From the general practice to the operating theatre: Rural training 'delivers in spades' for ACRRM GP Registrar

Dr Emma Jones,
ACRRM GP Registrar, Kalgoorlie, Western Australia

Australian GP training applications closing soon

Raised in Bunbury on the beautiful Geographe coast of Western Australia, Dr Emma Jones still has a soft spot for her hometown.

Once she completes her training as a GP Registrar, however, she's planning on setting up practice in one of the smaller rural communities dotted across the south-west of the state.

"Bunbury is a little too big for me now... and it has parking meters!" she jokes.

Still, she will be a net gain for rural Western Australia when she begins life as a fully-fledged Rural Generalist doctor.

"Like many other medical students, I was sure I'd be an Emergency Physician in the city - that was before I realised Rural Medicine was the career for me."

She is now 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.

Emma's father is a sonographer who provides ultrasound services across south-west WA, so she had an early appreciation of the important role that local health services play in rural communities.

When her younger sister had to spend time in Perth for medical treatment, Emma also experienced first-hand the difficulties that rural families face in accessing healthcare out of town.

A rural placement that she undertook at Merimbula on the NSW Far South Coast, as part of the John Flynn Placement Program - and her time at the Rural Clinical School in Kalgoorlie - really opened her eyes to a career as a Rural Generalist doctor, however.

"Through these experiences and some other rural placements, I began to realise that rural doctors were very much the type of doctor I wanted to be.

"They were inspiring, their skills were incredible and they were very generous mentors, providing me with lots of support and advice.

"I also began to realise that the combination of doing both General Practice and hospital-based work in a collegiate and friendly environment was very appealing to me.

"That's when I decided to pursue a career as a Rural Generalist, rather than spend my career as an Emergency Physician in a city hospital."

She hasn't been disappointed.

Since graduating from Medicine, she's undertaken training placements in Kalgoorlie, Bunbury and Karratha, as well as at major hospitals in Perth.

"Along the way, I've done a lot more four-wheel-driving and camping than I'd ever done before!" she laughs.

She is currently based in Kalgoorlie for a training term in Paediatrics, and will head to Perth later in the year to do some more Emergency Medicine training at Royal Perth Hospital.

She hopes to undertake advanced training in Anaesthetics next year, with a view to becoming a rural GP Anaesthetist in south-west WA in the future. There, she plans to mix her General Practice and Anaesthetics work with Emergency Medicine work at her local rural hospital.

Emma speaks highly of the wide scope of training she has experienced in rural hospitals and general practices, and the close team approach that is evident in rural health settings.

"For example, in a city hospital you might only speak with an Ear, Nose and Throat (ENT) Specialist on the phone, or communicate with them through a more senior doctor.

"Recently in Kalgoorlie, however, we had a visiting ENT Surgeon at the hospital and I just went over and had a chat with him about a patient I wanted assessed. The interactions are much easier and more relaxed here."

The GP Supervisors at her rural placements have also been very supportive and approachable mentors.

"They recognise the importance of developing the next generation of doctors for their communities" she says.

"They genuinely want you to have a positive learning environment in their town, and they want to ensure you have a good work-life balance."

She adds that training in a rural setting often delivers a more diverse learning experience.

"If I were to do some Paediatrics training at a hospital in Perth, I would be on a sub-specialty team and I would only get to see the kids with diabetes and a handful of other conditions.

"In Kalgoorlie, though, I'm on a generalist Paediatrics team and it is literally very general - we cover one-day-old neonates through to children under 16 years. It makes for a comprehensive and well-rounded training experience.

"There is so much more opportunity for hands-on learning in a rural setting, too.

"As a junior doctor in a city hospital, you are much lower in the pecking order in terms of getting to do clinical procedures.

"In a rural setting, however, you are the doctor scrubbed in with the Surgeon for theatre - there's no Surgical Registrar or anyone else standing in line before you to assist with the operation.

"In my current Paediatrics term, I am attending the deliveries of babies as well as Emergency Department calls for paediatric patients - it's a very direct experience that is hard to get in a city environment.

"I know that I always have advice and support readily available from my supervisor and other rural medical colleagues, though. I've felt much more supported in my rural training settings than I have in many city-based terms."

While life as a rural GP Registrar can involve some on-call and after-hours responsibilities, Emma says this is made up for in other ways.

"A term I was doing in Perth involved driving more than an hour each way to get to and from the hospital, but in Kalgoorlie I can go home for lunch. It makes a big difference when you don't have to spend hours in heavy traffic to get to work.

"Then there are the rural patients, who really appreciate what you are doing for them."

Emma says she chose the ACRRM pathway because it provides the best type of training experience for the doctor she wants to be.

"As a Rural Generalist doctor, I will get to do that wonderful mix of collegiate, practice-based GP procedural work as well as hospital work.

"It's very hard to train for that in the city, as it is very much office-based General Practice work there.

"ACRRM's curriculum is designed to provide you with the wide range of skills you need to work as a Rural Generalist.

"On a personal level, too, the rural doctors I have met at ACRRM's workshops and conferences are truly the most interesting and welcoming people I've ever met professionally.

"They genuinely want to hear about what you are doing, and they want to help you in your training journey - they are very friendly and open, and they really want to welcome you to their world.

"They are incredibly inspiring doctors who are doing amazing things in their communities."

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

Her training is being delivered by Western Australian General Practice Education and Training (WAGPET), the sole provider of the Australian General Practice Training (AGPT) Program for GP Registrars in Western 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.