. “I have been able to learn and apply medical knowledge while working. In the future, I am sure that my exposure to hospital protocol and workflow will be beneficial as a medical student.” For Kelvin, medicine was the next logical step after his undergraduate degree. “Medicine appealed to me because of my passion for helping people in the healthcare environment, while providing a challenge, beyond my current undergraduate degree,” Kelvin said. “I have also developed a curiosity following a patient’s journey from diagnosis to treatment and was not able to fulfil this in my undergraduate degree.” When it comes to choosing a specialty, Kelvin is keeping his options open. “I have considered general practice in the past because of its flexibility compared to working in a hospital. However, I expect that my interests will change as I begin clinical placements in 2019.”

“General practice gives you the opportunity to build connections with your patients, strengthening your ability to provide the best possible patient care.”

TIPS: WORKING AND STUDYING

ere are our top tips to making full-time study and part-time employment a successful and positive experience.

• find a supportive employer who understands that you are also a student • find a workplace that will allow you to work flexible hours. For example, less hours during semester and more during break periods • find a way to combine your work and your studies, for example, find a position where you can apply the skills which you are learning in your medical degree, and learn skills which will help you be a good doctor • plan and schedule your week to ensure you’re spending enough time studying while meeting all your commitments • while study and work are important, do not forget to make time each week to look after your wellbeing and remember to keep in touch with your friends and family.

GP First 33

TIPS FOR INTERNATIONAL STUDENTS

“Educators in Australia enjoy when their students are engaged and ask questions, because it shows you are eager to learn.”

s students begin university, many will be moving out of home for the first time, but for some, this move can mean crossing over to a new continent.

As an international student, not only are you contending with the difficulties of medical school, you may also be struggling to fit into a new culture. This can mean learning an unfamiliar language, eating strange food and adjusting to a new home. You may also be miles away from any family, friends or support networks. This can make you feel isolated and lonely. Despite the challenges, once you apply your medical school knowledge in practice, you will begin to see how rewarding it is to study medicine in Australia.

First and foremost, look after yourself This point remains true regardless of whether you are studying internationally or locally. Studying medicine can be overwhelming, especially at the beginning. Try to keep up with the lectures, but also don’t overstretch and burn out. Set time aside every week for yourself. Reflect on what you can do to make your learning process more efficient. Learning the course content in medical school can be drastically different from how you learnt in your undergraduate degree or high school, especially if you studied overseas. Do not be afraid to break old habits and be flexible.

Utilise the support offered by your university Every university will have free support. This can include services specific to the needs of international students, such as help with your spoken and written English. Many universities offer cheap trips and day tours around

your local city so you can get to know the local area Your university will also offer a range of other general supports which can include counselling, peer-mentoring, advice on writing assignments, presentation skills, and techniques to improve your study. The university library offers a great range of free resources if you are looking for extra support, including study guides, online tutorials and library guides. If you are struggling in class, do not be afraid to talk to your lecturer or tutor. Email them questions or to ask for clarification if you are confused. You will find that educators in Australia enjoy when their students are engaged and ask questions, because it shows you are eager to learn.

Do not neglect your social life While passing exams may be your first concern, remember it is the social activities which will truly enrich your time in medical school. Social events are especially important for students who live far away from their family and cultural networks. While international students may find themselves drawn to other international students, don’t forget to make friends with the local students. Talking with local students will improve your English skills faster and you will also get to know more about local Australian traditions and culture. Talking to more people can also help you become a better listener, and this is a very useful skill for a doctor. Attend events in or outside university. A good place to start is to join the on-campus clubs and societies. GPSN is a fantastic way to bond with fellow students in medical school. There are also other university clubs focusing on special interests, such as academic, social or spiritual.

HOW TO SUPERCHARGE YOUR STUDY

alk to your peers and the people in the years above. These people are your friends and allies — sometimes they may even mentor you.

Studying in isolation is not helpful. Remember, medicine is about people and about collaboration. It is not a mad science where you must lock yourself up in a dungeon and find all the solutions by yourself. Instead, connect with people from your small learning groups or with someone who sits next to you in class. Form study groups and learn from each other — you can go through the lecture content or share how you best optimise your study method. If you are ever worried about looking silly in front of your peers, remember that textbooks are there for you. Take note of the books your lecturers recommend. In most cases, it may be Talley and O’Connor or Robbin’s. A book that a lot of us found useful is USMLE First Aid for Step 1 and its cousin textbooks. These books are

designed to help the American medical student pass their equivalent of Phase I cumulative exam (USMLE Step 1). If you do not like reading, there are also numerous other online resources that you can find. Ask any second-year student and they should be able to name a few and tell you the pros and cons. Once you have found the best way to study medicine and pass exams, you will find the OSCE clinical skills exam to be the next big hurdle. Do not let this scare you. Find a few friends and practice. While studying medical science by yourself can make you very knowledgeable, it will not work for OSCE. This exam also assesses your ‘performance techniques’ as a doctor, so it is important to learn how to build a rapport with the patient. Frequent practice is the only way to be an expert, so start practising early. By Charles Changhan Xu, medical student at ANU. GP First 35

SCUBA TO STETHOSCOPE

efore starting my medical degree,” said Kieran Lloyd, aged 32, “I was worried that I would be the token old guy in the year.”

From his teenage years, Kieran had an ambition to become a doctor. “But I was young,” said Kieran, “and I was scared by the perceived workload.” Instead of going straight to medical school after high school, Kieran waited until he was ready, filling his 20s with travel to over 40 countries and a diverse list of jobs. “During my 20s I worked as a barista, baker, sound engineer and PADI SCUBA Instructor. Being a SCUBA Instructor was an amazing job that took me all around the world and taught me so much about myself.” After almost a decade of travel and work, Kieran knew it was time for a change. “I woke up one day and I knew I was ready to leave the diving-travel-bum life behind.” “I decided that if I didn't come home I'd get stuck in that world forever and, despite how pleasant the travel lifestyle is, I didn't want it for the rest of my life.” “So I flew home, enrolled in a chemistry undergrad degree, and then aimed for admission to medicine.” An offer soon came in from Kieran’s first preference, Australian National University (ANU). Kieran’s worries about being the “token old guy” on campus were unfounded. “It turns out that the wide diversity of ages and backgrounds in my cohort means I fit right in at ANU. Since enrolling, I have not looked back.” To all mature-aged students, Kieran advises them to withhold any negative expectations about fitting in or making friends.

“No other specialty or area of medicine can match the level of patient continuity and sense of collaboration with people to improve their health than in general practice.” 36 GP First

“Some of the best friends I've made at ANU are seven or eight years my junior and from completely different backgrounds – people I would never have otherwise met.” “On campus, there is a great sense of camaraderie because we are all slogging through it together, and that has a way of pushing those normal social categories, such as age, aside.” “Plus,” Kieran added, “I think being a bit older subtly changes a patient's perspectives on you as they presume you are more experienced than some of the younger looking students.” A career in general practice is on the horizon for Kieran. “No other specialty or area of medicine can match the level of patient continuity and sense of collaboration with people to improve their health than in general practice.” “The diversity of general practice appeals to me – I do not want to study and work my knuckles raw through this degree and beyond only to narrow my focus to one system for the rest of my career.”

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CHANGING THE PACE

at Holloway arrived for his first year as a medical student at the Australian National University (ANU) as a fresh-faced 31-year-old.

He’d already worked for two government departments and completed officer training with the Royal Australian Air Force (RAAF). He didn’t think he’d end up studying to become a doctor. “I had never really thought of being a doctor growing up. In a (gratefully) healthy family, I didn’t have too much exposure to doctors as a child, so it didn’t really cross my mind,” Pat said. “After watching my partner’s journey through medical school, coupled with my own search for purpose after leaving the RAAF, I started to contemplate medicine...I never thought I had the marks to get in.” For Pat, his career started with an undergraduate double degree in geology and digital media at ANU.

trucks and cotton harvesters), foreign military and returning ADF equipment.” For Pat, the exposure the ADF and Defence activities while working in biosecurity, would lead to his next journey. Still a long way from medical school, Pat then joined the RAAF where he completed officer training before commencing air combat officer training and finally worked in logistics. Pat left the RAAF to take up the role of National Firearms Manager with the Department of Immigration and Border Protection. “I was able to liaise with various agencies and trade companies to manage the import and export of firearms and other weapons,” Pat said. However, a year into this role, things changed for Pat.

“After my undergraduate degree I promptly joined the public service working for the Department of Agriculture,” Pat said.

“My partner, Sarah, was studying medicine and I was intrigued enough and decided to sit the Graduate Australian Medical School Admissions Test (GAMSAT) as my undergraduate degree was about to ‘expire’.”

“I spent six years working on quarantine and biosecurity requirements for imported machinery (think giant dump

“I was lucky enough to be offered a place as a medical student at ANU.”

38 GP First

“My work allowed me to move to part-time when I commenced the fouryear Doctor of Medicine and Surgery (MChD) in 2018.” However, it has not always been smooth sailing for Pat. “Being back in the tertiary sector and managing the volume of material at medical school has been one of the biggest challenges I’ve experienced in a long time! But it has been 100 per cent worth it.” Pat is interested in a future in general practice. “I am interested in general practice because of the range of patients that will walk through the door and the fact you will have no idea what’s going on and have to solve it as best you can and call in the relevant help. I am cognisant that I do not want to work in a big city, and so a regional or rural practice could be a great future.” “General practice gives you the opportunity to become an integral part of the community. Primary care interests me the most, so accident and emergency medicine is also something I’m looking into. Although you do not necessarily have the longer term

“Medicine is a marathon and you have to sprint...it is a massive undertaking, far greater than a normal university course, and far more challenging and demanding of time and effort than most other endeavours.” engagement with patients, the acute problem-solving nature of the ED is really appealing.” Pat has many words of wisdom for mature-aged students looking to study medicine. “Medicine is a massive undertaking, far greater than a normal university course, and far more challenging and demanding of time and effort than most other endeavours.” “I consider the pressure of first year to be greater than any of my training in the Air Force – especially when you consider the duration medical school goes for.” “Medicine is a marathon and you have to sprint. It is hard to tell this early on what the outcome will be. For me the joy of learning and problem solving more than compensates for the hard work, and the goal of being in the profession of health care is a great one to keep in mind.” “You have to be prepared to be at the bottom of the ladder again, and do not expect to be able to do it yourself. You will need support from course mates, teachers and family. You will have to prioritise and learn that medicine is going to take priority over other things you’d probably have more fun doing.” “But if you are making a career change, the life skills you have will also help bridge any gaps you might have in medical knowledge.” GP First 39

WHAT ARE YOU DOING OVER THE SUMMER? MY RURAL GENERAL PRACTICE PLACEMENT IN WOOLGOOLGA

hat are you doing over the summer? For the last three years, my answer has always been the same: â&#x20AC;&#x153;Iâ&#x20AC;&#x2122;m going to Woolgoolga for a rural GP placement!â&#x20AC;?

