After one year of Fellowship training, Dr Toni Smith reflects on her achievements and where a career in rural generalism will take her and her young family.

Dr Smith currently works between Katherine and Darwin on an emergency medicine placement. We sat down with her to find out what it's like to be a Rural Generalist in the Northern Territory.

Tell us about your journey into rural generalism and why you chose ACRRM.

I started training with ACRRM at the beginning of 2023. I have always worked regionally because I prefer the lifestyle and size compared to that of a big city and personally, I feel that the scope of medicine that you practice in smaller centers is greater and more fulfilling.

I was working in a hospital surgical ward with the intention of becoming a surgeon, but everything changed after I fell pregnant. The reality is that that career path is very difficult with a small family, and I wanted to pursue something that would provide me with a set of skills to work anywhere life takes me. I was looking for a training program which would give me the most opportunities in the long term.

With ACRRM, all of this was possible. Especially with the range of Advanced Specialised Training (AST) options and the experience you gain in training. The program is very flexible and provides me with the freedom I was looking for.

Have you decided on your AST, and how do you think this skill helps your community?

I haven't committed to an AST yet. For me it will depend on the community I end up living in and the need that the community has. I think Palliative Care could be a good option, but it depends.

I believe that as a Rural Generalist, to a degree your specialty will pick you. A lot of us are flexible in that sense and will embrace whichever opportunity is needed for that community.

What does it take to be a Rural Generalist and do the work you do?

A Rural Generalist at their core needs to have the ability to embrace any situation that is thrown at them and to be up for any challenge. There is so much variety which makes the role very exciting but challenging at the same time.

Every place you work and community you are a part of is different. You have to accept the good and the bad as a Rural Generalist and be able to grow into the place you are working and be able to adapt to the community's needs.

What does a typical day at work entail?

I am still new to training, so am currently working in the emergency department (ED) in Katherine as part of my Core Generalist Training. Working in ED means there is no “typical” day for me. I can get any sort of presentation from a high-speed crash where the car has rolled over, to a kid with a snotty nose – it's quite broad and that's what’s exciting. Though I am looking forward to having more work/life balance at my next placement due to there being no shift work.

What inspired you to join the Registrar Committee?

Shortly after joining the ACRRM Fellowship program, they put a call out for new Registrar Committee members. I thought it would be a great opportunity for me to have a voice and to be able to shape the program I was a part of.

I had explored joining other college’s training programs, but I wasn’t happy with how they treated their registrars. I felt that their committees were more tokenistic.

Joining ACRRM’s Registrar Committee is the best decision I have ever made. I feel that I have a voice and that the registrars are listened to at a College-level. We have a seat at every table, which is not the case in every college.

I love being able to talk to registrars and to hear their concerns and thoughts. As someone who joined the College a little later in my career, I feel that this position gives me the ability to say that changing your path later is not a bad thing. Your skills are not wasted. You can make a change in your career if you want and still use the skills you already have.

With other colleges, there is a perception that once you make a decision, that’s it, that's the path you are on. But being a Rural Generalist and training with ACRRM gives you that flexibility and it's what I am passionate about and want to let other doctors know.

What advice would you give to medical students and junior doctors who are thinking about training as a Rural Generalist?

My advice to any medical student or junior doctor is to talk to people, explore what's out there and take your time. It’s not a race – all experience you gain is valuable and will make you a better doctor.

Working in a job is very different to when you are a medical student. But you can build a career that has lots of facets, and I found that rural generalism gave me more options, both medically and personally, than any other specialty.

Want to explore the possibilities of rural generalism? Discover Fellowship here.

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