Author: Hamed Shahnam
The experience and knowledge that I acquired during the John Flynn Placement Program (JFPP) has surpassed all my expectations. It has encapsulated the beauty, challenge and excitement of rural medicine. I have had the opportunity to work within the local teaching hospital, assist in the operating theatre, consult patients within clinics, observe provision of youth mental health services through Headspace clinics, as well as flying to remote mines, communities and cattle stations with the Royal Flying Doctor Service (RFDS).
The opportunity to attend Headspace youth mental health clinics was another highlight. It demonstrated the complexities and extent of mental illnesses affecting adolescence and youth in Port Augusta. I witnessed the impact and relationship of drug and alcohol on youth mental health. I now better appreciate the role of general practitioners in assisting these young patients to navigate the complex healthcare system in order to access various services.
The richest experience was the flights with the RFDS. I was able to observe, assist and support my fellow doctors in the delivery of outstanding medical care to the remotest corners of South Australia. I learned about how valuable these primary services are to those who face enormous geographical barriers in order to obtain basic primary healthcare services. I also greatly appreciate the challenges of liaising, coordinating and implementing specialist access to patients living within these regions. I observed the exceptional advocacy and support that RFDS and their doctors provide to patients. It was wonderful to witness the strong emphasis on teamwork during services deliveries, particularly during a paediatric retrieval from a remote Aboriginal community. The doctors, nurses and pilot on the flight demonstrated remarkable collaboration to bring the young boy safely to Port Augusta, where specialised paediatric care could be accessed.
More profoundly, I have a deeper understanding of attributes that enable the provision of outstanding patient care. I believe thanks to the placement experience I am better at communicating with patients and healthcare professionals, in particular communication skills that are important when consulting vulnerable youth. I now greatly appreciate a team based approach to the provision of healthcare and the role that GPs play in coordinating various services. Personally, it has been a startling realisation that patient’s social and mental health are a key component of patient care. Without addressing this component, doctors are not able to holistically care for patients
Practically, I was given abundant opportunities to apply my knowledge and clinical skills in a safe, supervised environment. I have for the first time been able to perform phlebotomy and with every opportunity I have gained confidence and proficiency. I have performed cardiovascular, respiratory, ocular and history taking assessments on real patients. This opportunity will not have been afforded to me until my third year of training. Given the importance of early exposure and training as a medical student, I feel better equipped to undertake clinical activities thanks to the JFPP.
The social experience of the JFPP has also been fantastic. Living with my mentor and his family, including two young children has been eye-opening. I have frequently wondered about how medical practitioners manage the various competing demands of work, family and lifestyle. Living with my mentor and the discussions that we have had clarified many aspects of life as a rural GP. I have also enjoyed observing the dynamic and complex act of parenting two young children, despite the added pressures of being a rural GP. I have thoroughly enjoyed getting to know the nursing staff, doctors and allied health professionals during my three-week stay. I truly hope that the scholarship does indeed continue into the future as I believe JFPP is one of the few placement experiences that enables pragmatic understanding of life a rural doctor.
Finally, the work within the hospital was another eye-opening experience. My GP mentor provides hospital services within the community. It was wonderful to work with him in a non-conventional hospital system, where GPs are the primary care providers. I also worked with resident paediatricians, as well as surgeons and appreciate the challenges these specialists face when working in a rural setting. Working with the paediatricians enabled me to confront the evident gaps in the health of young Aboriginal children and factors that contribute to the current state of disadvantage. I encountered numerous cases of perforated ear drums, hearing impairment and failure to thrive. I was touched by the dedication and commitment that these doctors and nurses demonstrate to bridge the evident healthcare gaps. The surgical experience was another climax of my placement. For the first time in my academic career I was given the opportunity to observe the activities that occur within the operating theatre. It was an amazing opportunity to apply my anatomical knowledge in the context of the operating theatre. I also became more aware of the role of an anaesthetist and operating theatre nursing staff.
The placement has offered me a wide range of personal and social experiences that has shaped my understanding of rural healthcare and living as a doctor within these communities.