Despite the predictability in my response, my placement experiences have been far from predictable. The diversity of patient presentations in primary care is astounding, ranging from behavioural issues in young children, to potentially sinister presentations of chest pain and even the removal of a fish lure that was accidentally caught on a finger. By returning to the same community for the past three years, my rural GP placement has broadened my perspective, allowing me to participate in the management of patients holistically, managing not only health concerns but their broader psychosocial sphere. This has provided a snapshot of what it means to have a life-long relationship with patients. Woolgoolga is a small beach-side town with a population of 5300 on the Mid-North coast of New South Wales. What you notice when you first arrive is the lack of traffic and crowds, the relaxed atmosphere and the beautiful sprawling beaches. Woolgoolga features a large Sikh population and is the centre of the blueberry industry in Australia.

“Providing care to [the refugee] population was challenging... however, it demonstrated the intrinsic humanity to medicine, which is to help others irrespective of background or beliefs.”

A unique and hands-on placement

Hospital, which was an eye-opening experience.

My placement was undertaken at Beach Street Family Practice with my mentor, A/Prof John Kramer OAM (pictured above).

Many of the health outcomes we often take for granted in Australia were deprived from those who flee wartorn countries. Providing care to this population was challenging, especially with the linguistic and cultural barriers.

As one of two practices in the town, my placement was much more hands-on than would have been experienced in a metropolitan setting. Within the practice, there was the integration of multidisciplinary team care, with nurses who triage and manage walk-in presentations, a treatment room to perform excisions of potential melanomas and the integration of pathology services and allied health. My mentor has a strong interest in paediatric Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). I was fortunate enough to be involved in school visits, involving doctors, teachers, psychologists and parents.

Highlights and challenges Another highlight was telemedicine between patients at Woolgoolga and ASD and ADHD specialists at the Royal Far West in Sydney, which facilitated healthcare access for those who are geographically far away. Furthermore, I attended a refugee clinic at Coffs Harbour 42 GP First

However, it demonstrated the intrinsic humanity of medicine, which is to help others regardless of background or beliefs. We also visited Yarrawarra, an Aboriginal cultural centre, and the Aboriginal Single Men’s Living Quarters near Corindi Beach. This was a unique experience of Aboriginal cultural immersion which provided an invaluable insight into the health challenges of the Aboriginal population. Culturally, I was fortunate enough to participate in many activities organised by my mentor and the community. These included an outdoor cinema, sight-seeing at Woolgoolga Headland, a visit to Wedding Bells State Forest and Mary’s Waterhole and the annual Woolgoolga Christmas concert. Overall, a GP placement, particularly in a rural setting, is an enlightening experience — certainly one of the best ways to spend your summer break.

ow to get extra general practice placements

During medical school, most students will be exposed to only a few weeks of general practice during one clinical rotation. Extra experience in general practice is a great way to learn more about the specialty, discover what areas interest you, and to add to your CV. Try the following ideas to gain more general practice experience during medical school. Shadowing your GP Your GP is familiar with you and you are comfortable with how they conduct consults and medical procedures. What better way to gain insight into general practice than shadowing your own doctor? Applying for scholarships and awards Notable award systems which provide general practice experience include the John Flynn Placement Program and scholarships provided by the general practice medical colleges and Regional Training Organisations. Tapping into the rural doctor networks Many rural doctor networks provide cadetship schemes to encourage more doctors to work in remote and

regional areas of Australia. For example, the NSW Rural Doctors Network has a placement scheme called “Working HUGS” (Working Holidays for Under GraduateS) which entails a one-week placement in a rural setting. This is open to first and second year medical students. Contacting the GP unit at your university Your university is affiliated with a number of GPs, many of whom will be willing to accommodate medical students over the university break. They are also more likely to accept students from an institution to which they are connected. The Aboriginal Community Controlled Health Service These placements are initiated and operated by the local Aboriginal community to deliver holistic, comprehensive, and culturally appropriate health care to the community, particularly Aboriginal and Torres Strait Islander populations. Senior students Older medical students have undertaken GP placements and will be able to provide mentoring about which GPs fostered good relationships and encouraged learning. They might also be able to introduce you to GPs. By Elizabeth Wong, GPSN National Chair.

“A GP placement, particularly in a rural setting, is an enlightening experience — certainly one of the best ways to spend your summer break.”

WRITE & BUILD A MEDICAL CV A curriculum vitae (CV), also known as a résumé, is essential during your medical training and beyond.

Your CV outlines your experiences relevant to the role you are applying for and helps you stand out from the rest of the applicants. Recruiters can receive hundreds of applications for a single role and may spend less than 45 seconds “screening” a CV.

Remember: a medical CV will have a completely different layout to a résumé for a role in another industry.

Put together your CV during medical school During medical school, a CV may be required when applying for medical electives, research projects and scholarships. Once you graduate from medical school, a CV is essential. If you start collating your information early on, you will be sure to remember the exact dates and ensure nothing is missed. Before sending a CV, always have someone read through it and give feedback. Your university can support you — many universities run workshops throughout the year to polish your writing skills. It is also becoming increasingly popular to hire a professional service to help write your CV.

Your medical CV must:

What to include in a medical CV

Order the information in your CV so that the most relevant information is seen first. Put your personal details, such as name, contact details, qualifications, and medical registration number at the top. After that, be sure to include the following information, putting the most relevant information higher. • education and other qualifications, including the institutions where those qualifications were obtained and what year • professional career history (only include roles which are relevant to the position you are applying for) • clinical skills, history and experience • volunteer experience • research experience, projects, publications and presentations • professional development courses and conferences attended • any awards, honours or scholarships • other useful skills, such as languages spoken • two to four professional referees.

Who can I use to provide a reference?

• be clear, concise and straight to the point —for a student or graduate with little professional work experience, do not write more than two to three pages

You will be asked to provide at least two to three references (sometimes called a referee). Always ask someone if they’re happy to give you a reference before listing them on your CV.

• be written in plain business English, free from spelling and grammatical errors

There are different types of references – professional references and personal references.

• be written in the third person (do not use firstperson pronouns such as “I” or “my”)

A professional referee should be someone who has observed your skills in a professional setting. This can include employers, colleagues, a client or a supervisor.

• use a professional-looking design with easy-toread fonts such as Arial or Helvetica • use sub-headings and bulleted lists to draw attention to important information • not include a photo, unless you are asked to • only include information relevant to the role for which you are applying • never contain fabricated or embellished information. 44 GP First

However, many medical students may not have multiple professional references. If this is the case, you may consider listing a personal reference. A personal reference is someone who knows you well enough to provide an insight into your character, skills and work ethic. Do not list your friends or family members; ask for a reference from an upstanding member of your community. This could include a professor, teacher or volunteer coordinator.

Preclinical years Your preclinical years are the time to dip your toes in the water to discover what special medical areas interest you; start learning new skills and participate in activities which you can add to your CV. To build your CV during your preclinical years, you can: • join a student-run medical club at university, such as GPSN, and attend events that will help you make connections and give you the chance to experience different areas of medicine • join a GPSN National Working Group project and gain practical experience in leadership, organisation and research • apply for positions of interest on different committees — a lot of positions do not require previous experience — you can learn important organisational skills, improve your communication skills, and meet many like-minded people • consider applying for the John Flynn Placement Program — it is a fantastic way to get hands on experience in rural general practice — it offers around 300 rural placements to medical students to experience rural clinical practice in Australia • gain volunteer experience, for example through your local hospital, overseas volunteering or as a first aid officer • remember that extracurricular activities are important for your health and can look great on a CV.

Clinical years By now, you should have a basic medical CV. Your task now is to keep it updated, while still exploring new opportunities. To build your CV during your clinical years, you can: • get involved in a research project — this will teach

you useful skills for your career • attend networking events to meet health professionals and researchers in your field of interest • apply for scholarships, honours and awards • keep up your extracurricular activities, committees and volunteer experience — if you haven’t involved yourself in these activities, it is not too late to start.

Junior doctor You will need a CV during the application process to the Australia General Practice Training (AGPT) program — the government-funded GP training program. As a junior doctor, this is the time to tailor your CV to get accepted into the AGPT program. Both general practice medical colleges have different requirements, and the Regional Training Organisations (RTOs) — the organisations which deliver GP training — may also have specific requirements. Be sure to complete the mandatory hospital rotations for general practice. You can read more about mandatory hospital rotations on page 69. During this time, consider doing a short course to expand your skills beyond what you’ve learnt in medical school and in the hospital system. Once you are accepted into the AGPT program, this will make your CV look more attractive to prospective training practices. Different areas in Australia have different healthcare needs; think about where you want to complete your GP training and see if there are any special skills needed to support the population in that area. Extra courses and skills to consider include: mental health, skin cancer, chronic disease management, children’s health, geriatrics and minor procedural skills. By Carina Petersen, 2019 GPSN University of Western Australia (UWA) Chair.

GPSN University of Western Australia (UWA) members practice their skills at a Clinical Skills Event.

GP First 45

MAKE THE MOST OF YOUR GP ROTATION

hen asked about how they found their general practice placement, students often say it was either “the best thing ever” or they “did not do much”.

• skin checks • cervical screenings and pelvic exams • mental health screening

How can you improve your chances of loving your GP term, or is it all in the hands of your university and GP supervisor?

• vaccinations and injections

Here is how you can make the most of your GP placement.

• diabetes management.

Set the agenda Before you start, think about your goals for the placement. Do you want to practise skills, observe procedures or just get a feel for what it is like to be a GP? Things you might like to see or do include: • antenatal checks 46 GP First

• otoscopy, fundoscopy, dermoscopy • spirometry Think about what level of participation you are comfortable with. This might be observing consultations, performing histories and examinations under supervision or seeing patients in a separate consultation room and then reporting back to your GP. When you meet your GP supervisor, bring up your goals. Make it clear how you want to be involved and tell them

what you would like to do or see. Your GP supervisor will try their best to accommodate your goals.

