Tell us about the Aerospace Medical Association and what you will be doing at the scientific meeting.

The Aerospace Medical Association hold their scientific meeting every year, usually within the United States. Often, it is held in conjunction with the Undersea and Hyperbaric Medical Society's annual meeting. There are a wide range of individuals and organisations present - from government regulators such as the Federal Aviation Administration and Australia's own Civil Aviation Safety Authority, to airlines, militaries, space agencies such as NASA and European Space Agency (ESA) to related organisations involved in extreme environment medicine. Previously, we have had members of the Australian Antarctic Division present.

This is my first time attending an AsMA meeting in person, and I am very excited to do so. The scholarship I was awarded was offered to international members and designed to help offset the cost of attending. I will be presenting as part of an international expert panel discussion the risk of stroke with patent foramen ovale (PFO) in pilots.

Approximately 30 per cent of the population have this atrial septal defect however in cases of stroke under the age of 50, a PFO has often been considered a major contributing cause. This is controversial and in some discussions the presence of a PFO may be a red herring and not related to the stroke.

Obviously, stroke carries a significant morbidity but also ongoing risk of recurrence and sudden incapacitation which can affect the ability of a pilot to safely perform their duties. Thus, this creates some uncertainty in risk stratifying this group of young pilots who may have had minor strokes (i.e., without long-term deficits) and thus certifying their fitness to fly. 

I will be presenting one such case alongside Prof Christian Gericke (consultant neurologist for CASA) in a series of five cases. We hope that the panel will lead to the development of consensus guidelines on how to manage and certify these pilots.

What made you choose to study aerospace medicine?

I have always had an interest in all things aerospace since I was a child. During my ACRRM Fellowship training, I had the opportunity to work for a GP clinic in Geraldton that provided remote outreach services via the air. As part of this, I had completed my initial aviation medicine training through Monash University to become a Designated Aviation Medical Examiner (DAME). This allowed me to assess and certify the fitness-to-fly for pilots in these rural areas. This was an essential service as so many rural communities are highly dependent on small charter and agricultural aviation businesses to function. Without a local DAME, pilots would have to travel to Perth for appointments and tests, often causing a big disruption in services. While working in this job, the flight experience that I gained led to me eventually completing my commercial pilot licence. This gave me further insight and appreciation into the work that pilots undertake.

During the latter half of my Fellowship and post, I undertook a variety of short and post-graduate courses, including hypobaric (altitude) chamber sessions, centrifuge experience up to 8G, ejection seat training, spatial disorientation simulations and opportunity to visit some world leading institutions (including ESA Space Operations Centre and NASA Johnson Space Center). Last year this culminated in my graduation from the Master of Aviation Medicine at the University of Otago, which also include studies in Space Medicine and Aeromedical Retrieval.

Currently, I am in my final semester of my Fellowship with the Australasian College of Aerospace Medicine. Through this training, it has led to me running my own aerospace medicine practice to continue provide healthcare for pilots and passengers – which has included a monthly fly-in to Bunbury to run a clinic at a flying school.

My combined experience of rural health, emergency medicine and aerospace had led to spending the last three years working with the Royal Flying Doctor Service Western Operations. Using my knowledge of the aerospace environment as well as having a practical understanding of the logistics and planning in aviation operations has been incredibly useful in working in aeromedical retrieval. One great highlight of my time at RFDS has been the opportunity to team up at work with my wonderful wife Grace again. She came onboard as a flight nurse early in 2023 and we’ve been fortunate to do many memorable retrievals out of Kalgoorlie in the last year.

To me, studying and working in this field has been a wonderful combination of a lifelong passion with my calling as a Rural Generalist. I love being able to draw on a broad background, with the lived experience of being both a remote doctor and a pilot and apply it to a highly specialised situation. As well, it is great to have this specialised area of practice that I can keep on returning to that maintains the interest and drive to keep at it.

What’s next?

At time of writing, my career has taken another change.

Recently, I completed my officer's training with Royal Australian Air Force as a reservist. I was brought onboard due to my civilian experience to help support our military aircrews. It is really humbling to be involved with such a proud and wonderful organisation as the RAAF, particularly as my father and my maternal grandfather were former aviators. Further to this, I am about to say goodbye to the RFDS (and my appendix) as I will be beginning training with the Australian Antarctic Division.

It is funny reading my previous interview with ACRRM, where I mentioned my career might go more remote. I can blame former ACRRM President and current Head of Polar Medicine unit Dr Jeff Ayton for that! As time has gone on and meeting more people who share the interesting mix of aerospace medicine and remote health, it has become inevitable that this is something that you must do. Antarctica is really the closest you can come to exploring another planet without boarding a rocket and thus it has become a closely studied space travel analogue.

Looking at ways we can optimise and support humans in these remote environments has become an increasing area of interest in my work and research. It also offers one of the most challenging jobs as a RG- having to be not only the GP, but the surgeon, anaesthetist, dentist, psychiatrist, physiotherapist, radiographer and the lab technician all in one.

It will be a tough but interesting training program prior to deployment. I've been lucky to secure a spot at Davis Station, which the next season will have quite heightened aviation activity and thus both my DAME and aeromedical retrieval skills will come into use.

In our first member story with Anthony, he and this then fiancée, now wife, nurse Grace Mowtschan had made the media for being in the right place at the right time, following a triple fatality on the Indian Ocean Drive highway.

Grace and Anthony came across the accident on their way home from work and were able to assist the emergency crews in looking after the patients. Using the skills he learnt in his ACRRM training, including the Rural Emergency Skills Training (REST) course. Grace was working as a flight nurse with the RFDS. She will be packing her bags and heading to Tasmania with Anthony, where she hopes to undertake rural agency nursing.

Read chapter one of Anthony’s story here.