ISSUE 4, OCTOBER 2011MAKING HEALTHCARE ACCESSIBLE

rural health workforce

Challenge issued to universitiesAustralian universities should do more to encourage rural students to pursue health careers, according to Rural Health Workforce CEO, Dr Kim Webber.

“Universities have a crucial role in overcoming Australia’s rural health shortages by training our future workforce,” she says. “We need a proactive policy for rural students so they can go on to make a difference for rural communities.”

Dr Webber called on universities to offer more in the way of scholarships and support for country students, particularly in the fields of nursing and allied health. She also highlighted the fact that most medical schools were failing to meet their rural intake targets.

“Thirty per cent of Australians live in a rural area, yet country students are under-represented in health courses at major

Australian universities,” Dr Webber says. “The government target for medicine is that 20 per cent of entrants should be from a rural background – yet most medical schools are nowhere near that.

“If specific universities can’t meet those targets, I think we need to start thinking about giving those medical places to universities that can.”

Figures from the Medical Review Training Panel show that in 2010 only 7 per cent of medical entrants at the University of Queensland were from a rural background. For the University of Adelaide the figure was 9 per cent, while the University of Sydney reported 13 per cent.

Dr Webber says research shows that students from a rural background are more likely to return to rural communities to live and work once they’ve graduated. She also praised the role played by regional universities in enabling rural students to study closer to home.

“The bush needs more home-grown talent if we are to overcome the current maldistribution of the health workforce in this country,” she says.

“The shortage of healthcare workers is most acute for doctors, particularly in smaller towns and remote locations, but there is also a shortage of other health professionals, such as physiotherapists and mental healthcare workers.”

Home-grown talent… nursing student Morika West takes time out from her studies at the University of Notre Dame’s Broome campus in far north-west Western Australia. She is pictured at Entrance Point, with the turquoise waters of Roebuck Bay in the background. Morika is a Broome local who has lived in the Kimberley most of her life. She says it is important to have more Indigenous nurses working in places like Broome and Derby because they can be of great assistance to Indigenous patients. Morika is a member of her rural health club, Kimberley Regional Alliance for Students in Health, and has her sights set on becoming a midwife because of the happiness that new babies bring to the world.

Across the divide

Local learning works for Morika

TALES FROMA DOCTORIN PARADISE

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3,000 DAYS OFF FOR RURAL GPs

Give rural students a go

DUBBO ATTRACTS YOUNG HEALTH PROFESSIONALS

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For Dana Slape, the recent rural high school visit to the Top End of the Northern Territory was something of a home-coming.

Dana is a third year medical student at the University of Western Sydney but her family ties are to Larrakia country in and around Darwin. It was a connection that was broken when her grandmother was evacuated from the northern city during the Japanese bombing raids in World War Two.

“As an Aboriginal Australian who had not yet been to their place of heritage, it was significant to spend time in Darwin,” she says.

“Being able to return to my roots and feel like I was helping make a positive contribution to the students of the area of all backgrounds was a very important event for me.

“I feel like this trip - and seeing the magic of the Top End - has given me a great deal of spiritual satisfaction and a sense of belonging.”

“Seeing an Aboriginal GP registrar at Miwatj made me feel very proud,”Dana was also impressed by the Aboriginal Medical Services she visited – Wurliwurlinjang in Katherine and Miwatj in Nhulunbuy. “Seeing an Aboriginal GP registrar at Miwatj made me feel very proud,” she says.

Dana says she now intends to apply to do her intern year in Darwin so she can use her professional skills to make a difference for local people.

“The passion I have to help improve the health of individuals and communities has been heightened by this trip and I will proudly come back to work in the NT.”

The Top End rural high school visit program was organised by NT Health Workforce, the Rural Workforce Agency for the Northern Territory.

Rural high school visits can also lead to some unexpected turns, as this doctor discovered …

When Emma Cunningham was a first year medical student at ANU in 2004 she went on a rural high school visit to Cooma, in the foothills of the Snowy Mountains.

Little did she realise, that one day she would return to the town to live and work as a doctor.

Dr Cunningham started recently as a general practice registrar at the Bombala Street Surgery and has been enjoying the ski season in the New South Wales alps.

“It’s only an hour to Perisher from here so a few of us from the practice have managed to hit the slopes on our days off,” she says. “We’re really in a great location, being an hour from Canberra and an hour from Bega on the coast.”

Dr Cunningham also enjoys the fact that she can walk to work in five minutes, a far cry from the traffic snarls in Sydney where she did her undergraduate degree.