• asking allied health staff to teach you, or if you can join their consultation

This may seem like a small thing, but introduce yourself to all the staff and find out what they do — your curiosity and interest will go a long way. Remember, allied health and nursing staff are great sources of information.

• asking the practice nurse if they need help.

Make the most of every opportunity Do not shy away from unexpected opportunities. You might be able to go to after-hours clinics, attend home visits or spend time with allied health and nursing staff. Follow up with patients throughout your placement. See if you can sit in on later consultations, look at investigation results, correspondence from hospitals and specialist letters. Ask the GPs about their job. Find out about their pathway to general practice, the challenges and benefits, and any advice they have for your future. While many patients enjoy speaking to medical students, sometimes, a patient may say they are uncomfortable having you in the consultation. This should be respected and you should not take offence — for some patients, going to a GP can be scary. Take every opportunity as a learning experience — remember, knowing how to make people feel comfortable is an invaluable skill as a doctor. You can use your spare time effectively by: • having some study materials on hand

Always ask to be shown how to use the practice software, write specialist referrals, order investigations, fill out prescriptions and bill patients. Do not be shy about asking for feedback and don’t be afraid of constructive criticism.

Troubleshooting Never just sit in the corner. If your supervisor does not involve you as much as you would like, you can try: • aiming to ask at least one question at the end of each consultation • asking whether you could be responsible for part of the next patient’s consultation, such as history or examination • asking to practice a specific procedural skill, such as blood pressure, the next time a patient needs it done. If none of these ideas works, you should raise the issue with your supervisor, and if that fails, talk to your medical school. I hope that these tips help you to gain more experience and enjoyment during your time in general practice. Best of luck for your future GP placements!

Written by Laura Roden Laura is the GPSN National Secretary. She is undertaking her medical degree at the University of New South Wales. Laura has been involved with her local GPSN club, where she was the Club Chair.

Doctors and medical students across Australia can get help and support through our network of doctors’ health advisory and referral services. Confidential advice and support is available on the following help-lines: • • • • •

New South Wales and the Australian Capital Territory (02) 9437 6552 Queensland (07) 3833 4352 South Australia and the Northern Territory (08) 8366 0250 Victoria and Tasmania (03) 9495 6011 Western Australia (08) 9321 3098

We all struggle sometimes — there is help and support for doctors and medical students

Visit www.drs4drs.com.au to find out more. Doctors’ Health Services Pty Ltd is funded by the Medical Board of Australia.

GP First 47

INCREDIBLE INDIA

was born in Tamil Nadu, India, and migrated to Australia with my parents at the start of high school. My extended family live in Tamil Nadu and I have strong ties to my roots.

At the end of my fourth year I decided to do three weeks of placement at the Christian Medical College (CMC) in Vellore, Tamil Nadu, India. Although it was not a necessity to complete my degree, I was keen to experience medicine around the world. I did one week rotation with infectious disease, one week of general medicine and one week at the Community Health and Development Unit (CHAD). Although I did not hear much about CMC as a child, the CMC Vellore community in Adelaide is of a sizeable number and I have several family friends who are either from Vellore or studied at CMC. I have met several doctors from CMC during my placements. Despite working in different fields of medicine, all these doctors had one thing in common, their admiration and passion for the work done by CMC. While I have always wanted to try medicine in India, these experiences compelled me to go earlier than planned. One night I got on my computer and searched â&#x20AC;&#x153;CMC international student placementsâ&#x20AC;?. Everything fell into place. While I was comfortable travelling to India, I was still nervous about going to an unknown place, interacting with doctors who supposedly receive the best training and my limited medical knowledge.

The joys and challenges I count myself lucky to have parents who instilled the importance of knowing my mother tongue, Tamil, and helped me become fluent in both Tamil and Hindi. Knowing the local language was immensely beneficial to help me navigate the town and benefit more from my interactions with patients. 48 GP First

The doctors and patients were pleasantly surprised when I conversed in Tamil and this allowed me to build more than just superficial rapport. The other international students at CMC considered me local which was hilarious because I had never been to Vellore and, just like them, I was a clueless tourist. CMCâ&#x20AC;&#x2122;s reputation attracted patients from all over India and Bangladesh. Some travelled 1000km to come to this hospital. This also meant that patients spoke several languages. While most of the doctors at CMC were at least trilingual and translated for me, it was still hard to keep up. I also struggled with the medical terminology in the local languages as I have never had to use them in my regular conversations. The number of patients one doctor saw every day was truly intimidating but the way the doctors handled the crowd was impressive. Although I went to CMC alone, I made a lot of new and lasting friends. Our weekend trips to the local temples, forts and waterfalls as well as our regular hikes and dinner adventures are some of the highlights of my trip.

What I learnt I got to see so many new things. My time at CHAD was filled with house visits which mainly involved postnatal checks with nurses, blood pressure (BP) checks and prescribing. Healthcare workers were treated almost like family. Travelling to the local villages was fun and the locals were very friendly and always offered us food or produce from their farms. I also met a farmer who was over 100 years old and was yet to retire. CHAD has a leprosy clinic once a week which was definitely new to me, something I may never see again. I saw several patients with HIV and TB as part of the infectious disease rotation.

There were also a number of lunchtime teaching sessions, case presentations and journal discussions that I attended. The main learning point for me was making the most of the five minutes you get with a patient and being absolutely efficient. Also, taking over 100 BPs in less than two to three hours has improved my skills significantly.

for the serious patients and helped educate patients on healthcare. This day was truly an eye-opening experience. I was able to observe the barriers to providing and accessing healthcare in a rural community.

To those considering an overseas placement

A memorable day

I strongly recommend that everyone do an overseas placement, if possible, and at do least one in a developing country.

The best day was when I joined the local outreach team to travel over 80 km from Vellore to the Jawadhi Hills to provide primary healthcare to the tribal community.

Start planning at least 9 months in advance and allow ample time for communication with the host institute and processing time for paperwork.

This was one of the perks of being an overseas citizen of India as foreign nationals were denied access to this restricted area due to safety issues.

Do not let finances get in the way as there are many scholarships and loans provided by universities, notfor-profits, and organisations such as banks, insurance companies and more.

Being an unmarried 20-year-old in this community was the equivalent of being an unmarried 40-year-old elsewhere in India. In this community, it is common for women to have two to three children by the time they are 18 years. It is also considered normal for men to kidnap women they want to marry. Most of the people in this community worked as labourers or farmers with limited or no education; healthcare was not a priority. I observed basic health checks, prescriptions and treatment of basic ailments. I also helped with referral

If you are eligible to apply for HECS-HELP, you can most likely get an OS-HELP loan for overseas travel. Make sure your safety is always a priority. Visit a travel doctor before leaving Australia for your placement and make sure your vaccinations are up to date. Written by Bridget Joseph Xavier, GPSN Chair at the University of Adelaide (UoA). She has been a GPSN member since 2015 and a national council member since 2017. She has also been involved in the teaching and obstetrics societies at UoA. Her areas of interest are physician training, general practice and anaesthesia.

GP First 49

RESEARCH AS A MEDICAL STUDENT FREQUENTLY ASKED QUESTIONS

here are many benefits associated with undertaking a research project as a medical student.

Not only does research give you the opportunity to contribute to the medical field, but it also helps you build your professional network, get an inside look into a specialty and boost your CV.

What are my research options? Each medical school has different options. It is up to you to browse your university website or talk to a course coordinator to discover the opportunities available. Some common options to consider include: • full-time research electives

How do I find a project? There are many places where you can start: • see if your medical school has a database of research projects suitable for medical students • get in touch with the student research coordinator at your university or a medical research institution or centre • ask your lecturers (if in pre-clinical years) or registrars or consultants (if in clinical years) if they have any research projects available • a summer research scholarship scheme • talk to friends who are currently doing research projects.

• full-time summer research projects and scholarships

What sort of project should I pick?

• volunteer or part-time research projects during the year

If you do not have any prior research experience, it might be easier to start with a full-time research experience such as a summer research project or a research elective.

• enrolling in a research higher degree. To help you pick which option is right for you, first consider your long-term career goals and then make a list of the advantages and disadvantages of each option. Talk to as many people as you can for their advice, experience and perspective. 50 GP First

This lets you focus on learning the ropes of research and is often a more supportive environment since you can get involved with your research group’s day-to-day activities. There are also other students and staff nearby if you need help. If you are thinking of doing a project part-time, alongside

your medical degree, consider the demands of the project and how much time you will need to spend in person. It is often more manageable to do a project which can be done on a computer in your own time, as opposed to a wet lab project which may require you to do experiments on-site. Make sure you are coping well with your medical degree before taking on the additional responsibility of a parttime research project. You do not have to know what specialty you want to do before you start your first research project. As a medical student, it is often said that any research is worthwhile because it can develop good foundations and skills for future research projects. Once you work out what specialty you want to pursue, you can focus your research on that area. Consider beginning with a retrospective data project (where the data is already collected) since you can get started straight away, as opposed to a prospective data project where you may need to wait for data collection.

How do I choose a research supervisor? If you want a project publication, consider checking the publication record of the supervisor online (try Google Scholar or PubMed). See if they include students as authors on their publications.

Your research supervisor will often become your mentor, so pick someone who inspires you and from whom you would like to learn. If possible, speak to current and past students who have done projects with that supervisor to get their opinion on the supervisorâ&#x20AC;&#x2122;s skills. Tell the supervisor what you want to get out of a project and aim to have a clearly defined endpoint for the project. For example, let them know if you want a project that can lead to a conference poster and/or presentation or a publication in a medical journal.

How do I balance research and university? Remember that your medical degree takes priority, especially if you are doing a project in addition to the requirements of your medical degree. Let your supervisor know when you have busy periods in medical school. Allocate chunks of time for research and consider using a diary or calendar app for managing your time. This will ensure you have time set aside for research each week and is often more productive than spending fragmented time on research. Consider presenting your research as a poster or oral presentation at a conference â&#x20AC;&#x201D; this is a great networking opportunity which demonstrates your interest in a specialty. There are often grants and scholarships available to help cover travel expenses.

Written by Craig Coorey Craig Coorey is a final year medical student at the University of Queensland (UQ) and a member of UQ GPSN. During medical school, he completed research projects studying cancer cell biology, air pollution epidemiology, paediatric endocrinology, bibliometrics, breast cancer pathology and epigenetics and kidney transplants.

