July 2008 Archives

Hi All

Last night I went to a GPSN/Advant sponsored moot court case, based on a real life situation, where a child died unnecessarily due to a combination of errors – Briefly:

The girl was 12yrs old, an Olympic gymnast from the Ukraine over here for a Asia-Pacific training camp. She fell and hit her head during a routine, never loss consciousness, but vomited an hour or so later. She was brought in to a non-metropolitan hospital, where a second year GP registrar, who was working 30+ hrs at the local ED (a practice/Queensland Health agreement) due to a staffing shortage and was the only resident doctor. He failed to do an adequate neurological assessment and due to the fact that CT was not available, unless the pt was transferred 2hrs to Brisbane, the junior doctor sent her home without radiological investigation. At the time, language barriers, fatigue, lack of support and errors in clinical judgements were some of the reasons brought up.

The case was VERY thought provoking and many issues and reflections were discussed (the GP compare narrated much of the case). Some issues about impaired doctors surfaced- whether it be due to alcohol or fatigue– and the general consensus was that unless an absolute emergency, the doctor should NOT come in to work. On the surface that seems fine, but how would that go in a remote region? What if you are the only doctor or if there happened to be a massive VRE/gastro outbreak amongst other staff at the time so you couldn’t decline? If you do notify someone, do they (in the REAL world) just tell you to suck it up as they went through worse in their day? Is it professional suicide especially with the increasing competition for training positions?

I am just interested in your thoughts

Cheers

Hey guys, I wrote an article for the GPSN (General Practice Student Network) newsletter. Have a read, it may sway you towards/deter you from General Practice.

"Do you have what it takes?"

As a general practitioner, you see all age groups from newborn to elderly. You will see people with any illness, disease, or problem.’ (Anonymous)

The above statement really depicts what GPs do on a daily basis. They are the front line of our medical system. They have to be well-equipped to deal with whatever comes through their consultation door. This is important to take note of, because patients visiting their GP, present with their own unique set of signs and symptoms and often do not have a referral letter that details their medical history.

The breadth of knowledge that GPs require during their day to day consultations is astounding. From acute to chronic, GPs are involved with the prevention, diagnosis and management of a great variety of medical conditions. Although referral to other specialists may be sought, the majority of cases are handled by GPs. When specialist care is organized, it is the GP who integrates the opinions of multiple specialists, and develops an appropriate management plan for the patient. It is also the GPs role to assist in monitoring the patient during their course of treatment and beyond, and to initiate any further actions when necessary.

It’s no wonder why GPs are the busiest individuals of the medical profession. Without them, our health system would surely collapse. This is what makes General Practice, an exciting and adventurous career option, but at the same time, a challenging and intellectually stimulating one too. It involves hard work, excellent time-management, aptitude, intelligence and interpersonal skills… the complete package really.

Apart from a stimulating and challenging career, General Practice provides a range of different options to suit individuals that are interested in taking this vocational pathway. Training programs have been designed to ensure that trainees can develop into competent unsupervised GPs, in an urban or rural setting, or both, which several current registrars have decided to do. General Practice offers a great deal of flexibility with work hours and allows individuals to combine work, family and lifestyle to make it a rewarding career. The two GP colleges, RACGP and ACCRM also offer trainees with the chance to ‘up-skill’ in a variety of advanced training programs such as anesthetics, obstetrics, surgery, paediatrics and emergency medicine, provided you practice at a rural post. You end up with your fellowship along with a graduate diploma of your chosen special interest. This permits you to be a GP that can perform the advanced skills that you have been trained in, such as performing a Caesarian.

So it really comes down to this, do you feel like you are capable of the skills required in General Practice? If you are, does the following list excite you about your future medical career?

Being a diagnostician
Staying away from hospital bureaucracy
Being part of the frontline of the Australian medical system
Having the flexibility to combine work, family and lifestyle
Involved in the process of continuity of care

If you answer ‘Yes’ to both, I highly suggest you consider General Practice!

P.S. While writing this article, I gained inspiration from reading the GP profiles on MMC :)

A heads up for Victorian junior doctors: Applications for RO training in 2009 close soon on the 17th of July!

Radiation Oncology Training in Victoria

Vacancies commencing in 2009

Applications are invited from suitably qualified medical practitioners for registrar training in radiation oncology in Victoria, commencing in early 2009.

Radiation oncology is a clinically and technically challenging oncology sub-specialty, for which training is undertaken under the auspices of the Royal Australian and New Zealand College of Radiologists (RANZCR). The duration of training is five (5) years. 2009 will see the introduction of a new RANZCR training Curriculum for Radiation Oncology. Further detail on the new RANZCR Curriculum and assessments is available at www.ranzcr.edu.au

Radiation oncology registrar training in Victoria can be undertaken at the William Buckland Radiotherapy Centre (Prahran and Traralgon), Austin Health (Heidelberg and Ballarat), Andrew Love Cancer Centre (Geelong) and Peter MacCallum Cancer Centre (East Melbourne, Bendigo, Box Hill and Moorabbin). All these radiation oncology departments participate in a single, combined selection process for new trainees.

Registrars entering training in 2009 may be expected to move between training centres from time to time, to gain the best possible radiation oncology training experience and ensure exposure to all the necessary learning opportunities to allow you to satisfy the requirements of the RANZCR Curriculum. Subject to receiving a satisfactory annual review of progress, trainees will be offered a suitably accredited position for the next year of training, taking into account the specific appointment policies of individual health service providers.

From February 2009 onwards, there are various vacancies to commence training at the Andrew Love Cancer Centre, the William Buckland Radiotherapy Centre or Peter MacCallum Cancer Centre.

General enquiries regarding the training program in Victoria should be directed to Dr Matthew Seel (2008 Convenor, Victorian Joint Training Committee) on (03) 96561004 or
matthew.seel@petermac.org. Enquiries regarding the specific details of employment and training experience at an individual training centre should be directed to the Director of Training of that department.

Further information about the application process should be directed to Ms Mary Toye, Division of Radiation Oncology, Peter MacCallum Cancer Centre, Locked Bag 1, A’Beckett Street, Melbourne 8006. Phone: (03) 9656 1004.

Applications close at 4.00pm on Thursday 17 July 2008

Interviews are scheduled for Friday 29 August 2008. Candidates short-listed for an interview will be notified of the interview details.

The Royal Melbourne hospital is now offering a combined rotation for interns - melanoma and plastic surgery. Sounds like a great idea for anyone interested in dermatology... I wonder if any other hospitals have something similar interns can do?

I'm interested in doing a Masters in Int'l Public Health part-time during internship and residency and was wondering if this is advisable. What have people heard/read/been advised about doing that? - is it possible to do a course with the workload of internship/residency/having to go rural/needing to prepare for training programs? Is an MIPH even useful in the 1st place (I'm thinking of going into Ob/Gyn later)? Any information would be greatly appreciated.