My time in General Practice

So you think you might want to be a GP? Or, perhaps, general practice hasn’t ever been a specialty on your radar. Irrespective of where you fall on this scale, your wonderful journey through medical school will undoubtedly find you spending some time in an incredibly diverse world, filled with an overload of information and, almost certainly, a true appreciation for the quick wits that most GPs are equipped with at all times.

Throughout last year, I had the wonderful opportunity to engage in two GP terms in metropolitan Sydney, and whilst one would assume that these two practices would be similar seeing as they were a twenty minute drive from one another, I would soon learn that this certainly was not the case. This represents the true beauty of general practice: a diverse demographic of patients each with their own unique health journey, which is carved out by an individual GP. I hope that by sharing my experiences with you, the mythical aura of placement becomes something that you can develop certain expectations for and plan toward in order to make it one of your most memorable placements yet.

My first exposure to being a student in a practice setting kicked off at Rouse Hill Town Medical and Dental Centre, a large multidisciplinary clinic equipped with Medical, Dental, Radiology, Physiotherapy and Pharmacy departments. Running via a corporate model under the ForHealth banner, it became clear that this clinic was used to taking a high volume of patients at all times. I recall my initial conversation with the Practice Manager involved her revealing that they were desperate for more GPs to join, despite already having twenty on the team! Much to my fortune, Dr Praveen Devineni, a seasoned GP who served as the Medical Director of the Rouse Hill clinic, Regional Clinical Director for NSW, and Head of GP Education and Supervision, was allocated as my supervisor. I mention this impressive array of roles filled by Dr Devineni because it opened my eyes to the fact that, unlike a lot of specialties that corner individuals into a set clinical role, general practice could open the doors to incorporate leadership roles and get involved in teaching. My time spent at this centre involved everything from taking simple histories and conducting 6-week baby checks to administering vaccines and suturing up emergency patients in the state-of-the art treatment room – this was essentially a miniature E.D. which was fully staffed at all times. If you find yourself in a large clinic such as this, don’t hesitate to ask the Practice Manager if you can float around between the GPs, nurses and imaging departments to maximise your exposure. I found it was especially useful to take a quick history from patients in the waiting room for my supervisor while they were in a consult, as this allowed me to develop a nice and succinct way of handing over a patient to my senior.

Towards the end of the year, I was then allocated to Railway Road Medical Centre – a smaller GP-owned clinic in an adjacent suburb of Western Sydney. The clinic was owned and operated by Dr Murali Thiruvengadem, a highly experienced GP who had truly seen it all. Dr Thiruvengadem’s practice was equipped with three other general practitioners, and whilst still busy, it was nice to have time in between patients to have a chat with Dr Thiruvengadem about case studies. As you will find, GP presentations tend to operate on variants of the same flavour, and although you may see one type of presentation, it is a great idea to ask your supervisor on hypothetical variants of the case and whether that would change our management. Dr Thiruvengadem was very open about the challenges with running a bulk billing practice, and I especially benefited from gaining an insight towards the logistic considerations that go into staffing and stocking a clinic to deal with the various needs of the community.

My tip to all who have GP placements is to realise that whilst it is a great setting to learn the medicine we read about in textbooks, it is also an environment to answer any questions you may have about the administrative elements that allow such clinics to run seamlessly.

By Ashvin Bandodkar

GPSN National Vice-Chair – 2023