GP First 51

APPLYING FOR GRANTS AND SCHOLARSHIPS

edical school can be financially draining. Fortunately, there are plenty of scholarships and grants to help ease the burden.

There are many types of scholarships — some help pay for your textbooks, some offer unique placement opportunities, and others help pay your tuition costs.

good place to get experience in preparing applications. Scholarships are often available through the Australian Medical Association (AMA), Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM) and are promoted on these organisations’ websites.

Here are some tips to give you the best chance of success with your scholarship and grant applications.

As the scholarships offered may change each year, search for opportunities on an annual basis. Subscribe to the mailing list of each organisation to keep up-to-date.

Know what scholarships are available

Make sure you are eligible

A good place to start looking for scholarships is your university website. Each university will have a different range of scholarship opportunities, and many are only available to students within particular year levels of the medical program. Usually, only a handful of people will apply for these scholarships each year. This means that applications for university-specific scholarships have a high chance of success and are a

52 GP First

Some scholarships are only for people from certain backgrounds or circumstances, for example, those with financial hardship, Aboriginal and Torres Strait Islanders, Australian citizens and those in rural regions. If you don’t fall into one of the eligibility categories, you should keep looking for other scholarship opportunities.

Address the selection criteria Each scholarship will have a list of selection criteria, which may include a personal statement addressing

specific documentation (for example, confirming your current financial situation or academic results). Addressing each criterion in the same order as they are listed on the scholarship overview will ensure you donâ&#x20AC;&#x2122;t miss anything and demonstrates to the assessors that you have systematically addressed each requirement. Observe any word or character limits strictly.

Keep track of the due dates Scholarship applications will only be accepted if they are received by the due date. Take specific notice if the application has any special submission requirements (for example, mailing certified copies of documents) and ensure that you allow time to meet those requirements before the due date.

When writing an application, do not simply list your experience, achievements or awards. Give examples to illustrate and explain how each of your life experiences and achievements have shaped you as a person.

Always post hard copy mail at least one week before the due date to ensure it arrives in time.

Explain how you have made a difference to others around you and the factors that were considered for any awards that you have received.

Keep a copy of all of your drafts and final submissions for all of your scholarship applications.

Keep a record of your scholarship applications

Clearly illustrate what change you envisage the scholarship will make to you personally in terms of skill development, financial stability, or personal growth.

Most scholarship selection criteria are similar and significant proportions of your previous applications to unrelated scholarships can often be reused to form the basis for a new application.

After writing your personal statement, re-read the application and ensure that each paragraph clearly and directly addresses the relevant question.

This can save a significant amount of time, however, you always need to tailor the content to the new scholarship and administering organisation.

Ensure that your writing style is formal and that there are no spelling or grammatical errors.

Continue applying, even if you are not successful

Know about the scholarship and who is assessing it

A scholarship application is a very worthwhile use of your time.

Research why the scholarship was created: the goals, objectives and services or programs offered by the organisation administering the scholarship. Research the characteristics of past recipients, including any post-scholarship reflections or reports. Knowing these factors allows you to tailor your application to highlight experiences, personality traits and achievements that would likely be viewed favourably by the assessing panel. You should exclude any irrelevant achievements or experiences, as these may not substantially add value to your application (in the assessorsâ&#x20AC;&#x2122; eyes), while using up space in your word limit.

If successful, an application that took two to ten hours to research and write may earn you $500 to $5,000 (or even more in some cases). This is equivalent to working a job paying over $50 per hour. Scholarships are often poorly contested, so the odds of receiving one are reasonably high if you apply often enough. Remember, you will never receive a scholarship if you never apply.

Search through a list of scholarships and grants on the GPSN website Visit gpsn.org.au/scholarships

By Matthew Riggs. Matthew is the GPSN James Cook University Chair. He is a Year 6 (final year) medical student and is interested in rural health, illness prevention, internal medicine, paediatrics and mental health. He enjoys the diversity of general practice and the opportunities for continuity of care and to develop strong therapeutic relationships with patients, especially in rural settings. Over the past five years, he has successfully applied for eight scholarships, which have provided him with cash payments, attendance at conferences and overseas placement opportunities.

GP First 53

A PLACEMENT LIKE NO OTHER

he John Flynn Placement Program (JFPP) is a fantastic opportunity allowing medical students to undertake fully funded rural or remote placements for two weeks each year over three or four years.

The program is funded by the Australian College of Rural and Remote Medicine (ACRRM). Students work alongside a rural doctor, experiencing the diversity of rural practice and expanding their hands-on skills.

third year of medical school, which was the last year I could apply. I remember being so excited when I received the email, which also invited me to apply for the remote stream of the program. This would allow me to complete my placements in a remote Aboriginal community in the Northern Territory. I was fortunate enough to gain a spot in Ti Tree, a community of a few hundred people just north of Alice Springs.

Students live with a community host and return to the same rural location each year, creating lasting connections with the people and the place.

I was both excited and terrified, all ready to go until I received a phone call the day before I was due to travel on a bus from Alice Springs. I was told that the clinic could not take me anymore.

From rural Tasmania to East Arnhem land, dozens of health services across Australia open their doors to the lucky students selected for the program.

This turned out to be a blessing in disguise; instead, I headed for the community of Yuendumu, about 300km north-west of Alice Springs.

While the selection process for this scholarship is competitive, I highly recommend applying (if need be, every year from first year, as I did).

There, I was welcomed with open arms to the community health centre, which consisted of Luana the manager, Mel the permanent nurse, Krissy the administration wizard, Amy the GP, Robyn the child health nurse, two Aboriginal health workers and five other fantastic locum nurses and midwives.

A once in a lifetime experience I was finally successful in applying for the JFPP in my 54 GP First

What I experienced I was immediately “parallel consulting”, seeing my own patients and learning quickly how both the culture and the medicine in the outback are different. With presentations and diseases that I had never seen before, I learned that I would need to think outside my limited knowledge and pool all the resources possible. I dispensed medications, performed health checks, counselled patients, listened to their worries and tried to work with them to develop solutions. I inserted cannulas, implanons and nasogastric tubes, took blood, and helped with evacuations of several sick patients with the Royal Flying Doctor Service (RFDS). Outside of the clinic I was fortunate enough to interact with the community regularly. I visited people’s homes, which were so different to my own, played with the kids at the local pool and youth centre, talked with the elders at church, and watched the local footy games. Each time I returned over the next two years, I felt like I was coming back home to somewhere I was welcome. Every time, I left with new experiences, new skills, new friends, and an even greater appreciation for Walpiri and Indigenous culture. Although many of the nurses at the health clinic rotated through for a few months at a time, they were always trusting and pushed me to my limits, while making sure I did everything right.

WHO WAS JOHN FLYNN?

o most Australians, Rev. John Flynn is most recognised as the man commemorated on the $20 banknote.

In 1880, Flynn was born in the rural town of Moliagul, Victoria. In 1911, he completed training to become a Presbyterian Minister and was posted to a rural mission 500km north of Adelaide. Here, Flynn learnt of the struggles faced by rural Australians, particularly in accessing healthcare. He had a vision to provide a ‘mantle of safety’ for the ‘people of the bush’. In 1928, Flynn founded what became the Royal Flying Doctor Service (RFDS), the world’s first air ambulance. Flynn also founded what would become Frontier Services, which still to this day supports the safety and wellbeing of Australians living in regional and remote areas. Flynn was appointed an Officer of the Order of the British Empire (OBE) in 1933. He died of cancer in 1951, aged 70.

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All in a day’s work On the first day of my final placement, two febrile children without a focus of infection presented just before the clinic closed at 4:20pm. I ended up cannulating and running IVs for those children, then staying until 3:30am the next morning with the nurse on call, who asked me to organise the RFDS evacuations. It was terrifying to speak to the senior evacuation staff in Alice Springs and Darwin and the RFDS coordinators. However, I am so thankful for that experience and responsibility.

What I learnt The JFPP gave me more than medical experience — it helped me develop independence, confidence, communication skills, cultural awareness, and appreciation for the amazing work of remote area practitioners and those who live in remote communities, facing a plethora of challenges people in metropolitan areas couldn’t fathom. I strongly recommend that anyone considering applying should do so — there are so many places JFPP can take you, and I have never met anyone who regretted entering the program.

Written by Susanne Kitching Susanne graduated in 2018 from Monash University where she was the Club Chair of GPSN Monash University. She was elected to the GPSN National Council as the 2018 Local Events Officer. Susanne has a special interest in rural health and medical research.

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WHY GENERAL PRACTICE? General practice is a rewarding and diverse specialty; all medical students should consider general practice as their speciality of choice. Below, GPRA members share why they are passionate about general practice and what they love about general practice in Australia.

Dr Rosie Gentle I am passionate about general practice because... “...every day is different. The continuity of care is rewarding, as is getting to know your patients. Doing pre-conception counselling with a patient followed by celebrating a pregnancy, monitoring throughout and then getting to meet and treat the baby is so special — it is something no other speciality provides. There is so much breadth — you never stop learning and you can delve deeper into any area you love. You learn to treat the patient, not just the disease. These are just some of the many reasons I’m so passionate and thankful that I decided to choose general practice."

Dr Jessica Zimmerman I am passionate about general practice because... “...I love the continuity of care I’m able to provide to the community. As a part-time GP, I’m spending two years at my practice and I have developed strong therapeutic bonds with my patients and their families. I love seeing my patients improve and grow over time, particularly my patients with mental health concerns. Being a rural GP is particularly rewarding as I can follow a patient for their entire journey from emergency to community follow up. I enjoy being able to care for people in the nursing home. I am able to support and comfort them and their families towards the end of their life. I love coming to work every day and I feel incredibly lucky to be a local doctor."

Dr Alyssa Vass I am passionate about general practice because... “...of the unparalleled opportunities it provides to create genuine partnerships with patients for better health, as they define and shape it for themselves. No day is ever the same and patients teach us something new every time they walk through our door, with their unique stories and their unique trust in us. In general practice, I get to focus on my passion for Aboriginal and Torres Strait Islander health through community-based and community-driven care."

Dr Bushra Ahmed I am passionate about general practice because... “...general practice allows me to take care of a young boy with a rash and then counsel his teenage sister regarding her contraception options. I also see their mother for regular cervical screening and help their father return to work after a back injury. I am able to support their grandfather to stay at home when he gives up on the chemotherapy for his metastatic lung cancer. I am able to do all this and more while still being able to kiss my own kids goodnight and take them to swimming lessons on a Sunday morning."