She is particularly happy to be working as a rural doctor in a caring community where the variety of practice means there’s never a dull day. Dr Cunningham is experiencing everything from emergency treatment through to acute and chronic care.

Just recently she felt a sense of déjà-vu when she helped host a group of 30 medical students from ANU, who visited Cooma to get a taste of rural medicine and rural life.

Rural high school visits are one of the main activities organised through the National Rural Health Students Network, which is supported by Rural Health Workforce. Each year about 400 university rural health club members volunteer to speak to country secondary school students about healthy lifestyles and opportunities for health studies at tertiary level. The program aims to encourage young people from the bush to pursue careers in medicine, nursing and allied health. As this story shows, the visits can have a particular personal resonance…

2. Across the Divide

For health careers in the Northern Territory, talk to the experts www.gpnnt.org.au

Emma finds her feet - near the ski slopes!

Dana connects with her country

Hands-on experience … Dana Slape runs a plastering activity with a student at St John’s College in Darwin. Sessions like these were a feature of the Top End rural high school visit program. Picture: Glenn Campbell

Dr Cunningham did some teaching with the students from her old university and spoke to them about her own experiences making the transition from the city to the bush.

It is a pathway that began during her time as a committee member with the ANU rural health club, ARMS, and included a third year rural clinical placement at Bombala, just down the road from Cooma.

By that stage, her parents were living at Grenfell in central west NSW, where they operate a farm with goats, sheep and crops.

“It really made me aware of the issues associated with rural health workforce shortages and I became determined to do something about it,” Dr Cunningham recalls.

She successfully applied for a cadetship with the NSW Rural Doctors Network, the state-based Rural Workforce Agency which supports and recruits rural GPs. The cadetship helped to pay for her final two years of medical studies. In return, Dr Cunningham was required to spend two years as a junior medical officer in a rural hospital.

She happily moved to Wagga, where she completed her internship, residency and – for good measure – a third year learning advanced rural skills training in emergency medicine. She was also supported through the Federal Government’s widely acclaimed Prevocational General Practice Placements Program (PGPPP).

Dr Cunningham has certainly come a long way since that school visit in 2004 when she was in charge of the ARMS blood pressure station for the local kids at Monaro High in Cooma.

Downhill doctor … Emma Cunningham ready to take off at Perisher.

Rural locum work is something Melbourne doctor Raj Pillay can highly recommend to his city colleagues.

It has taken him far and wide throughout Victoria, providing welcome breaks to hard-working country doctors.

Along the way, Dr Pillay has practised a variety of medicine not normally seen in the suburbs and also met some equally diverse characters in towns like Jeparit, Nhill and Orbost.

He fondly remembers people like the 101-year-old woman whose birthday he attended in Cann River at a party organised by the local bush nurses.

This sprightly centenarian still did her own shopping and had great clarity of purpose. Asked the secret of her long life, she told Dr Pillay: “Know your limitations, enjoy this moment and let the past take care of itself.”

It is experiences like these that keep Dr Pillay coming back for more locum visits organised by the Rural Workforce Agency, Victoria (RWAV).

“One of the main reasons I do locum work is because I want to support rural and remote communities” “There are major personal and professional growth opportunities in rural and remote medicine,” he says. “There is so much to learn from working with country folk. You know, we get so caught up making a living in the city and they can teach you about having a life.”

Dr Pillay has also discovered how great the need is for locum services in rural communities where solo GPs can carry a heavy burden.

“One of the main reasons I do locum work is because I want to support rural and remote communities,” he explains. “The best way I can do this is by stepping in so local doctors can have a holiday with their families, and return to their towns feeling refreshed and reinvigorated.”

Across the Divide 3.

For health careers in Victoria, talk to the experts www.rwav.com.au

Doctor expands his horizons in rural Victoria

The Rural GP Locum Program (RGPLP) was launched by the Federal Government in December 2009. Since then Rural Health Workforce has run the program in partnership with its member Rural Workforce Agencies. Together, we have delivered some great results.

