Lottery tickets and ocean views - rural GP training the ACRRM way

Dr Georgina Mills,
ACRRM GP Registrar, Kangaroo Island, South Australia

Australian GP training applications closing soon

When Dr Georgina Mills was undertaking GP training at Port Lincoln on South Australia's Eyre Peninsula last year, a farmer came into her consulting room wrapped in bandages.

"He'd been using an axial grinder, and wasn't wearing any protective gear" she says.

"Somehow the grinder had flipped over and ripped through his forearm and thigh. It had just missed his femoral artery.

"In true farmer fashion, he'd patched himself up and left it a couple of days before deciding he should come in and see us.

"He said 'I think I need some stitches, doc'.

"And I said 'I think you need a lottery ticket.'"

It is just one of many encounters that make Georgina's work as a rural GP Registrar interesting - though she adds "if I had one wish, it would be that farmers would put some safety gear on!"

Dr Georgina Mills and her partner, Dr Scott Marschall (pictured), love the 'backyard' of their house on Kangaroo Island.

Georgina and her partner, Dr Scott Marschall, are now working as rural GP Registrars on Kangaroo Island, off the South Australian coast.

Both are 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.

Georgina was raised in Adelaide and her father is a specialist Ophthalmologist, but the pull of Rural Medicine was too great for her.

Following her training, she plans to work as a Rural Generalist doctor, combining General Practice work with Obstetrics or Anaesthetics. She may also undertake additional training in Plastic Surgery to provide more complicated skin services to her community. Scott plans to work as a rural GP Surgeon.

"We also have a dream to open a B&B on the side, if we end up living in a beautiful coastal town!" she says.

With extended family who were sheep and cattle farmers, Georgina spent a lot of time in rural South Australia as a child.

"We'd visit them in the holidays and we camped a lot in rural areas, including on Kangaroo Island.

"My uncle used to be a rural GP at Port Lincoln — where Scott and I trained during our fifth year of Medicine in 2013, and as GP Registrars last year.

"We really loved our time there.

"I considered specialty training, but every time I came to the country I thought 'this is where I want to be'.

"Instead of going down the Ophthalmology path, I just asked Dad to teach me the things I'd need to know in treating eye emergencies.

"I like that, as a rural doctor, you can do a wide scope of things, and that you need to be resourceful with whatever comes through the door.

"I wanted to be away from the politics of a big hospital, and I also wanted to appreciate where I live and how beautiful it is - it can be a calming aspect to your lifestyle."

It doesn't come much better than Kangaroo Island.

Georgina and Scott live right on the beach and 'commute' the twenty minutes into town for work.

"We feel like millionaires - our house looks out over the ocean and the view is spectacular" she says.

"We recently had friends here from the mainland. We took them to the markets in the morning and dolphin spotting in the afternoon - it's pretty hard to beat that!"

She adds that if the rural lifestyle isn't enough to get you hooked on Rural Medicine, the clinical work certainly is.

"You see an enormous variety of patient presentations, and you have your fair share of motor vehicle accidents, resuscitations, heart attacks, critically ill babies and obstetric emergencies.

"You wouldn't generally see these things as a city-based GP Registrar.

"You also get much more hands-on exposure, but with great supervision and support from your colleagues.

"We have to do our own orthopaedic reductions, and our own anaesthetics for this.

"We get to do obstetric deliveries, we act as Neonatologists when the babies are born, and as their Paediatricians when they get a bit older.

"We also do a lumps and bumps list every few weeks. It's a mini skin surgery list and one of our senior doctors is around to advise us on the more difficult procedures.

"We have visiting specialists who come here regularly, and we often assist them in surgery. We can talk one-on-one with them and get really valuable advice. As a junior doctor in the city you would rarely have that direct access.

"As a medical student and now as a GP Registrar in a rural setting, I have always felt that I am really useful to my colleagues and my community."

While Kangaroo Island has around 5000 permanent residents, another 200,000 tourists visit each year.

"Between the practice and the hospital, life as a doctor here is busy, but we have six full-time doctors and great nursing staff" Georgina says.

"Our colleagues are all senior Rural Generalist doctors with a huge amount of experience in Obstetrics, Anaesthetics, Emergency Medicine, Surgery and much more - and they are really generous in terms of the support they provide to us.

"A lot of my friends in the city are doing specialty training to become Paediatricians, Surgeons or Physicians. It is really tough and they are very stressed out.

"I think as a city-based trainee you can feel more isolated - which is ironic, given some of the physically isolated locations you get in Rural Medicine - but as a rural GP Registrar, you work as part of a very close-knit local healthcare team.

"The support and camaraderie here is something I'm very grateful for."

Georgina says she and Scott chose ACRRM's GP training pathway because of the wide range of skills training it offers.

"The fact that it is a direct pathway to Rural Generalist Medicine appealed to us. It also has a real focus on training you to be a 'Jack of all trades'. In metropolitan areas your GP training can be quite limited in terms of what you can do.

"With the ACRRM pathway, you also have to train in an advanced skill, and be working in a community which needs that skill.

"This leads to a more appealing training experience."

While at high school and university, Georgina was a very successful rower, representing South Australia at the Australian Rowing Championships in 2014. She also competed in numerous marathons and triathlons.

On Kangaroo Island, she is enjoying beach running and plans to join the local netball team.

"Another thing I'd like to get involved with is the local conservation group" she says.

"I really like the community vibe of cleaning up the beaches, reducing single use plastics, and protecting the Island's coastline and local wildlife - it's a nice way to live, keeping the place pristine and beautiful. It's great to play a part in keeping it that way."

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 Georgina Mills is undertaking her ACRRM GP training as part of the Australian General Practice Training (AGPT) program.

Her training is being delivered by GPEx, the South Australian Training Organisation delivering training to doctors selected to specialise in General Practice in Australia.

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.