Dr Jared Cruikshank I am passionate about general practice because... “...general practice plays a critical role in the broader community. General practitioners are everyone's first port of call for health concerns. They act as a single point of contact for patients and other healthcare professionals to integrate complex issues. On top of all this, doctors in general practice quietly monitor and prevent disease wherever possible. Such contributions should be recognised and assisted."

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A CALL TO HEAL HOW GPs CAN WORK TOGETHER TO CHANGE THE WORLD Professor Michael Kidd AM is the Patron of GPSN and GPRA. He is a past president of the Royal Australian College of General Practitioners (RACGP), and a past president of the World Organization of Family Doctors (WONCA). He has recently been appointed as the Director of the new World Health Organization Collaborating Centre on Family Medicine and Primary Care.

Prof Michael Kidd (left) with GPRA CEO Dr Andrew Gosbell (right) in Melbourne.

want to share with you some insights on the global movement underway to ensure healthcare is available to all people.

I want to highlight the role that general practice is playing in this development, and how GPs are working together to change the world as we answer the “call to heal”. This is done through our daily clinical work, through our contributions to the education and training of the future general practice workforce, and through our support for the advancement of research in general practice and primary care. As doctors, we never stop learning, and I have been spending some of my time in Canada over the past year, learning about healthcare and university education in North America. Before coming to Canada, my perception was that it is a lot like Australia, only cold. A large country, with strong agriculture and mining, great scenic beauty, multicultural big cities, thriving rural towns and isolated remote communities, and proud Indigenous peoples with a strong heritage. I have always found that Canadians are a lot like Australians, except Canadians tend to be less direct and more polite! In my first week in Canada, at the encouragement of my husband, Alastair, I went to Winnipeg and visited the remarkable new Canadian Museum for Human Rights.

The two-year training program includes supervised clinics in general practice every week, as well as special skills rotations, which include emergency medicine, low risk obstetrics, care of the elderly, palliative care, mental health and more. Like Australia, general practice is a highly sought-after medical specialty in Canada. The top graduates from medical schools compete for training places in the nation’s training programs, which are run through the Departments of General Practice/Family Medicine in each university medical school. This model of university-based registrar training allows much more integration of the training of medical students and GP registrars than we can currently achieve in Australia. It also provides additional resourcing to support impressive programs of research in each academic department of general practice across the country. I was also impressed to learn that over 70 per cent of the members of the College of Family Physicians of Canada (the local equivalent of the RACGP and ACRRM) serve as teachers of medical students and GP registrars. This is an extraordinary level of contribution to the future by the GPs of Canada. As GPs, we are part of a global family and we can learn from each other’s experiences.

It is an extraordinary building with wonderful content that tells the story of human rights in Canada with characteristic humility and honesty and an acknowledgement that things could, and should, have been better. Walking through the museum is a very emotional experience. I hope that one day we will see a similar institution established in Australia.

Universal healthcare One of Canada’s great commitments to human rights is through their universal health system, ensuring healthcare is accessible and affordable for all their citizens. This was first introduced back in 1966, and reinforced in 1984 by the government of Trudeau the Elder. Australia following with similar reforms during the Whitlam Government era with the introduction of the precursor to Medicare in the 1970s.

General practice in Canada One thing that has surprised me in Canada, has been discovering the length of training required to become a specialist general practitioner, which is called a family physician in Canada. Nowhere else in the world claims they can train a competent and confident specialist GP within two years of graduation from medical school. Yet the Canadians achieve this through a very intensive training program for their GP registrars, with every rotation focused intently on providing the skills needed to be a competent GP.

A GP registrar working in a refugee health clinic in Toronto. GP First 59

UN Sustainable Development Goals In 2015, the countries of the world, including Australia, signed up to the new United Nations Sustainable Development Goals, the SDGs, 17 goals which aim to make the world a better place for all people. The SDGs set targets for the next 15 years. By 2030 the commitment is that the nations of the world will have worked together to eradicate poverty, we will have zero hunger, no child will go to bed on an empty stomach, we will have healthcare for all people, we will have universal education, especially for girls, we will have gender equality and support the empowerment of women, we will have a healthy global environment and nations of the world will work together to support sustainable development and peace and justice for all. They are commendable goals and I hope all nations live up to their commitments. Only one of the SDGs is about health, but all 17 are dependent on a healthy population and all 17 have an impact on health and wellbeing. The health SDG calls for “ensuring health lives and promoting well-being for all people at all ages.” This is what the WHO calls “universal health coverage”.

Healthcare for all people As GPs, we have a role in making health for all people a reality. It is only through strong community-based healthcare services, delivered where people live in urban

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and rural areas, that we will see equitable, high quality healthcare services for all. Indeed, the new Director-General of the World Health Organization, Dr Tedros, the former Minister of Health of Ethiopia, recently wrote: “Family practice is the best way to provide integrated health services at the primary healthcare level. With an emphasis on health promotion and disease prevention, family practice helps keep people out of hospitals, where costs are higher and outcomes are often worse.” This is high level endorsement for the work that GPs, and the members of our practice teams, do in countries all around the world. In October 2018, the leaders of the world came together in Astana, the new capital city of Kazakhstan, under the auspices of the WHO and UNICEF, for a global meeting on strengthening primary healthcare, and to commit to making the health SDG a reality. This is only the second time in world history that the leaders of the world have come together to discuss primary healthcare, and how we deliver healthcare to every person in every family in every community in every nation of the world. The leaders of the world signed up to the Astana Declaration, which commits every nation to ensuring health for all people, through strong primary healthcare. Global declarations are important but it is important to ensure these commitments roll out at a local level.

Left: Indigenous health clinic in inner-city Toronto. Right: GP registrars training at the University of Addis Ababa in Ethiopia. Below: Prof Michael Kidd (left) with World Health Organization Director-General, Dr Tedros, and Dr Hassan Salah (right).

General practice around the world

Canada and elsewhere.

One of the most exciting developments I have seen in Canada is the work of Canadian GPs to support the development of the specialty of general practice in Ethiopia, in East Africa.

These new medical schools will soon be graduating 3,000 new doctors each year. This community-based curriculum, combined with the postgraduate specialty training of these new doctors in general practice, will transform the delivery of community-based healthcare to the people of Ethiopia, and provide a model that can be adapted for use in other countries across Africa and elsewhere.

Working in partnership with colleagues at the University of Addis Ababa, GP educators from Canada have helped to establish that countryâ&#x20AC;&#x2122;s first specialist GP training program. General practice is now an established specialist medical discipline in Ethiopia and the first specialist GPs are graduating and moving out into the community to reform their nationâ&#x20AC;&#x2122;s healthcare system. The potential contribution of this development to the Ethiopian healthcare system is immense. The country is growing at a rapid rate and its population is approaching 90 million and many live in extreme poverty. Many people have difficulty accessing any level of healthcare. In recent years Ethiopia has opened thirteen new medical schools using an innovative community-based curriculum, based on the curriculum of similar medical schools with a strong community focus in Australia,

It provides a great example of how much we can achieve by working together. Through my global experiences, I see hope in general practice. I see hope in the work of GPs serving their patients and their communities every day. As GPs, we are called to heal, not just to heal our individual patients, but to heal our communities, heal our nations, and heal our planet. Our world needs strong general practice more than ever. Working together, we are helping to change the world. Written by Professor Michael Kidd AM. Sections of this editorial were included in the 2018 Ian McWhinney Oration of the College of Family Physicians of Canada, first published by Canadian Family Physician. GP First 61

WITH GPEx, YOUR PATH TO GENERAL PRACTICE SUCCESS IS AS INDIVIDUAL AS YOU ARE. Our registrars not only achieve some of the highest results in Australia, they are continually supported to forge their unique path in general practice, well beyond fellowship. Contact us and find your path.

FROM UNI TO JUNIOR DOCTOR

or every junior doctor, the beginning of the internship is a daunting time; it is the beginning of the rest of your career.

This is the time to get hands-on experience and decide what areas of medicine interest you. You will also gain access to a number of different doctors who may inspire you to pursue their specialty. Remember, as you make your way through rotations you will be faced with a new set of responsibilities and exciting experiences. No matter what specialty you choose what you learn will help you be a safe and skilled doctor.

LIFE AFTER MEDICAL SCHOOL SURVIVING YOUR INTERNSHIP YEAR

he beginning of the internship is a daunting time for every young doctor; it is the beginning of the rest of your career.

As you embark on the journey, along comes a new set of responsibilities and exciting experiences — and a sense of anxiety. I was in the same position only 12 months ago — excited about my new career, but worried I was not ready. However, I have learnt a lot in making my way through rotations over the past year. Here are the tips which, with the help of my colleagues, I have identified to help you survive your internship and the rest of your medical career.

It is ok to not know As you start out on the wards or in the emergency department (ED), it is only natural to second-guess yourself. It is important to remember that as much as you may feel the pressure to know everything, you are a junior. The intern year is designed to allow you to test your skills and knowledge and grow as a clinician with the support of your seniors. 64 GP First

There is always someone nearby to ask for help — you are encouraged to ask questions. This does not just apply to clinical situations. A lot of your role as an intern will comprise of clerical work, scripts and discharges. A lot of this can be hospital or rotational-specific, so ask everyone around you for help, particularly nurses and pharmacists. Remember, the ward pharmacist is a wealth of knowledge and is your best friend.

You are all in it together Everyone you will work with is part of the same team. Be nice to one another and help each other out. If you have the time, offer help a busy colleague by inserting a cannula into a patient or a do quick discharge. A little help goes a long way and people will remember. This doesn’t just apply to your fellow interns, this applies to all staff. No matter the size of a hospital, all staff will take note of those who are friendly and are a team player, and those who are not. Being a part of the team makes a better work environment for everyone.

Work on yourself and embrace opportunities Medicine is a competitive career; it is important to make sure you don’t get left behind. If you know what you want to do and where you want to end up, that’s great. If you are not sure, ask around and find out what you need to do to follow that path. If you are like me, and are still figuring things out, that’s fine. You don’t have to work towards something specific to work on your career. The junior years are the time to try things out and to see where you want to take your medical career. As a junior doctor, resources and opportunities surround you, and everyone is keen to help. Help ranges from teaching and courses to research, audits and advocacy. While it may not be apparent at first, most registrars are keen to teach and students keen to learn, and consultants often have audits and case reports waiting to be picked up. There are resources and opportunities everywhere, from supervisors to the education officers and the Junior Medical Officer (JMO) office. It is safe to say that everyone around you wants you to succeed — you just need to seek out the opportunities.

