Tuesday, 19 April 2016

Students learn realities of asbestos diseases

It’s an unfortunate fact that asbestos diseases are a part of the Latrobe Valley’s story, however Monash Rural Health is doing what it can to arm medical students in the region about how to best assist local sufferers.

For the past eight years, first year medical students at Monash Rural Health Churchill have been educated about the realities of asbestos diseases for its sufferers by those who understand it best, Asbestos Council of Victoria/Gippsland Asbestos Related Diseases Support Inc (ACV/GARDS).

This week ACV/GARDS has again addressed local students as part of Monash Rural Health efforts to ensure students are well versed in the social and clinical contexts of the range of asbestos-related diseases.

Left to right: ACV/GARDS CEO Vicki Hamilton, medical students Naomi E-M and Glenn Teng, carer Dorothy Roberts, Monash researcher Dr Margaret Simmons, carer Marie Smith and medical student Lily Kang.

ACV/GARDS executive and volunteer members were joined by carers, a local mesothelioma sufferer and long-time Traralgon oncologist Dr John Scarlett, all of whom shared their stories and expertise with students.

As the long-time Chief Executive Officer/Secretary of ACV/GARDS, Vicki Hamilton OAM knows only too well the devastation of these illnesses, having lost two family members to asbestos disease – her father and her grandfather.

Monash Rural Health researcher and sociologist Dr Margaret Simmons, who teaches a social perspective on health to medical students, calls on Ms Hamilton and her team each year to share their expertise with local students as part of the course’s exploration of respiratory health.

Ms Hamilton, a committed educator, said many of these students had limited knowledge of asbestos diseases, the risks of asbestos exposure and the impact of a diagnosis on not only a patient but their entire support system.

Dr Simmons said it was vital students understood the issue of asbestos in terms of its impacts on health, some of which may not arise for years, or even decades after exposure.  “We are very proud and appreciative of the strong partnership we have developed with Vicki and her team, and of their passionate input into the course,” she said.

“The work of ACV/GARDS is so important in this area and students often comment on how little they knew about the product; they are surprised at how extensively it was used in the past and often shocked, that despite its dangers being so widely known, asbestos is still not banned in many countries.”

"This is important stuff for medical students to know because when a patient comes to them when they are practising, they will have these people’s lives in their hands..."

Ms Hamilton said the information provided helped students no matter where they end up practising in Australia. “This disease is on the rise all over Australia and the world; particularly given the increase in ‘do it yourself’ home renovations, since asbestos was used so widely in the building and construction industry,” she said.

Overseas imports present a further risk, according to Ms Hamilton. “Increasingly, imports from overseas countries that have not banned asbestos, like Australia did in 2003, are coming into Australia in a range of products including cement fibre board used for flooring, children’s crayons, ceramic tiles and brake linings, which is alarming in terms of future exposures,” she warned.

Dr Simmons said that while ACV/GARDS informed students about the devastating impacts of asbestos on people’s health – and what doctors need to be aware of – the organisation also highlighted “in a positive and compassionate way” the many services it offers sufferers and their families.

Almost 90 students attended this week’s tutorial and student feedback was positive. “I talk about the physical, emotional and social aspects,” she said. “It is not just about the illness itself but about everything that comes with it and how the approach of a doctor can affect the medical path these sufferers and their families travel.”

“This is important stuff for medical students to know because when a patient comes to them when they are practising, they will have these people’s lives in their hands and I want them to be clear that each decision they make should be made as though they are treating one of their own family members,” she said.

Ms Hamilton said mesothelioma rates in the Latrobe Valley were seven times the state average. “Every second person knows someone who has been affected here,” she said, adding that asbestos disease included various forms of mesothelioma as well as lung cancer, asbestosis and pleural plaque disease.

“We advise the students that a really good start is to take a holistic approach to their patient – when someone presents with symptoms, ask them where they worked, where did their family members work and look at the possibilities – patients can sometimes expect doctors just to ‘know’ things but they don’t just ‘know’, they need help from the patients,” Vicki said. “It goes both ways – we also support sufferers and their families to advocate strongly for themselves when they go to the GPs.”