In the 18 months from December 2009 to 30 June 2011, RGPLP has:

• Provided3,105daysofleaveforruralandremoteGPs, while maintaining access to healthcare for their local communities

• Delivered343locumplacementsnationally

• Introduced104GPstorurallocumworkforthefirsttime

• Subsidised2,529daysoflocumreliefforthehostpractice(thismeansthatthe Federal Government contributed $500 per day towards the locum fees)

Rural Workforce Agencies provide the following support for doctors undertaking rural locum work:

•Administrativeassistancewithprovidernumbers, medical registration insurance and CPD certification

•Matchingofdoctorstosuitablepractices

•Assistancewithaccommodationandtransport

•Placementbriefthatcoversthecomputersystem, practice information and background on the town

•Handoveronfirstdayofplacementandhelplinesupport

To register for locum work, go to www.ruralgplocums.org.au

Dr Raj Pillay … “there is so much to learn from working with country folk”.

Locum program delivers 3,000 days off for rural doctors

Workforce agencies makes locum life easy

Dr Pillay’s most recent foray into rural Victoria was at St Arnaud where he spent two weeks filling in for a husband and wife doctor team.

Local practice manager Jill Arnott is delighted with the way he has fitted in and how it has helped the practice provide continuity of care.

“It’s a huge thing for our doctors to get a break,” she says. “Being on call at the local hospital, they can get dreadfully tired after 12 months. When they come back from leave, they’re feeling bright and ready to go.”

It’s a theme echoed by Kathy Huett, CEO of East Wimmera Health Services.

“If we didn’t have someone like Raj, local doctors would burn out or take leave, forcing us to close the health service. That of course has knock-on effects for neighbouring community health services which would have to shoulder the load.”

For his part, Dr Pillay is particularly grateful to his home practice in Melbourne – Modern Medical Health Care at Caroline Springs - for allowing him time off to pursue his interest in rural locum work.

He would like to see more of the large city practices encouraged to take a similarly enlightened view for the benefit of the broader community and the development of their people.

Dr Pillay is also thankful to Rural Workforce Agency, Victoria for introducing him to locum work at Kinglake in the wake of the Black Saturday bushfires and helping him to obtain emergency skills training.

He has since become a trainer in Rural Emergency Skills Training (REST) and also recommends Advanced Paediatric Life Support (APLS) as a way for city doctors to prepare themselves for country practice.

Dr Pillay says any city doctor looking to explore locum work in rural Victoria would be well advised to check in with RWAV (www.rwav.com.au) who can match them to a suitable placement.

“RWAV is very professional, government-funded and has the interest of the community genuinely at heart.”

4. Across the Divide

For health careers in New South Wales, talk to the experts www.nswrdn.com.au

Finding fulfilment in a rural community

When Melissa Pellow was working on placement in Sydney, the traffic used to drive her crazy.

It would often take her more than an hour to get from Sutherland Shire to the Prince of Wales Hospital in Randwick. It amounted to a big chunk of dead time each week.

That’s all changed now since returning to her home town of Dubbo, where she is practising as an exercise physiologist and dietitian.

Melissa has rediscovered the joys of rural life and has plenty of spare time up her sleeve to play netball, touch football and tennis. She and her partner are also in the process of buying a three-bedroom house in the nearby town of Wellington – for under $200,000!

“I always intended to return to this area to live and work,” says the University of Wollongong graduate and former SHARP rural health club member. “It has a much more diverse patient base than the city, including Aboriginal health.”

Melissa divides her working week between the Dubbo Medical and Allied Health Group and the Wellington Aboriginal Corporation Health Service.

She is conscious that her dual qualifications are of immense benefit to rural communities where there are shortages of allied health professionals.

“One of my key goals is to raise awareness of healthier lifestyle choices,” she says. “That way we can reverse some of the patterns we’re seeing with people becoming too sedentary and eating poorly.”

Melissa is also a big fan of the multi-disciplinary practice where she works in Dubbo because it makes it easier for patients to access different types of primary healthcare under the one roof.

“We often see people with multiple health issues and it’s an advantage to bring in other professionals to help them,” she says. “Since being here I’ve liaised with a social worker, the mental health team, doctors, a chiropractor and a physio. It’s much more holistic care.”

“I’m not just here for work, I’m here to invest in the community” … Edin Hoogesteger, chiropractor.

Chiropractor has a cracking good timeEdin Hoogesteger and his wife Jess haven’t looked back since making the move to Dubbo 18 months ago.

“We wanted to be part of a closer-knit community than Sydney,” explains the 27-year-old chiropractor. “We certainly found it because the people here are incredibly friendly.”

Edin, who practises at the Dubbo Medical and Allied Health Group, also enjoys being part of a multi-disciplinary team that collaborates for the benefit of the patient.

He happily refers patients to doctors and physiotherapists who work alongside him at the centre, knowing that everyone has a part to play in primary healthcare.