However, at the end of the day, this is still a job, and it is important to make a life outside of work. Have friends outside of medicine, give yourself a break from it all and a chance to talk about anything else. As busy as your internship is, when you leave work, you can actually leave work. This means you have more time than you’ve had in medical school to work on your hobbies or try a new one.

Look after yourself Internship can be hard, but you must remember to look after yourself. Schedule in regular exercise, join a sporting team, and get your own GP. As stressful as work is, it is important to take your lunchbreak and do your best to leave on time. These things are vital to keeping sane during internship. If things start getting too much, it is ok to reach out. This can be to a friend or partner, or your GP.

Enjoy the year At the end of the day, medicine is an amazing career and internship an amazing year – enjoy it! Give yourself the chance to grow as a clinician and make the most of every opportunity.

Make a life away from work

Remember to be a team player. Help out your fellow interns and be nice to those around you.

Medicine is hectic, and you can easily find yourself consumed by it — stuck in the dreaded “medical bubble”.

Most importantly, take time out for yourself. Make a life away from work and be sure to look after you. You can’t treat your patients if you are off sick.

By Dr Jayden Murphy Jayden is an intern at Tamworth Rural Referral Hospital. With an interest in rural health, he is the Health Education and Training Institute (HETI) Rural Representative. In 2017, Jayden was the GPSN National Chair and in 2016 he served as the GPSN National ViceChair. He obtained his Doctor of Medicine at the University of Wollongong in 2017, where he was also the GPSN Club chair in 2015. He is also a graduate of Griffith University.

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FROM MEDICAL STUDENT TO INTERN

he huge transition from medical student to doctor is exciting. It is normal to experience anticipatory anxiety with this new stage in your medical career.

Despite all the advice and preparation, there will be days as an intern where you don't have time to exercise, when you have to eat takeaway for three days straight, don't get to reply to that important message or go to that family dinner. There may be times when you feel out of your depth at work and you have to call your registrar three times with the same question. It happens to most interns and it passes. You can do a few practical things to prepare for your amazing first year. It is very likely that your medical training has equipped you with most of the skills you need, but there are a few things you may do to make it easier for yourself. For example, try to proactively look after your mental and physical health and practise healthy habits, which are realistic to maintain throughout your intern year.

Before your first week Try to plan ahead for your first week. First, establish a trusting relationship with a GP close to where you live. Talk to them about starting your new role. Seek treatment for any common low-grade or chronic medical conditions. For example, anaemia, migraines, irritable bowel, dysmenorrhoea, anxiety often resolve with simple treatments. Discover relaxing ways to fall asleep and to manage fatigue. Try to establish healthy patterns of sleep by conditioning your brain with mindfulness, meditation, relaxation techniques and/or breathing exercises. Do whatever works for you. An online brief course in cognitive behavioural therapy techniques has been shown to reduce depressive symptoms in first year doctors. You can try it at: moodgym.com.au Establish a regular exercise routine that may be continued while you are working. For example, attend a regular gym or dance session, use the stairs instead of the lift, join a sporting team that does not mind if you miss a few games, walk to work if possible, get up earlier for a run or a bike ride with friends. Arrange to live in a stable household with or near people you love when you start your new position.

feel out of your comfort zone with new rotations. Ask for assistance, support and teaching. If you find any aspect of being a doctor difficult, ask for help from a trusted colleague. You will often find that other new doctors are concerned about the same things but don’t talk about them. Also ask for help from allied health staff, especially nursing staff. They have often been on the ward or in a department for a lot longer than the doctors and know exactly what is going on. They may seem really busy but if you are honest and say you need their help because you are unsure of what exactly to do, they are more than willing to help. For instance ask the administrative staff about paperwork, the pharmacists about doses and drug interactions, the nurses to help with procedures, the speech pathologists to help assess swallowing. Debrief with your clinical team and your own trusted GP after any traumatic experiences. Manage fatigue and night shifts. Sometimes night shifts can wreak havoc with your body clock. It’s often surprising how adrenalin keeps you going while you are working and then makes it difficult for you to sleep. Treat fatigue as you would treat jet lag. Get through it knowing it is temporary. Don’t overthink it.

During your first term as an intern

Try to get enough sleep on your time off by implementing the sleep techniques you practised as a medical student.

Reassure yourself you are still learning and it is normal to

Remember the simple things like drinking enough water,

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having a bath, eating healthy food, getting out in the fresh air during the day.

On your precious time off work Manage your time off effectively. You may work about 40 to 50 hours a week and require about 56 hours a week for sleep, leaving you about 60 hours a week of flexible time. Obviously you need time to do housework, commute and attend to administrative tasks. However, some of these tasks may be delegated, minimised or avoided. You can now afford to pay for home help, shop online, engage a competent accountant, and live reasonably close to where you work if possible. Try to connect with your family and people who energise you, eat nutritious food, get enough sleep, exercise, relax and take time for solitude and things you enjoy. Try to keep connected with people you love – your family and your non-medical and medical friends. Plan things that help you relax on your time off. Sometimes scheduling all your administrative tasks and social gatherings into your few days off can be stressful in itself. Getting away if you have a few days off in a row may help you switch off. If this is not possible, simply get out into the fresh air as often as you can.

Try to separate your work life from your home and social life, this will help you rejuvenate and you will be a more effective, empathetic doctor when you return to work. Avoid ruminating about work on your precious time off. To try to change your mindset and ask: • Can I influence it? • Why am I reacting this way? • Is there another explanation? • Why is this triggering me? • What is the worst that could happen? • What is the best that could happen? • What is the most realistic outcome? • What would you advise a colleague? Reading this short article may seem a little overwhelming, but the suggestions are not prescriptive. Experiment with what works for you. Trust yourself. Be kind to yourself. Keep connected. We are all still learning – please spread this article around and add your own ideas. Written by Clinical Professor Leanne Rowe AM. She is a GP and past Chair of the RACGP. Her book ‘Every Doctor: Healthier Doctors=Healthier Patients’ www.everydoctor. org, co-authored with Professor Michael Kidd AM, is about thriving in medicine as well as addressing the tough issues in medicine.

YOUR JOURNEY TO GP FELLOWSHIP Are you interested in people and holistic care? Want a rewarding, challenging specialty? Become a highly-skilled GP – train with us Learn a range of clinical skills Be part of a local community Every day is different Work with a supportive team

Do you have what it takes? Australian General Practice Training Program Find out more at www.mccc.com.au, 1300 622 247 or info@mccc.com.au

Be challenged. And satisfied. Be the life changer. And saver. Be esteemed. And part of the community. Be relied on. And free to choose your path.

Be a GP â&#x20AC;&#x201C; visit wagpet.com.au

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Dr Yusof Mutahar WAGPET GP Registrar

PREPARING FOR GP TRAINING Mandatory hospital rotations

obstetrics and gynaecology, and anaesthetics

Certain hospital rotations must be completed by doctors in their postgraduate years. These mandatory hospital rotations do not have to be completed before application and entry into the AGPT Program. Where possible, all rotations should be completed prior to the second year of the AGPT Program.

Refer to the relevant college documents below and ask your preferred RTO for more information.

If you have completed additional hospital experience, post general registration, you may be eligible for recognition of prior learning once you commence on the AGPT Program. Please contact your preferred Regional Training Organisation (RTO) within your preferred training region, or relevant college/s for further information.

The following is a guide to rotations required Postgraduate Year (PGY 1)—Rotations required to achieve general registration: medicine, surgery and emergency

Postgraduate Year (PGY 2) or later— fellowship requirements If on the RACGP Fellowship pathway: paediatrics and three rotations of choice relevant to general practice If on the ACRRM Fellowship pathway: paediatrics,

What to consider before starting training Here are a few things you can do to prepare while in the hospital system: • Ensure you are a part of the Going Places Network (GPN). • Familiarise yourself with the training pathways into general practice, think about which GP Fellowship is right for you. • Think about where you would like to work as a GP registrar or GP and your clinical interests, as your clinic’s location may determine the types of patients you treat. • Research each RTO; each offers different options as to how and where you can train. • Think about extended skills you would like to develop in your GP training and if these skills would suit your goals and clinical interests. Portions of this article have been taken from the Department of Health’s 2019 AGPT handbook. Visit agpt.com.au for more information.

JOIN THE GOING PLACES NETWORK The Going Places Network (GPN) is a network that ensures general practice does not fall off the radar during hospital training. The key features of the network are the GP ambassadors and the bi-monthly eNewsletter.

You can contact your GP ambassador by emailing enquiries@gpra.org.au

Contact your GP ambassador when you:

Through the network, junior doctors are kept up to date with the latest information on general practice, including Fellowship pathways, application process and dates, and the breadth of opportunities available in general practice.

• have questions about general practice during hospital rotations

What is a GP ambassador and how do they support me?

• want to network with other prevocational doctors, GP registrars and more.

GP ambassadors are a point-of-contact for prevocational doctors wanting to know more about general practice. A GP ambassador can: • support prevocational doctors as they deal with the pressures of hospital rotations

• want to know more about the GP training application process

Did you know...? If you are a GPSN member and you have updated your member details to tell us you have graduated, you may already be a part of the GPN network.

• answer any questions about general practice training

If you have graduated and have not updated your member details, or if do not receive the GPN eNewsletter, simply visit gpra.org.au/update

• organise GPN events.

There is no cost to be a member of the GPN network.

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MY HEALTH RECORD

here has been a lot of discussion in the media regarding My Health Record, Australia’s national eHealth record system, an online repository for data on individuals’ health and healthcare.

