University Senior College Old Scholar, Victoria Langton (Class of 2013 and Valedictorian) has just completed her second year of Medicine at the University of Adelaide and is currently on placement in via the John Flynn Placement Program (JFPP) in Broome, in Western Australia.
In her report below, Victoria outlines the variety of patients she’s encountered, the significant role her mentor has had on her confidence as a practicing professional and what it means to be resident doctor in such remote communities.
For my John Flynn Placements I am fortunate enough to be placed with Kimberley Aboriginal Medical Services (KAMS) in Broome, Western Australia. Broome is the centre for most services in the Kimberley and serves the Aboriginal populations of the remote communities as well as the tourists in the dry season. While I mostly work with my GP mentor in remote Aboriginal communities, I also have opportunities to spend time working with the doctors at the Broome District Hospital. The hospital is very small but it provides 24 hour anaesthetic and procedural obstetric cover, emergency medicine, general surgery, visiting specialist services, various clinics and allied health services. All the doctors at the hospital are registered general practitioners also trained in anaesthetics and obstetrics. Below is my recount of my activities during my placement in the Kimberley.
Week 1 involved one of the highlights of my placement – attending the remote “two nurse two Aboriginal Health Worker” clinics at Bidyadanga, Lombadina, One Arm Point, and Beagle Bay. These clinics have one visiting GP for one day per week, meaning I had free reign to parallel consult and see as many of the patients as I was able and then present to my GP mentor for review. Taking histories and examining patients independently was exhilarating and enabled me to practice my full range of clinical skills. To have the chance to take histories from patients, to think about their differential and conduct the appropriate exams, consider what might be the relevant investigations and perform them and then institute appropriate management, including making up the correct medications, with the safety net of a senior colleague was a cherished experience. I relished the chance to properly and genuinely use clinical skills and clinical reasoning in order to help people and found it very rewarding. I feel like my skills developed a lot, in particular the skill of presenting patients to senior colleagues, since this is a skill you simply cannot learn in any other way. I also developed several procedural skills, including dipstick urinalysis, POC BSL and HbA1c, venipuncture, cannulation, vaccination, and giving IM, IV and subcut injections. In addition, I was able to perform Well Child and EACHs Health checks, make up medications and prescriptions, write patient progress notes and referral forms, book RFDS flights, follow up discharge summaries, and understand all the paperwork that is required for Aboriginal patients living in remote areas and participating in the Australian public health system. The autonomy and freedom I had while consulting meant I gained a holistic view of being a rural doctor and accelerated the development of all my clinical skills. I truly felt like the doctor, nurse, pharmacist, dentist, optometrist and diabetes educator! Spending time in remote Aboriginal communities was definitely worthwhile and fulfilled one of the main educational dreams I had when choosing this particular rural placement.
Week 2 involved working with the Community Child Health Nurses in the Dakas Street Clinic, spending time with the Aboriginal Liaison Officer (ALO), working with the community midwives and spending time in the Maternity Ward of the Broome Hospital, and finding out what life was like for the Allied Health Professionals by following physiotherapists and occupational therapists for a day. My time with Marcie the ALO really emphasized the differences in healthcare access in remote and urban areas of Australia. A lightbulb moment for me was in the Maternity ward when I discovered a newfound love for neonatal medicine by being involved in a neonatal resuscitation and then the further management. On my day in the ward, seven babies were born, and four of those were by caesarian section. Throughout my placement I continued to be amazed at the variety of patients I saw, with no two patients being alike and no two days being the same. I saw paediatric, adult and geriatric patients, patients with TB respiratory symptoms, immunosuppressed patients, and patients with sexually-transmitted disease, just to name a narrow sample. I find the diversity of work as a rural doctor addictive and using my placement as an opportunity to discuss personal experiences with healthcare staff one-on-one reaffirmed my sense that rural practice is an interesting and rewarding pathway. I have learnt that there are a wide range of further training options for a procedurally-minded GP to pursue to provide a terrifically engaging and stimulating career.
I certainly believe that competency is not about inherent brilliance but rather about repeated exposure and experience. I am grateful for every experience I accumulate, and especially those on this placement. My GP mentor created a learning environment that was encouraging and tolerant and believed in me when I did not have the courage to believe in myself. While I felt out of my depth, her judgment was correct and meant I learnt more than I would have otherwise dared. It is this mentor relationship I value the most out of all my placement experiences.
Must Do Social Activities In Broome
- Evening movie at the outdoor Sun Picture Theatre
- Sunsets & swimming
- Camel Rides along the beach
- Gantheaume Point
- Malcolm Douglas Croc Park
- Lunch at The Mango Place
- Drinking the best Ginger Beer in Australia at Matso’s Brewery
- Visiting pearl shops including Kallis and Paspaley and the Pearl Lugger
- Weekend Court House Markets
My sincere thanks to all the staff at the John Flynn Placement Program and to the wonderful staff at Kimberley Aboriginal Medical Services, Broome, Western Australia.