“It’s mainly GPs that we have referrals with because they are the core of the system,” he says. “The physio here is great, too. We often treat the same conditions and so we refer to each other as appropriate.”

Being five minutes from work is an added bonus of life in a smaller centre than Sydney. This gives Edin and Jess more time each week to see friends, play touch football and do volunteer youth work for the local Baptist Church.

“I’m not just here for work,” says Edin. “I’m here to invest in the community as well.”

Edin and his wife have also invested for the future, having bought a house together – taking advantage of comparatively low property prices.

“You definitely get a lot more bang for your real estate buck than Sydney,” he says. “Owning a home here is not such a burden on your finances which means you’ve got more disposable income to do the things you want.”

For Edin, it’s all neatly encapsulated in a local saying: “The best thing about Sydney is the road to Dubbo.”

Dietitian savours better life balance

“This area has a much more diverse patient base than the city” … Melissa Pellow, exercise physiologist and dietitian.

Rural health professionals often enjoy the opportunity to work in teams for the benefit of their patients. That’s certainly the case at the Dubbo Medical and Allied Health Group.

It’s a busy practice, with more than 14,000 medical patients alone on its books. It is also a great example of multi-disciplinary primary healthcare in a rural setting.

The roll call of professions include: doctors, practice nurses, a physiotherapist, dietitians, chiropractors, a psychologist, podiatrists, neurologists, a paediatrician, a psychiatrist, an occupational therapist, a diabetes educator, a clinical social worker and a remedial massage therapist.

Teamwork attracts young health professionals to rural settings

Brothers with a vision for better health: Bharat (left) and Vijay Pandya.

Happy team: Dr Sunita Agrawal, one of the partners at Dubbo Medical and Allied Health Group, with GP registrar Dr Zahraa Sadeq, practice manager Mauren Thornhill and physiotherapist Rajal Pandya.

This one-stop-health-shop is the brainchild of founding partners Vijay and Bharat Pandya.

The brothers wanted to create a medical centre which would attract young professionals to Dubbo, thereby lessening their own workload and leaving a legacy for the town.

Vijay, a doctor, says: “Nowadays the younger person is looking for more balance in their life and they’ve got the right attitude. A big practice gives them a hope of having a life.”

Bharat, a chiropractor, says: “Once new professionals start here, they realise the respect they have in a rural community; it’s a lot more intimate than it tends to be in the city.”

Dubbo Medical and Allied Health Group also has a big focus on training the next generation of health professionals. It can accommodate two GP registrars each year and one medical intern. It is also happy to consider placements for nursing and allied health students.

Regional New South Wales has some fantastic career and lifestyle opportunities for young health professionals. Nowhere is this more apparent than Dubbo, a thriving city of more than 30,000 people, and a major service centre for the west of the state. We interviewed a number of young doctors and allied health workers during a recent visit to Dubbo, organised through the NSW Rural Doctors Network – the state-based Rural Workforce Agency. Here are their stories…

Across the Divide 5.

For health careers in New South Wales, talk to the experts www.nswrdn.com.au

As the sun sets on another day in Dubbo, Naomi Langburne sits back and admires the view.

“The sunsets here are beautiful,” she says. “They always seem to be this crimson colour and you really do notice a lot more stars at night compared to the city.”

Achieving a sense of work-life balance is important to Naomi, a psychologist who practises at two of the local clinics.

She and her family moved to Dubbo from Sydney in May, attracted by the prospect of a better lifestyle and plenty of work opportunities.

“I suppose it was an adventure,” she says. “We thought it would be exciting to do something different and live in the country.”

That decision has paid dividends. Naomi has swapped her unit in Sydney for a house on a big block of land with rural views and her children adore visiting the famed Western Plains Zoo (the lemurs and spider monkeys are favourites).

But there is plenty to do as a psychologist in a rural area, so Naomi has been busy.

“We see a variety of clients,” she says. “It expands you professionally because you have to be innovative and develop knowledge in a broad range of areas including issues to do with farming.”

Asked how she would rate the move to regional New South Wales, Naomi is quick to reply: “It’s been an overwhelmingly positive experience.”

Psychologist hones her harmony

“The sunsets here are beautiful” … Naomi Langburne, psychologist

Dr Christie Beveridge lives on 12 acres of rural paradise, 10 minutes from the centre of Dubbo, New South Wales. Being so close to town, she gets to ride her horses in the morning before heading off to see her patients at the Dubbo Medical and Allied Health Group. “You can’t do that in Sydney,” she says. Dr Beveridge is pictured with Sniper.