If you didn’t tell the Australian Government not to create a My Health Record for you in 2018, and you have a Medicare card, you already have one. But unless you or a healthcare provider has activated the record by accessing it or uploading a document, it is just sitting there, empty. As soon as one of those ‘trigger events’ occur to activate your My Health Record, a few things will happen The last two years of your Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) claims information will appear in your record. At that point, your healthcare providers can upload other types of information. Pathology and diagnostic imaging providers can send reports to the record, and you can add details of your own, like emergency contact information. I think there are many benefits to having a My Health Record as a patient, particularly if you suffer from chronic illness and see many different healthcare providers for treatment, or if you’d like certain information to be made available to clinicians in the event of an emergency. As a GP, I find I get most benefit from My Health Record when I’m seeing a new patient who is visiting from out of town. Checking the record can provide access to information I wouldn’t otherwise have, like their current medicines, allergies and adverse reactions. 70 GP First

Like anything involving the internet, the best thing you can do to shield your data is to set a unique password and keep it safe. Another thing you can do is use the system’s in-built access controls. You can set up a PIN to restrict access by particular healthcare organisations to your whole record, or to particular documents. You can also remove particular documents from view by anyone. If you decide you don’t want your My Health Record, you can cancel it at any time. GPs and patients often tell me they are concerned about insurance companies, government employees or prospective employers getting access to the record. The law prohibits these types of access. At the time of writing, moves are also underway to amend the legislation governing the use of My Health Record to close a loophole that could allow law enforcement entities to access a record without a warrant (a power that has never been exercised). I’m excited to see what the future holds for My Health Record. The system will continue to evolve, just as it has since its inception in 2012. I think the next generation of GPs will embrace its potential for patient care. Knowledge is power, so get familiar with your own My Health Record, if you have one, and find a way to manage the data within to suit your needs. By Dr Rob Hosking, Chair of the RACGP eHealth and Practice Systems network.

ENTERING GENERAL PRACTICE

he pathway from the hospital system to general practice can be confusing â&#x20AC;&#x201D; not to mention the stress of your hospital rotations.

In this section, we break down how to get into the general practice training program. You can also read about a range of options to consider once you are in general practice, as well as important information to know once you are a GP registrar.

THERE ARE TWO MEDICAL COLLEGES THROUGH WHICH YOU CAN OBTAIN GP FELLOWSHIP

â&#x20AC;˘ The Australian College of Rural and Remote Medicine (ACRRM), provides a GP Fellowship that specifically focuses on the needs of rural communities. â&#x20AC;˘ The Royal Australian College of General Practitioners (RACGP), provides a GP Fellowship that focuses on the needs of metropolitan and rural communities.

BECOMING A GP THROUGH THE AGPT PROGRAM The Australian General Practice Training (AGPT) program is the leading training program for medical graduates wishing to pursue a career in general practice in Australia.

Fellowship. You must nominate either the rural pathway (training in rural or remote areas) or the general pathway (training in inner or outer metropolitan areas).

The Australian Government funds around 1,500 AGPT training positions per year. As the training program is government-funded, there are certain eligibility criteria you must meet to qualify for the program.

You will also nominate up to four training regions within a Regional Training Organisation (RTO). Your nominated RTO delivers your GP training. You can only choose a training region, not a specific location, and you will stay in that region for the duration of your training.

To be accepted into the AGPT program you will apply through a medical college (ACRRM or RACGP). This will be the college through which you will obtain your GP

Applicants are shortlisted to their highest available training region preference. RTOs will advise applicants if they have received an offer.

BECOMING A GP THROUGH OTHER PATHWAYS There are other pathways to become a GP in Australia. Both medical colleges have different pathways suited to different needs. This includes full-fee paying pathways, pathways for international medical graduates based on previous training and experience in general practice, and more. Visit gpra.org.au/training/fellowship-pathways for more information. The Remote Vocational Training Scheme (RVTS) is a government-funded GP training program for medical practitioners working in rural and remote communities

throughout Australia, and doctors working in Aboriginal Community Controlled Health Service. You can choose either ACRRM or RACGP as your medical college. You do not choose an RTO. Through this training scheme you live and work in your remote location while conducting your GP training remotely, supported by distance education and remote supervision. If you are interested in this program, apply directly with the RVTS. Visit rvts.org.au for more information.

WHAT ARE REGIONAL TRAINING ORGANISATIONS? The GP training program is delivered by a national network of Regional Training Organisations (RTO). Before you start your GP training, you will choose a training region within an RTO in which to undertake your training. An RTO deliverers GP education and training within a specific geographical region. For more information, visit: agpt.com.au The current RTOs and training regions are below. Northern Territory Northern Territory General Practice Education (see p.1), ntgpe.org Western Victoria Murray City Country Coast GP Training (see p.67 & 74), mccc.com.au

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Eastern Victoria Eastern Victoria GP Training (see p.37), evgptraining.com.au South Australia GPEx (see p.62), gpex.com.au Western Australia Western Australia General Practice Education Training (see p.68), wagpet.com.au Tasmania General Practice Training Tasmania, www.gptt.com.au North West Queensland Generalist Medical Training, gmt.edu.au South East Queensland General Practice Training Queensland, gptq.qld.edu.au New South Wales GP Synergy Limited, gpsynergy.com.au

THE AGPT PROGRAM Medical school 4 to 6 years; MBBS or equivalent Get involved and learn more about general practice through joining your local GPSN club.

Hospital training

Minimum 12 months. You can apply for the AGPT program during your first year in hospital. You will start general practice training the next training year. When you apply for the program you must pick a Fellowship pathway and an RTO to deliver the training.

ACRRM Fellowship pathway specifically focuses on the needs of rural communities

Year one

Year two

Hospital Training Time

12 months of Core Clinical Time (CCT), usually completed in a hospital

12 months of Hospital Training Time (HTT)

Primary Rural and Remote Training 24 months total

• 6 months community primary care • 6 months hospital and emergency care • 12 months rural/remote experience

To obtain Fellowship, ACRRM candidates must complete a fourth year of Advanced Specialised Training (AST).

Year four

focuses on the needs of metropolitan and rural communities

Core Clinical Training Time

Primary Rural and Remote Training (PRRT) consists of:

Year three

RACGP Fellowship pathway

General Practice Training 12 months total Term 1, 6 months Term 2, 6 months

General Practice Training 12 months total Term 3, 6 months Extended skills, 6 months RACGP candidates can conclude GP training after year three and earn Fellowship of the RACGP (FRACGP). Otherwise, candidates can choose to continue their training for 12 months and earn FARGP, which allows them to specialise in rural general practice.

Advanced Specialised Training

Advanced Rural Skills Training

12 months total

Candidates earn Fellowship of the ACRRM (FACRRM) and can work as a GP in Australia.

Candidates earn FARGP and/or FRACGP, and can work as a GP in Australia.

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EXTEND YOUR GP SKILLS

here are a range of extra skills available as part of the GP training program.

Depending on your chosen Fellowship pathway and College (RACGP or ACRRM), there will be different programs under which you can pursue this additional training. Extended Skills Post (ESP) are for those on the RACGP Fellowship pathway. An ESP can be completed in a discipline other than, but relevant to, general practice. This provides registrars with the opportunity to extend the depth and breadth of their knowledge and skills. An ESP is a six-month accredited term and is negotiated between you and your Regional Training Organisation (RTO) . Below are some of the ESPs you can experience as part of your GP training (in alphabetical order): A: Aboriginal health, academic research, aged care, alpine sports medicine, anaesthetics & aviation medicine C: child and adolescent health, chronic disease management, critical care & custodial medicine D: dermatology, disability medicine & drug and alcohol medicine E: emergency medicine

F: family planning, forensic medicine G: geriatrics H: health policy, hospital in the home M: medical education, mental health O: obstetrics and gynaecology P: paediatrics, palliative care, psychiatry S: sexual health, skin cancer medicine, sports medicine. For those interested in furthering their rural skills this is known as Advanced Specialised Training (AST) for ACRRM and Advanced Rural Skills Training (ARST) for FARGP. These training posts are generally a 52 week full-time term, except for surgery, which is a 24 month term. Skills include: Aboriginal and Torres Strait Islander health, academic practice, adult internal medicine, anaesthetics, emergency medicine, mental health, obstetrics and gynaecology, paediatrics, palliative care, population health, small town rural general practice (remote medicine) and surgery. Each RTO offers different options. Once you are with an RTO, talk to them about your interests in advance. This will help your RTO to help you plan out your GP training.

HOW DOES GP REGISTRAR EMPLOYMENT WORK?

orking as a doctor in the public hospital system, you will be employed as a salaried medical officer. An employment award or enterprise agreement (EBA) covers all aspects of your remuneration and other employment terms and conditions.

GP registrar working hours

Things are much different in general practice training.

Depending on the training practice, weekend consulting, after-hours and on-call work, and home, hospital and nursing home visits are a normal part of general practice.

You will still be an employee, but you will typically be working in a small business setting and the National Terms and Conditions for the Employment of Registrars (NTCER) outlines the minimum terms and conditions which you, as a GP registrar, may receive. The NTCER, based on the National Employment Standards in the Fair Work Act, outlines remuneration, leave entitlements, work hours and other employment terms and conditions for registrars in the AGPT program and training in GP practices. It is negotiated between General Practice Registrars Australia (GPRA) and General Practice Supervisors Australia (GPSA). Before employment begins, an employment agreement is negotiated and signed between the GP registrar and their training practice. Training practices are obliged to offer the minimum terms and conditions set out in the NTCER, but many offer terms and conditions above the NTCER. Under the NTCER, GP registrars usually receive a guaranteed base wage as well as a percentage of billings income depending upon the number of patients they see in the practice. GP registrars may be able to negotiate terms and conditions in their employment agreement, particularly in the later stages of training when they are more experienced and seeing more patients.

Full-time GP registrars work 38 hours a week. This includes education time and administration time. Consultation hours, the hours spent seeing patients, are usually between 27 and 33 hours a week. However, this can vary, especially in rural areas.

2019 minimum salaries for a full-time GP registrar • GP term 1 $75,328.23 per year (or $1,448.62 per week) • GP term 2 $90,564.39 per year (or $1,741.62 per week) • GP term 3 and above $96,724.43 per year • (or $1,860.09 per week) • 9.5% superannuation is also included on top of the salary. Established GPs have a much higher earning capacity. The actual amount depends on the nature of the practice and hours worked. In addition, there is the opportunity to run your own medical practice or work flexible hours. Find out how much you could earn using our calculator: gpsn.org.au/earnings-calculator

Incentive payments GP registrars may be eligible to receive financial incentive payments in addition to their salary. Most of these extra payments are offered by the Department of Health to encourage GPs to practice in areas of need, such as rural, remote and outer metropolitan areas. Incentive payments vary, depending on the GP registrar’s experience and the location’s remoteness. GP First 75

BE A RURAL GP t is late Thursday afternoon and I am sitting in my clinic when a pleasant but profoundly deaf gentleman comes in to see me.

