From very early on in med school, I knew I wanted to do general practice. I always felt energised and excited by primary care placements in a way that just never clicked with me in hospital. I knew I had a love for community-based care and preventive medicine, but I didn’t really know where I wanted to go. Being from a regional community, I always expected I’d end up in a town of 30,000 people for the optimal balance of lifestyle and interesting medicine. But I took a chance and it has, without a hint of exaggeration, changed my life.
In late 2018, I was in Wilcannia on a placement for my med student elective. The nurse was showing me and a nursing student (now my partner of 3 years) the area around the outback town on the way to clearing kangaroos, emus, and wedge-tailed eagles off a nearby runway for the RFDS (Royal Flying Doctor Service) to land for a bi-weekly clinic. They took us down to the majestic Barka (the Darling River; at the time barely a trickle) which cuts through the town, past the “golf course” (a flat patch of dirt used more for early morning walks than a leisurely hit) and out to the airstrip on the edge of town – It is breathtaking country.
Western NSW is home to a small but dedicated cohort of rural generalists who care for their communities across outpatient, inpatient, and emergency settings. Some larger sites are staffed by permanent RGs who have a range of both general and subspecialised skills. Others, like Wilcannia, are held together with a delicate patchwork of fantastic Aboriginal Medical Services, nurse-run bush hospitals, telehealth, and fly-in-fly-out GP teams. All of them need more doctors.
Our remote communities are some of the most vulnerable in the developed world; Wilcannia’s male life expectancy is less than forty years. It can be harrowing, confronting, and at times chaotic, and prospective remote doctors should have no illusions that they will budge these statistics – that will require much broader public health reform.
But that doesn’t mean your practice has to be nihilistic. In Wilcannia I found a beautiful community whose lives have been ravaged for generations by the ongoing scars of fierce, unthinking colonialism and the tyranny of geographic isolation. But in a way, that makes your care, time, and dedication all the more meaningful. There is much you have to offer to remote communities, and much more to learn from them, as a student, practitioner, and human. Wilcannia remains one of the most fulfilling experiences I’ve had on my training journey.
As the world re-opens, med students will again have opportunities to undertake elective placements across the globe. But there are experiences just as enlightening to be had in our own backyard that shouldn’t be overlooked. And ‘our own backyard’ can mean anything – dusty outback towns, seasonally snow-dusted mountain villages, sun-drenched coastal communities, Antarctic expeditions, or any combination of the above
If you’re reading this, you’re considering general practice as a career. You owe it to yourself to explore the full spectrum of general practice, including the diversity of practice, beautiful communities and stunning environments that rural and remote medicine has to offer. In Australia, rural practice can mean so many different things depending on where you want to work and what you want to do; it’s very much a choose-your-own-adventure situation. You have endless opportunities to find your own niche and are always supported by your colleagues, ACRRM, the Rural Doctors Networks and their sister organisations. All that’s left to do is get out and explore.
These articles, from our GPFirst magazine, are aimed at inspiring the next generation of GPs by sharing real stories of working in practice.
All images supplied by Dr Jackson Blythe.