What a life! Doctor saddles up for rural health

A family friendly environment makes Dubbo a perfect destination for young health professionals, according to Dr Sunil Jacob.

Sunil is pictured with his wife Asha and their son Rahul with the beautiful Macquarie River in the background. This photo was taken on a Saturday afternoon at a local winery, with the sound of jazz music drifting across the vineyard.

The winery features a metal sculpture of a hippopotamus, upon which Rahul loves to climb. But his favourite destination is the nearby Western Plains Zoo where real creatures great and small hang out.

The social scene in Dubbo means the Jacobs, who are expecting their second child, are never short of people to see and things to do.

Asha and Sunil met while practising medicine together in Ireland. Since moving back to Australia, Sunil has become a partner at the Dubbo Medical and Allied Health Group and Asha works part-time at another local clinic.

Where family comes first

“The kids love it” … Dr Zahraa Sadeq, GP registrar with sons Ali, Yousef and Ibrahim, and her husband Dr Hayder Ridha.

There’s no such thing as a quick trip to the shops in Dubbo, according to Dr Zahraa Sadeq.

“Every time I go to Woolworths for five minutes it takes an hour,” she says. “You see so many people you know and they all want to have a chat. Not that I mind, it’s quite lovely actually.”

That sense of community definitely appeals to the young GP registrar, who came to Australia in 2005 with her husband Dr Hayder Ridha, an ear, nose and throat specialist.

Originally from Iraq, Zahraa lived in Ireland before coming to Australia. After a stint in Darwin, she and Hayder have settled in Dubbo, where he practises at the local base hospital and she works at the Dubbo Medical and Allied Health Group.

They are raising three boys aged nine, five and nine months. The fact that work is nearby and traffic snarls are non-existent

is particularly important for Zahraa so she can be on time to pick up the youngest from day care.

It also helps that everything is so close to hand when Saturday sport is happening for the older boys.

The cost of living is another factor. “We can afford a house on big land with a pool – and a far better quality of life than in a big city,” she says. “The kids love it.”

Zahraa is also appreciating the variety of medicine she is experiencing in general practice in a rural centre as well as the sense of community with patients.

“One of the beauties of being a GP is that sense of connection you develop with different generations of the same family,” she says. “You get to know the grandparents, mum, dad and the kids.”

Country life appeals to GP registrar

Jennifer Roe, Education Coordinator at Rural Health West, is pictured with two resuscitation mannequins nicknamed “Baby Brian” and “Brother Bruce”. Mannequins like these are used at some of the 25 skills-based workshops that the agency runs each year for rural and remote GPs. Topics include emergency airways, anaesthetics and obstetrics. A new two-day emergency skills course starts in November. It is called REACT (Rural Emergency Assessment, Credentialing and Training), with priority given to visiting medical practitioners. These are GPs credentialed to work in emergency departments at country hospitals.

Education

Rural Health West’s prime aim is to ensure the needs of rural and remote Western Australians are met by a highly skilled, sustainable health workforce.

Like every Rural Workforce Agency, it takes a holistic approach that encompasses recruitment, support, professional development and a level of care that stems from a not-for-profit philosophy.

The agency runs a variety of activities that go beyond recruitment - including family support programs and the annual Doctors’ Service Awards that celebrate the achievements of WA’s rural and remote doctors.

Then there are the popular monthly television broadcasts featuring the latest topics on health and medicine. Doctors from the Kimberley to the Goldfields tune in to these shows put together by Rural Health West.

Rural Health Workforce is the peak body for the seven Rural Workforce Agencies (RWAs) that operate in each state and the Northern Territory. The RWAs are not-for-profit organisations funded by the Australian Government’s Department of Health and Ageing as well as their respective State Governments. We visited Western Australia recently to prepare this profile on that state’s workforce agency, Rural Health West.

6. Across the Divide

For health careers in Western Australia, talk to the experts www.ruralhealthwest.com.au

How a Rural Workforce Agency adds value

In order to keep people connected and up-to-date, Rural Health West also hosts a number of educational conferences throughout the year. These conferences promote the professional development of rural doctors, enhance their skills and provide them with a vital link to other GPs and specialists.

The conferences are held in Perth and regional centres. They are endorsed for Continuing Professional Development points towards vocational registration by the Royal Australian College of General Practitioners and the Australian College of Rural and Remote Medicine.

Another major focus is on helping newly arrived doctors from overseas, guiding them through the Australian medical system and supporting them with vocational registration.