For the third time this week he proceeds to recount how he and my grandfather used to walk barefoot to school together â&#x20AC;&#x201D; loud enough for the entire waiting room to hear the story. My patients and I discuss local issues such as the impact of mining on the town, the upcoming town musical or where my parents used to work and what they are doing now, and many other non-medical but interesting discussion topics. This connection to the community and holistic continuity of care is one (amongst many) of my favourite things about working in a rural town. Some of my patients were in my primary school class and now I treat their whole family. Rural towns are incredibly supportive and inclusive of rural GPs; you can make many long-term friendships â&#x20AC;&#x201D; my patients say hello when I pass them at the weekend markets.

The benefits of rural medicine

Urban GP registrars are unlikely to be able to care for their own patients in the hospital. As a rural GP registrar, I can do pre-pregnancy counselling, diagnose and manage the pregnancy, deliver the baby, give the child the immunisations and manage the immediate and long-term health of mother and baby. Rural GP registrars also have the bonus of getting to live in the country, with benefits such as clean air, open spaces, no peak-hour traffic, and a close-knit community. I have a big house with a great view that is close to work, there is never any traffic, and the pay is good. I have chickens, a large veggie garden, a great big shed (with a ride-on-mower) and I can spend my summer evenings relaxing in my garden. Weâ&#x20AC;&#x2122;ve had metropolitan doctors invited around for bonfire nights, and I can cook for them with our outdoor pizza oven without fear of smoking out my neighbours. My hope is that by showing them the rural lifestyle, I can convince them to move and work rurally. The evidence suggests that a positive rural medical term can work wonders in building a sustainable rural workforce.

Rural medicine also brings about unique benefits.

The beauty of a rural lifestyle needs to be shown off just as much as the benefits of being a rural doctor.

I have the opportunity to contribute to the primary, secondary and tertiary care of my patients.

Rural general practice is a great profession and it enables a wonderful lifestyle.

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A good rural GP is able to keep abreast of new guidelines and evidence and critically appraise medical studies. Communication skills are a must for working in rural general practice. Breaking bad news, counselling griefstricken family members, educating on disease and reassuring parents are examples of vital communication skills. These types of skills come with time and practice.

How to best prepare for rural general practice The skill set of a rural GP is predominantly dependent on where you want to work. There are a few core skills that are essential everywhere, but some locations require specific skills. A broad set of internship and residency terms is ideal, including terms in paediatrics, emergency, obstetrics, mental health, anaesthetics, palliative care, general surgery, orthopaedics, geriatrics and general medicine â&#x20AC;&#x201D; although, not everyone will be able to attain those terms.

The challenges and skills required Rural medicine brings about unique challenges. To make a diagnosis and form a management plan without easy access to pathology, imaging and timely non-GP specialist review is a challenge, but one that makes you better. Training in a rural location encourages you to build on clinical reasoning skills based heavily on history and examination findings.

Look to where you want to work and talk to local GPs about what skills are needed. Think about where you want to live. Rural medicine can allow for mobility depending on your skillset (for example, remote or retrieval medicine), but patients are happier if you choose to stay long-term. Dr Bob Vickers works in Singleton, NSW and is a member of GPRAâ&#x20AC;&#x2122;s Advisory Council.

STUDENT MEMBERSHIP $30 Join the Australian College of Rural and Remote Medicine to start your journey to become a rural generalist. ACRRM.ORG.AU

JOIN US ON THE GOLD COAST FOR THE MUST-ATTEND NATIONAL EVENT FOR RURAL DOCTORS. SPECIAL STUDENT RATES AVAILABLE OR APPLY FOR SPONSORSHIP. VISIT RURALMEDICINEAUSTRALIA.COM.AU FOR MORE DETAILS

“General Practice is a specialty filled with opportunities to develop, learn and grow – both in and out of medicine.”

LECTURER, MUSICIAN, BOXER, DJ... STILL SPECIALISING IN LIFE! LAST YEAR, WE SPOKE TO DR DAVID LAM WHO TOLD US ABOUT HIS FINAL YEAR IN GP TRAINING. HAVING FINISHED GP TRAINING, DR LAM DETAILS WHAT LIFE LOOKS LIKE FOR HIM SINCE BECOMING A GP.

welve months ago I passed my Fellowship exams and was accepted as a Fellow by the Royal College of General Practitioners (RACGP).

As I settled into life as a GP, I thought my life would be too quiet without the stresses of exams and training. I can happily say that I was wrong. General Practice is a specialty filled with opportunities to develop, learn and grow – both in and out of medicine.

General practice and beyond; what my 2018 looked like… Rural general practice (Port Lincoln, Adelaide South Australia) It is indescribably rewarding seeing and treating whole families of all ages. GPs can’t fix everything but we work together to get each patient doing most, if not all, the things they want to do in a day, despite medical conditions. I have also, on multiple occasions, been paid in fresh tuna and oysters, which is awesome. Senior Lecturer (Rural Clinical School, University of Adelaide) I was very blessed to receive the University of Adelaide 2018 Best Rural Teacher Award. This is not because I am a perfect clinician but because I acknowledge the mistakes I’ve made as well as the positive moments in my career. I’m constantly looking at what worked well and what could have gone a better. This has become my style of teaching – taking sterile textbook content and converting it into a discussion on real cases that I’ve dealt with in my career.

I’ve found the key is to paint the picture – warts and all. The best and most engaging case discussion is when things didn’t go to plan and how I and my students and registrars can avoid or deal with that kind of situation in the future. Emergency department (Ashford Hospital, Adelaide South Australia) It is incredibly fascinating helping patients presenting to the emergency department – I treat patients with anything from heart attacks to strokes and broken bones to bleeding wounds. It is a fantastic and enlightening experience working so closely with all the different specialists in a tertiary hospital. Sports medicine As a mega sports fan, I was extremely excited to be the doctor at some South Australian National Football League (SANFL) games this year and to be selected to be the fight doctor at Port Lincoln’s first ever official boxing tournament. The band (Spanish Harlem) Soon after the release of our debut single, “My Momma Told Me”, my band, Spanish Harlem, were thrilled to be commissioned by Port Adelaide Football to play at each of their home games at Adelaide Oval during the 2018 AFL season. Stef, our new lead singer, is actually one of the nurses at the clinic. The DJ Crew (Lam Bros Disc Jockeying) On the back of the success of our night club DJ residency in Adelaide, my DJ crew, Lam Bros DJs, has been picked up for an interstate tour for 2019, starting off with Sydney with Melbourne and Brisbane to follow. GP First 79

Plans for the future

Rugby World Cub Tokyo 2019

General practice doesn’t have to be about sitting in clinic all day – it allows you to follow your passions – both in and out of medicine.

My travel plans have nothing to do with general practice – they purely part of the “keep David sane” plan.

Here are my plans for the future. Medical teaching I have been appointed the 2019 Rural Medicine Coordinator at the University of Adelaide Medical School. After becoming Port Lincoln’s first medical student who came back as a GP registrar and then returned as a fullyfellowed rural GP, I am honoured to be able to give back to the Adelaide Rural Clinical School program. I will continue to encourage and support bright young doctors to enjoy being the best doctors and people that they can be. Hopefully, some of them will consider rural general practice. The music We are playing at events and places all across Australia these days. I’m also keen to create my own music. My goal for the next few years is to hit the recording studio and write an album of original music with which to tour. Mental health How did we ever expect someone with diabetes or asthma to go and religiously take their medications if they are too depressed to get out of bed or too anxious to leave the house? As important as it is, mental health care is generally poorly resourced and badly taught amongst us doctors. Around the same time, my girlfriend became an accredited mental health social worker, I also made it a point to undergo training (Focused Psychological Strategies) to help patients with their mental health. Together, we have just launched our brand new rural psychotherapy clinic, “Wellness SA” in Port Lincoln, South Australia, and are excited to help a remote area in dire need of mental health care.

Sports and travel are two of my favourite things so I’m already counting down to following the Wallabies to Japan in October. It’s important for all medical professionals to maintain passions and hobbies outside to medicine – rugby is mine.

What I have learned in the last 12 months To cut myself a break Post-fellowship, I’m a little bit better at having dedicated “David time”. Playing the piano just for me without an audience, asking people to call me back only after I’ve finished enjoying my dinner and Netflix, making sure I allow a sleep-in. To be honest I have learned that if I don’t know something, it’s absolutely okay to say it out loud. Patients and students don’t expect you to have all the answers, they are more interested in how well you deal with a situation when you don’t know all the answers than your ability to bull#$* your way through something. Get to know each member of your team Introduce yourself, tell everyone who you are and find out their name – this includes reception staff, administrators, nurses, allied health and IT. Everybody has an important part to play and your team can do amazing things once there is trust, be it in clinic, a band, or a football squad. Be patient I’m learning not to always go chasing career opportunities that don’t want to be chased as this is exhausting and discouraging. More often, I’m focusing on and enjoying what I’m doing right now rather than stressing out about the future. This is what’s called “mindfulness” and it is life-saving.

“In medicine, it is okay to feel tired, overworked or demoralised...just make sure you let someone else know so they can help.”

Advice to medical students Ask lots of questions Asking questions is the only way you will learn. If you don’t ask, then you will never know for sure. There is a common misconception that asking questions makes you look dumb – this isn’t true. It makes you look attentive and conscientious. My best students and registrars by far are the ones that ask the most questions. Be keen and put yourself out there Don’t wait for an invitation, ask to watch and do things on the ward or in theatre. It is a fast-track way to getting to do them yourself. Textbooks are just a guide. The best experience is “hands on” and it also way more fun. Remember, there are some things in your life that you will only ever have one opportunity to do such as cool procedures or surgeries and there are some things that can just wait (like paperwork). Look after yourself If you don’t make the effort to look after yourself, nobody else will. Say out aloud how you are feeling, even it that means admitting that “you feel like garbage”. Particularly in medicine, it is okay to feel tired, overworked or demoralised. We all feel that from time to time. Just make sure you let someone else know so they can help. Don’t let the fun stuff pass you by: Travel lots. Fly to Sydney to go to a Drake concert. Join a boxing club or mixed netball team. Have a nice meal with a mate. There is enough time to pass medical school and your specialist exams with flying colours and have some once in a lifetime non-medical experiences. Follow David’s general practice adventures • Instagram: instagram.com/doctor_dj_d • Website: lambrosmusic.com • Youtube: youtube.com/user/nlsoundsnbeats GP First 81

Become a GPSN member today. It is FREE! We are a national network and a part of an organisation that supports you from medical student, to prevocational doctor, to GP registrar.

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