When it comes to delivering health care to some of the world’s most isolated areas, medical interns with the RFDS quickly learn that every day offers a new challenge.
On completing medical school, Dr Keziah Dilger jumped at the chance to move from Tasmania to South Australia to intern with the Flying Doctor in Port Augusta.
Over eight weeks of intensive work experience alongside senior rural generalists and retrieval specialists, she experienced the unique training ground that is the Australian outback.
“I knew rural work was exactly what I wanted to do and that I may as well start as soon as possible,” Dr Keziah said.
“I got to experience two sides of the RFDS: one where we run GP clinics out bush and provide very important primary care to people who otherwise wouldn’t be able to access it easily and the other part being retrieval medicine out in the middle of nowhere and having some very serious things going on.
“When you fly in and nothing is around you, you really get that perspective of how far away things are and how hard it is to get someone to Adelaide.”
Dr Arnold Chen is another junior doctor who recently interned with the RFDS at the Port Augusta Base.
Growing up and studying in cities, Dr Arnold’s only previous outback experience had been camping with mates.
“It’s very different working as a doctor in the bush,” he said.
“I’ve been given opportunities to fly to Marree, which is a clinic up north, and I’ve also been able to go with the team on a medical retrieval at a station.
“One of the most important things I’ve learnt is there are always people no matter how far you venture in the outback – it’s just they’re not always able to access important, simple things like medications. We tend to take that for granted in cities or even rural towns.
“The RFDS has always been something you hear about in primary school – learning about these ‘cool doctors who go flying and do medicine up in a plane’. I just never thought it would be something I’d ever experience.”
To become eligible for general registration, Australian medical graduates like Dr Keziah and Dr Arnold must complete accredited intern training (postgraduate year one training) across emergency, medicine and surgery disciplines.
Through the rotation offered by the RFDS in South Australia, medical interns share their time between the Port Augusta Hospital emergency department and the RFDS Port Augusta Base, forming a one-of-a-kind introduction to rural generalism – a field often described as the Swiss Army knife of medicine.
RFDS SA/NT Primary Care Clinical Director, Dr Amanda Bethell, said evidence showed if doctors trained in rural and remote regions, they were more likely to stay.
“In partnership with Port Augusta Hospital, we’re able to offer an intern and junior doctor term that comprises a combination of primary care and emergency medicine. It mirrors the experience of senior doctors like myself, who work across the emergency department and the RFDS,” Dr Amanda said.
“When Arnold came out on a retrieval with me, I was asking him, ‘How can we help this patient? There are no fancy blood tests, no fancy imaging’ – and it’s this hands-on coaching that helps him to think outside the square.
“He was able to travel with the patient in the aircraft and then in the ambulance to the hospital, which is a great opportunity for him to practise that skill of handing over a patient.
“Giving young doctors and trainees the opportunity to fly out to really remote places deepens their understanding of what people are up against and why we bring the care to them and enable them to stay in their community."
“It’s the only place in South Australia that you can do this breadth of work and gain this experience and understanding… and as far as I’m aware, it’s the only place in Australia.”
Dr Amanda Bethell, RFDS
With the nation facing a growing shortage of general practitioners, particularly in rural and remote communities, Dr Amanda said there was a world of opportunity for budding doctors to pursue a unique and exciting career.
“To be a great rural generalist, you’ve got to have a sense of adventure,” she said.
“You’ve got to be bold enough and brave enough to get yourself out of the city or whatever your comfort zone is. You need to be able to think outside the square and be creative.
“You encounter a whole bunch of really diverse people in their own context, as opposed to in a hospital building. This means learning skills in how to relate to people from a different culture to yourself, whether that’s an Aboriginal culture or someone from a European culture who has landed themselves in a remote Australian town.”
For Dr Keziah, who is now in her second intern year and working in Clare, a career in rural generalism means not only fulfilling work, but a flexible lifestyle.
“I think my passion for rural medicine comes from not wanting to do the same thing day in, day out,” she said.
“Rural generalism can be quite a range of things – GP, emergency medicine, anaesthetics, obstetrics, paediatrics, and a range of work that continues to be interesting and challenging.
“Country life is also really different to city life. It’s nice to work and live in communities and build those relationships. You get to build friendships with the staff that you’re working with.
“Sports always a big thing in the country and it’s been great to join local footy and netball clubs. It’s really nice to have people’s trust in a different sort of way – as a teammate.”
The RFDS SA/NT and Port Augusta Hospital intern rotation is an opportunity provided under the Australian Government’s John Flynn Prevocational Doctor Program (JFPDP), giving junior doctors the chance to live and work in a regional, rural or remote area. To learn more, visit South Australian Medical Education & Training (SAMET).
Learn more about the Flying Doctor.
