Same patient, different locations: ACRRM GP Registrars make a mark in Tasmania

Dr Louisa Tatton and Dr Antoun Boulos,
ACRRM GP Registrars, Launceston and George Town, Tasmania

Australian GP training applications closing soon

Dr Louisa Tatton always knew that working as part of a close-knit healthcare team would be a rewarding aspect of life as a doctor in a rural community.

"But I never expected it would involve my other half!" she says.

Both Louisa and her partner, Dr Antoun Boulos, are working as GP Registrars in Tasmania - Antoun at a general practice in George Town and Louisa in Retrieval and Emergency Medicine in Launceston.

Recently, they found themselves reviving the same patient - but in different locations.

"A patient had a cardiac arrest at the general practice where Antoun works, and Antoun helped to resuscitate him" Louisa says.

"The patient was sent by ambulance to Launceston, where I was working at the hospital's Emergency Department. He had another cardiac arrest there, so it was my turn to help revive him!

"It was truly a family effort - and thankfully the patient made a full recovery."

Both Louisa and Antoun 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.

Louisa is also completing a Diploma in Emergency Medicine, and has undertaken extensive training in this field.

She is currently working with an aero-medical retrieval service based in Launceston, and is also doing some work in the Emergency Department (ED) at Launceston General Hospital.

"Our aero-medical service retrieves patients from Flinders Island and King Island, and the more remote centres within Tasmania" she says. "We deal with anything from head trauma to heart attacks."

Louisa and Antoun will swap roles mid-year, with Louisa working as a GP Registrar in the general practice at George Town and Antoun taking on the aero-medical work.

Louisa was raised in semi-urban Melbourne but fell in love with Rural Medicine while a student at a Rural Clinical School. Antoun grew up in Perth, but also spent a lot of time in rural placements as a medical student and in his early resident years.

"I loved doing clinical placements with rural doctors, and seeing the breadth of their practice and their skill-base" Louisa says.

"The scope of medical practice I could do in a rural community really appealed to me.

"You get that opportunity to provide holistic care to your patients, which you don't often get in bigger centres where five specialists might each be looking after one part of a patient.

"As a medical student, I also did an elective term at a small Aboriginal community in Cape York and I found it fascinating. We've talked about spending some time there again in the future."

Louisa has a strong interest in Women's Health and Obstetrics, and initially thought about training to be a Specialist Obstetrician - but she found the reality of working in a big hospital was not quite as she had expected.

"I realised that what I found appealing about Women's Health was the stuff you do in the community health space - typically as a Rural Generalist doctor."

Louisa and Antoun have found Tasmania to be a great location in which to undertake their GP training.

"It's a really beautiful place to live and a great place to train" Louisa says.

"We love the proximity to the outdoors, and there are some terrific rural communities here.

"Being able to combine Primary Care work with Emergency Medicine makes Rural Generalist practice a great career choice, and Tasmania can really facilitate this style of practice.

"Depending on your location, it could even be possible to include some aero-medical retrieval work in your weekly schedule, making for a really interesting practice mix."

Louisa and Antoun chose ACRRM's GP training pathway because of the wide variety of skills training it offers.

"ACRRM's pathway equips you very well for life as a rural doctor" Louisa says.

"Rural practice is not simply office-based General Practice. You need a really solid foundation in Emergency Medicine and other skills too, because that's the kind of stuff that can walk in your door in a rural or remote community.

"ACRRM's pathway was also very flexible in enabling me to work in Retrieval Medicine while undertaking my General Practice training, and I was pleased that my previous clinical experience could be formally recognised."

Louisa and Antoun have greatly appreciated the support provided by their medical supervisors and other colleagues during their GP training.

"They have been very supportive and really generous in sharing their expertise with us" Louisa says. "They have even shared their holiday homes!

"We've really appreciated the greater opportunity for hands-on training, both in the general practices and hospitals in the smaller towns, and even in the larger hospitals in Hobart and Launceston.

"There are some incredibly experienced rural doctors here who have been practising in their communities for 30 years. They have a real breadth of knowledge and have also learnt to be self-sufficient, as you can be relatively isolated in some of the more remote communities."

Given Tasmania is a popular 'adventure destination', its medical services must be ready to cope with all types of injuries.

"We get a lot of mountain biking trauma from people going flat-out down the hill and landing on rocks and logs" Louisa says.

"There are also plenty of people out bushwalking in alpine areas and getting themselves into strife in pretty remote places."

She adds that with the Australian Antarctic Division's headquarters located just outside Hobart, there are opportunities for doctors trained in Rural Generalist Medicine to spend time in Antarctica.

When it comes to work-life balance, Tasmania is delivering in droves for Louisa and Antoun.

"Just last week, he bragged to me that he went surfing during his lunch break!" Louisa says.

"We also have access to stunning national parks, there are any number of physical activities to hurl ourselves at, and we can walk or cycle to work.

"We also have beautiful food and wine here, a great arts culture and a thriving creative scene. It's a really interesting place to be at the moment.

"Even when I'm doing my retrieval work, there are some lovely places to fly. The leg of the flight when you don't have a patient on-board, and you have time to look out the window, is absolutely beautiful.

"Tasmania's such a stunning place!"

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 Louisa Tatton and Dr Antoun Boulos are undertaking their ACRRM GP training as part of the Australian General Practice Training (AGPT) program.

Their training is being delivered by General Practice Training Tasmania, the Regional Training Organisation (RTO) in Tasmania for Australian General Practice Training.

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.