Meanwhile, at the coalface, Rural Health West organises much-needed locum relief for hard-working country doctors so they can return refreshed and revitalised to provide continuing care for their communities.

Locum services include BushBuddy, which provides short-term locum relief in Aboriginal Medical Services, and BushLocum, which gives city GPs the chance to experience rural medicine in a variety of locations throughout WA. Rural Health West also participates in the national Rural GP Locum Program, run by Rural Health Workforce.

Find out more about what Rural Health West does in the stories on these pages.

The recruitment team (above) at Rural Health West has a saying: “Right doctor, right practice.” This match-making philosophy underpins their efforts to do more than just fill vacancies in the bush. “If you’re a doctor looking to broaden your horizons, talk to us,” says Belinda Bailey, CEO of Rural Health West. “We have profiles on 65 practices throughout WA where we can find a place that’s right for you and your family.” The agency has specific on-the-ground knowledge of schooling, sporting and lifestyle activities that are so important when making a life-changing career move. Rural Health West runs a free recruiting service for practices, including screening, clinical interviews and development of employment contracts. Ongoing support is provided for both parties, including a structured professional development program for doctors. For further details, email docjobs@ruralhealthwest.com.au

Recruitment

Rural Health West recognises that students are the future of rural health. That’s why it has recently appointed Courtney Taylor as its student ambassador. Courtney, a first year medical student at the University of Notre Dame, in Fremantle is pictured (centre) with fellow students Selina Tsui and Ghassan Zammar. Originally from Busselton, where his father is a local GP, Courtney’s role is to talk to other health students about the services provided by Rural Health West and open their eyes to the opportunities that exist in rural health. He works closely with Heidi Greve, Workforce Development Project Officer for Rural Health West. The workforce agency maintains a strong relationship with WA’s university Rural Health Clubs.

Students

Laura Harnett (left) and Kelli Porter are shown with the resource kit that has been developed for practice managers in rural and remote WA. The plain-English kit contains information about employment contracts, the Medicare Benefits Schedule, telehealth consultations and much more. Kelli, Rural Health West’s Workforce Development Manager, explains: “We know that a well-run practice is easier to recruit to and assists the retention of GPs.” The kit will be available by the end of the year, but specific fact sheets are now online. Meanwhile, Laura is visiting practices throughout WA in her role as Rural Health West’s Practice and Workforce Support Coordinator. She helps out with set-up issues and training as part of a new service provided by the workforce agency. For further details, email workforcesupport@ruralhealthwest.com.au

Practice Support

•ProfessionalDevelopment

•Recruitment

•PracticeSupport

•Education

•Students&more…

Heather Waite, Professional Development Coordinator for Rural Health West, looks after a number of programs including GP Obstetrics Mentoring and Support. This is primarily for GP Registrars who have obtained a diploma from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists – and who want to go rural as part of their GP Registrar rotation. The aim is to give them the confidence to practise independently. A key element is a buddy system where they are paired with an experienced GP obstetrician or specialist who provides mentoring. Financial assistance is also available to attend conferences and workshops in obstetrics. The program is funded by WA Country Health Services and delivered in partnership with King Edward Memorial Hospital in Subiaco and Western Australian General Practice Education and Training. For further details, email pdprograms@ruralhealthwest.com.au

Professional Development

When Dr Trevor Lord does his rounds these days, it’s not uncommon for him to see a frill-necked lizard or a majestic jabiru in full flight.

Wildlife spotting is one of the fringe benefits of being a remote doctor in the Kimberley region of Western Australia - and Dr Lord loves his new “office”.

His patch is the Dampier Peninsula which he visits by four-wheel-drive. Travelling the Cape Leveque road, he calls in to communities at Beagle Bay, One Arm Point and Lombardina to conduct clinics on behalf of the Kimberley Aboriginal Medical Services Council.

This is approximately 2,500 kilometres and a parallel universe away from his old life as a GP in Perth doing industrial medicine for companies like Western Mining and Wesfarmers.

“I feel like I’m 25 again, surrounded by young people, in this stimulating tropical environment where I get to practise a real variety of medicine”Looking for a new challenge, he relocated to the north-west last year with his wife Jenny McConnell who had taken up an academic posting at the University of Notre Dame’s Broome campus.

“It’s great up here,” he says. “I feel like I’m 25 again, surrounded by young people, in this stimulating tropical environment where I get to practise a real variety of medicine. And to be in a place that is never cold is fantastic.”

