Dr Mark Zagorski knows a thing or two about supervising. After 40 years supervising General Practitioners (GPs) in Mount Beauty, Victoria, he has a wealth of knowledge around what it takes to be a supervisor and guide the next generation of Rural Generalists (RGs).
What made you want to pursue a career as a rural GP?

I always wanted to be a doctor and as a child envisaged flying around in a helicopter doing home visits in high rise apartments. After completing my intern year, my partner Jane had to complete her rural speech pathology attachment in Traralgon so I followed her and worked as GP Locum in two rural general practices and at the Central Gippsland Hospital as a Visiting Medical Officer. It was a steep and exciting learning curve, but I worked with excellent Rural GP supervisors who taught me well and cemented rural generalism in my future.

After marrying, we travelled overseas for two years and while Jane worked in Speech Pathology with people with strange English dialects, I completed Obstetric (Dip OBS) and Ear Nose and Throat training in the United Kingdom as I felt these would stand me in good stead for general practice.

On return to Australia, I entered the Family Medicine program with a GP rotation in St Kilda, a medical term at Maroondah Hospital, and a combined Emergency Department / Anaesthetics rotation at Maroondah Hospital where my anaesthetics mentor was a GP anaethetist. I felt I was ready for rural practice.

Although Traralgon gave us a taste of rural life, we were keen to move north of the Great Dividing Range. We searched for a job in Northeast Victoria and stumbled onto Mt Beauty Medical Centre which suited us to a tee.

In August 1981, we joined Dr Mark Robinson and his wife Jane in a partnership which lasted 25 years. Mark joined the Mount Beauty practice as a registrar in 1979 and we continued the association with the Family Medicine Program and had registrars for 3 to 6-month blocks from day one.

What inspired you to become a supervisor?  

I had learned so many skills from all the people I worked with since starting in general practice in Traralgon that it became second nature to share this experience with the registrars who came to Mt Beauty. Each one of them, in turn, has contributed something of themselves to our life experience. 

In the early 80s, our visiting General Surgeon, Mr Peter Danne, for whom I was providing anaesthetic services invited me to enrol in an Early Management of Severe Trauma (EMST) course which was in its infancy at that time. When it came for me to recertify four years later, he recommended I do the instructor course and so began my role as an EMST instructor. This instructing opportunity enabled me to develop innovative and exciting teaching methods which I then used with GP Registrars back in Mt Beauty and I was able to develop them further in my role teaching advanced first aid  at the Australian Ski Patrol Association recertification courses. I continue to instruct EMST courses 30 years down the track.

What does it take to be a supervisor? 

Teaching/supervision has changed incredibly over the years.  

Our modern registrars, interns, and medical students have access to terabytes of medical information which they seem to be able to commit to memory and prepare to be examined on in the context of general practice. When I look over their learning plans, I realise that it has taken me a lifetime to learn all those skills, so I see my supervisor role as helping them sort the wheat from the chaff in order to practice holistic health care. They in turn help me navigate the intricacies of information technology. 

At first, I thought supervision was all about imparting knowledge and skills, but I have realised that it’s about being a good doctor. I need to LOOK (at the learner’s behaviour and non-verbal cues), LISTEN (to what they are saying and not saying), FEEL (empathise with them about how they feel in the situation) and BE AVAILABE (give them your time) – I’m still learning too and supervising ACRRM registrars is a great way to continue my own education. 

Is there an achievement or contribution that you are most proud of since becoming a supervisor? 

In the early 80s when I first started working at Falls Creek Ski Resort and dealing with many dislocated shoulders, I practiced the Kocher’s technique with the patient sedated with Pethidine and Diazepam. The patient then needed a long period of observation as they were very sedated from the medications. A colleague taught me a better drug-free method of shoulder dislocation reduction which can be done in moments in almost any situation and I have taught this to everyone I have supervised. Years later, when I have met some of my students and registrars in other situations they take the time to report how they have used that technique successfully and passed it on to others. 

I also recall a paediatric burns course I attended where the presenting specialist was, to my surprise, a previous John Flynn student I had supervised as an undergraduate quite a few years in the past. It was a great course and I learned a lot from him.  

In 2020, I suffered an asystolic cardiac arrest in front of several of my colleagues who at one time or other I had supervised as registrars. I must have supervised them well as I am still here. 

 
At first, I thought supervision was all about imparting knowledge and skills, but I have realised that it’s about being a good doctor. I’m still learning too and supervising ACRRM registrars is a great way to continue my own education.
Dr Mark Zagorski
Libby and Mark award May 2021
Dr Mark Zagorski