City boy turns country doctor - and chooses ACRRM for GP training

Dr Geraldo Guimaraes,
ACRRM GP Registrar, Biggenden, Queensland

Australian GP training applications closing soon

When Geraldo Guimaraes arrived in Australia to do a Science degree, working as a doctor in a country town was the last thing on his mind.

"I came from a major city in Brazil, and had also spent time in Rome, so Melbourne was the smallest place I had ever lived!" he says.

Somehow, though, this city boy from South America fell in love with Rural Medicine. He is now a GP Registrar at Biggenden, a small community in country Queensland.

And he has no plans to go anywhere else soon.

He is undertaking GP training through the Australian College of Rural and Remote Medicine (ACRRM), which will lead to Fellowship of ACRRM (a 'FACRRM') - one of only two specialist General Practice qualifications in Australia.

The other doctor in town, Dr Dani Buchanan, is his GP Supervisor and a close colleague.

They have their hands full, providing primary care at their general practice and local aged care facility, as well as emergency care at the hospital.

"Biggenden is a great little town with a population of about 800 people - that's on a good day!" Geraldo laughs.

"I never thought I would consider a town this small - but it has been a very pleasant surprise.

"Dani and I get along very well, as do our wives. There's no reason to leave other than for a little while if my training requires it.

"We're working on a long-term plan to provide medical services here."

After graduating from Science, Geraldo was at a crossroads - he loved science, but didn't want to be a 'pure scientist'. He soon realised that Medicine would let him "do the science but also help people".

Pure chance exposed him to Rural Medicine.

"As a medical student I needed financial support, so I went to Centrelink and saw an advert there for a workshop on Rural Medicine. I went along and was inspired.

"I then attended some rural medical conferences. I met lots of interesting rural doctors, heard lots of interesting stories, and saw how highly rural doctors were regarded by the specialists.

"By the end of a first year elective in the rural town of Stanthorpe, I was hooked."

Now Geraldo can't see himself doing anything else.

"My wife is a naturopath and has her own business in Toowoomba, so we share our spare time between there and Biggenden.

"We're leading a very happy life. Every time we go back to Melbourne we say 'we really don't want to live here again'."

While life in Biggenden is busy, Geraldo and Dani have put a big emphasis on work-life balance.

"We have shaped our roster so one of us can get away while the other is on-call.

"This enables my wife and I to go to Toowoomba or Brisbane, to take in the theatre and do those sorts of things."

While Geraldo initially considered training in GP Obstetrics or GP Surgery, there's little need for these services in Biggenden. Instead, he's looking at doing additional training in Internal Medicine and Palliative Care - a better fit for Biggenden's ageing population.

"That's what I love about doing GP training through ACRRM" he says. "It is very flexible and lets me train in a way that best meets my community's needs.

"To me, ACRRM is the best choice for rural GP training. It is geared towards Rural Generalist Medicine, and it's a lot more straightforward in getting you to that point."

Meanwhile, Geraldo and Dani are making a big impact in Biggenden.

"The community really appreciates the level of care we provide, and that we want to stay here. They have even gone all out to help us find suitable housing - the Mayor included!"

Geraldo says in addition to the "great support" provided by Dani, his previous work in the Emergency Department at Bundaberg Base Hospital - about 80 kilometres away - has helped enormously.

"There has been a lot of effort in this region to support the doctors in outlying towns.

"The doctors at Bundaberg Base know what I can and can't do in my community. I can always call them when I need advice.

"When they knew I was going rural, they encouraged me to step up - getting me to put in catheters and arterial lines, and intubate patients.

"They said 'We want you to do it, because once you are in your community and we tell you over the phone that you need to do it, at least you'll have done it before'."

Life as a rural GP trainee has its share of interesting presentations.

"I had a patient recently who was driving through a paddock with a shotgun in her car. She hit a bump and the shotgun fired into her leg. That's not something you see in Brisbane!

"Another fellow came in after falling off a bull and was badly cut in the face. I told him that he'd need stitches, and he said 'Can't we just put some glue on it, doc? I need to get back to work!' In the city a patient would more likely ask for a referral to a plastic surgeon.

"We are also educating the locals that, if they feel chest pain at night, they really should go to the hospital - and not feel guilty about us being called in."

Geraldo says one of the big rewards of Rural Medicine is the ability to form close relationships with your community.

"One of my patients was recently diagnosed with cancer. He's had to go multiple times to Bundaberg for tests, and he's seeing a surgeon I know.

"He regularly comes in and when he has a new scan, he says 'Gerry, what do you think about this one?' It has been a real privilege to help him understand his treatment journey and receive holistic care."

Outside medicine, Geraldo and Dani are keen to participate in community life.

They have been doing some first aid training at the local Scouts group, and are busy organising a cricket match to introduce the local health staff and their families to the community.

"Given my wife is a naturopath and Dani's wife is a dietitian, we are planning some healthy cooking workshops too" he says.

"There's also a pool in Biggenden, so Dani and I, together with our wives, have joined in a few aqua-aerobic classes with some of the old-timers, just to lead by example!"

The application period for Australian General Practice Training (2019 intake) closes on 30 April 2018. To find out more about undertaking GP training via the ACRRM training pathway visit acrrm.org.au/agpt.

Dr Geraldo Guimaraes is undertaking his ACRRM GP training as part of the Australian General Practice Training (AGPT) program.

His training is being delivered by the Generalist Medical Training program (James Cook University's training program in the medical specialty of General Practice).

Becoming a GP in Australia

In Australia, junior doctors undertake a period of additional hospital-based intern training once they have graduated with a Medical degree from university. Thereafter, they can undertake further training to be able to specialise in a particular field of Medicine. To be accredited to work as a General Practitioner (GP) in Australia, doctors must first undertake a significant period of training as a GP Registrar.

This includes working in General Practice under the supervision of a GP Supervisor, while also undertaking formal training via one of two colleges - the Australian College of Rural and Remote Medicine (ACRRM) or Royal Australian College of General Practitioners (RACGP) - whose qualifications for General Practice are accredited by the Australian Medical Council. Training towards the qualification of Fellowship of ACRRM (FACRRM) also entails additional hospital-based training.