Dr Lord says he was well prepared for remote health thanks to courses in emergency medicine and diabetes treatment organised for him in Perth by Rural Health West, the Rural Workforce Agency that supports and recruits doctors in WA.

“Those courses were fabulous,” he says. “You couldn’t have had a better curriculum for a GP like me to get up to speed.”

Supporting doctors who want to make the transition to rural and remote medicine is one of the services provided by rural workforce agencies. Here is one story that demonstrates the value of proper preparation for a remote posting…

Across the Divide 7.

For health careers in Western Australia, talk to the experts www.ruralhealthwest.com.au

Doctor discovers a new world on the road to Cape Leveque

He also took Rural Health West’s advice to work at an Aboriginal Medical Service in Perth for a few weeks to familiarise himself with Indigenous health issues. That experience opened his eyes to the tremendous sense of community and family that is so valued by Aboriginal people.

He learnt about the intricacies of men’s and women’s business, and how Aboriginal health workers play a key role in facilitating treatment for their people.

Meanwhile, he observed how chronic disease is having such a devastating impact on the Aboriginal community.

Now that he is practising in the Kimberley, Dr Lord sees a steady stream of patients with health conditions that would be unimaginable in places like Melbourne and Sydney.

There are 24-year-olds with Type 2 diabetes, people in their 40s with chronic rheumatic heart disease and 15-year-olds who weigh as much as 140 kilos.

“You’re able to do an enormous amount of good by being a GP up here,” Dr Lord says. “All of what I see is real medicine for people who really need it.”

Dr Lord has also rediscovered the importance of listening and the physical examination, old skills that come into play when making clinical decisions in a remote setting without the benefit of X-rays and blood test results.

And while he may be working remotely, he never feels alone. Specialist colleagues at hospitals in Perth are happy to provide advice over the phone and Dr Lord is ever thankful for the support he receives from the Royal Flying Doctor Service.

“I’ve coped a lot better than I expected thanks to people like the RFDS, the wonderful remote area nurses and the simply inspirational Aboriginal health workers,” he says. “It’s actually a lot easier than you think.”

Learning the ropes of the Australian health system can be a tricky business when you’re a recently arrived overseas trained doctor.

But Rural Health West, the Rural Workforce Agency for Western Australia, has come up with a way of making life easier for OTDs.

Two years ago it set up a partnership with the Murray Medical Centre in Mandurah, an hour south of Perth, to provide practice orientation for OTDs before they go further afield into more rural settings.

One of the doctors who has benefited from this service is Dr Mirielsa Nufable-Ruiz, who obtained her medical qualifications in the Philippines.

Dr Nufable-Ruiz spent a week last year at the Mandurah clinic where she learnt about the Medicare billing system, referral processes, Aboriginal health, prescribing in Australia and clinical scenarios peculiar to WA.

These lessons helped her prepare for her current role at the Merredin Medical Centre in the WA wheatbelt, where she has been practising since January.

Clinic provides a helping hand for overseas doctorsThe fact that six out of the seven partners at Mandurah are OTDs themselves certainly makes a difference when it comes to relating to the new arrivals.

Dr Eileen Bristol, who came to Australia from Scotland in 1998, says she and the other partners are happy to supervise the new OTDs.

“There are a number of things that are peculiar to Australia, and it’s not just the Medicare system,” she says. “For example, there’s redbacks, box jellyfish, snakebite and stonefish. Working as a doctor in rural areas, you need to know how to deal with these things.”

When the OTDs first arrive in Mandurah they are inducted by Cara Rickman, the practice’s administration supervisor before being handed over to one of the partners for mentoring.

They also spend half a day at the neighbouring Nidjalla Waangan Mia centre in order to familiarise themselves with Aboriginal health.

“We like to put them in good stead for wherever they are going next in WA,” says Ms Rickman.

Doctor in paradise … a remote posting has worked wonders for Trevor Lord.

Mandurah “graduate” Dr Mirielsa Nufable-Ruiz takes in a golden sunset at a wheatfield in Merredin.

Dr Kali Hayward, one of two Indigenous GPs in South Australia, spoke at NRLDS. She is pictured with Trent Little, Rural and Indigenous Officer for the Australian Medical Students Association, co-hosts of the event with the National Rural Health Students Network. Trent is studying medicine at the University of Western Australia, and is a member of the university’s Rural Health Club. Dr Hayward is a board member of the Australian Indigenous Doctors Association.

Rural Health Workforce is the peak body for the state and territory Rural Workforce Agencies

About usRural Health Workforce seeks to improve community access to primary healthcare services in rural and remote Australia

We manage national programs that address the shortage of rural and remote health professionals. We do this by recruiting health professionals to work in rural and remote communities, engaging students in rural health careers and supporting health workers in the bush.

A not-for-profit organisation, we are funded by the Federal Department of Health and Ageing to whom we provide policy and program advice.

rural health workforce rural health workforce

Victor Harbor is best known for its whale watching. But a group of a different kind migrated to the picturesque seaside city on South Australia’s Fleurieu Peninsula in August.

More than 100 medical, nursing and allied health students from universities around Australia came to Victor Harbor to talk about rural health and listen to a range of expert speakers.

They attended the National Rural Leadership Development Seminar – an event hosted by Australia’s two largest health-based student organisations: the National Rural Health Students Network (NRHSN) and the Australian Medical Students’ Association (AMSA).

“We wanted to inspire the next generation of leaders in rural health,” says NRHSN Co-Chair, Jacinta O’Neill. “It’s important that these future health professionals have the skills to champion the cause of the rural and remote communities where they will be working once they graduate.”

Sponsors of the 2011 NRLDS included Flinders University and its rural clinical school, Spencer Gulf Rural Health School, Adelaide University, SA Health, Adelaide to Outback GP Training Program and the Rural Workforce Agencies from South Australia (Rural Doctors Workforce Agency), the Northern Territory (NT Health Workforce), Queensland (Health Workforce Queensland), Western Australia (Rural Health West) and Tasmania (Health Recruitment Plus).

Rural Health Workforce is proud to support the National Rural Health Students Network. The network combined recently with the Australian Medical Students’ Association to help groom future leaders in rural health…

Rural health students make a splash at Victor Harbor

8. Across the Divide

What a crew! Student delegates to the 2011 National Rural Leadership Development Seminar displayed the energy and passion that typified the event when they posed for this group photo outside the Adare Conference Centre in Victor Harbor. Rural Health Workforce wishes them well for their future careers as doctors, nurses and allied health professionals.

Members of the rural health roundtable listen to student questions. Pictured from left are Mark Booth, from the Department of Health and Ageing; Jim Birch, Chair of Rural Health Workforce; Kim Webber, CEO of Rural Health Workforce; Rod Wellington, CEO of Services for Australian Rural and Remote Allied Health; and Dr Sue Page, associate professor of medicine at the University of Sydney.

NRLDS was launched by Mr Leon Bignell, South Australia’s parliamentary secretary to the Minister for Health. He is pictured with Catherine Ryan, secretary of the National Rural Health Students Network.

Lori Tietz from Flinders University Rural Clinical School talks to delegates at NRLDS. They are occupational therapy students Lindsay Dundon, from Charles Sturt University’s Albury campus, and Sarah Falconbridge, from the University of Western Sydney. Flinders was a major sponsor of the event.

Like mother, like daughter...a commitment to rural health runs strongly in the family of Francesca Garnett, co-chair of the National Rural Health Students Network. She is pictured with her mother, Jan Schlunke, a psychologist from Ballarat, Victoria. Jan spoke at NRLDS, sharing the stage with her daughter who helped organise the event for 110 university students from across Australia.

Deb Kay (left), from Health Workforce Queensland, catches up with Kaitlin Dubrawski at NRLDS. Kaitlin is a third year medical student at the University of Western Australia. Health Workforce Queensland is one of the seven rural wokforce agencies represented nationally by Rural Health Workforce. The not-for-profit agencies recruit and support health professionals in rural and remote Australia. They are a great starting point for university health students interested in careers in the bush.

Across the Divide is printed on 55% recycled paper as well as paper fibre sourced from FSC certified forests.XXXXXX

We are also the peak body for the state and territory Rural Workforce Agencies, which recruit and support health professionals in rural and remote areas.

Together, we work to close the ‘divide’ in primary healthcare services between urban and non-urban Australia.

Stay in touch through our social media sitesConnect with the latest news from Rural Health Workforce via Twitter and Facebook. Our Twitter handle is RHW@RuralHealthOz and you can find us on Facebook at www.facebook.com/RuralHealthWorkforce

Contact usRural Health WorkforceSuite 2, Level 5, 10 Queens Road, Melbourne VIC 3004

Telephone 61 3 9860 4700Facsimile 61 3 9820 8383Email info@rhwa.org.au Web www.rhwa.org.au