Ms Hamilton said asbestos disease used to be poorly diagnosed and a silent killer but this had improved, in part as a result of increased awareness and education. As an organisation ACV/GARDS links in with the Gippsland Cancer Care Centre about new immunotherapy treatments and continually builds its own knowledge base. Ms Hamilton said ACV/GARDS also had medical equipment it could supply to sufferers to make them more comfortable.

She said she was encouraged by the responses of students she speaks to about asbestos diseases. “I once had a student approach me eight years after one of these talks and he said the tutorial had always stayed in his consciousness…that’s why I do this work,” she said.

Monday, 18 April 2016

Talented medical student won over by rural experience

High achiver: Matthew Howard won Monash Rural Health Churchill graduation prize for the highest aggregate mark. He plans to return to Gippsland with his family.
While it may have been love that first attracted Matthew Howard to West Gippsland, the experience of living in the local community won over the talented former Monash medical student, who hopes to return as a specialist in the future.

Matthew grew up in Geelong but moved to Bendigo to complete a Bachelor of Pharmacy after completing secondary school. Midway through the degree the high achieving student undertook GP placements and found a particular affinity for the diagnostic component of his studies.

“I felt that this was a step in the right direction for me and a challenge and I really enjoyed getting to be involved in all facets of patient care and communication,” he said.

What came next was a decision to move to Gippsland, where Matthew’s wife was born and had returned to work, and commence the graduate entry medical degree at Monash Rural Health’s Churchill site.

For five years, until the end of 2015, Matthew made Gippsland his home. His time spent with Monash Rural Health was marked by significant academic achievements. He took out the prize for Highest Academic Achievement for Monash Rural Health Latrobe Valley and West Gippsland year 4 students and followed that up last year with the Monash Rural Health (Churchill) Graduation Prize awarded to the graduate entry program final year student with the highest aggregate mark.

Matthew said studying locally offered multiple benefits for budding doctors. “I think you become part of the community,” he said. “As a student I felt everyone at West Gippsland Hospital and Latrobe Regional Hospital took me under their wing and I was never seen as a peripheral member of the team as all medical students are so welcomed and supported.”

“I felt really invested and I think I had far more practical opportunities as a rural student; I was assisting in surgeries by third year, I was able to really develop my practical skills in suturing and putting in IV (intravenous) lines, I was delivering babies in Warragul and seeing patients alone when I did my GP placement in Neerim South – all of those are opportunities a text book can’t provide you with,” he said.

Matthew credits his time with Monash Rural Health, where he built relationships with numerous local medical professionals who he described as “passionate, friendly and enthusiastic teachers”, with providing the foundations for his current medical internship at Melbourne’s Alfred Hospital.

“Now, as an intern, I am finding that the various roles of a junior doctor not so foreign to me due to the great hands on experiences I have had during my time at Monash,” he said.

Matthew’s internship program consists of intensive blocks of work in various units, including general medicine, colorectal surgery, urology, the emergency department and aged care. Though for now he and his wife, who has taken up a place in a speciality orthodontics training program, are committed to building their expertise in Melbourne, their longer term vision is to return to Gippsland.

“We definitely want to come back,” he said. “After spending time there and seeing the population growth around Gippsland we think that this is where we can best serve the community in health care and we think it’ll be a great region to one day raise a family.”

The humble young doctor said being awarded last year’s graduation prize was a surprise. “I didn’t know there was prize for rural students so I felt very honoured that my efforts and studies had all come to fruition – it was fantastic! I thank Monash University for a great medical course” he said.

Friday, 1 April 2016

New medical students welcomed in Gippsland

The importance of medical students prioritising their own health and wellbeing as they embark on intense years of study and training was emphasised during a recent welcome dinner for the cohort of Monash Rural Health Traralgon and Warragul students.

Held at the Black Tie function centre in Warragul, the dinner was attended by most of the 69 Monash medical students who will spend this year on placement with Monash Rural Health across West Gippsland and the Latrobe Valley.

Key general practitioners and specialists from the region’s two hospitals and numerous local teaching general practices were also in attendance. Monash Rural Health Latrobe Valley and West Gippsland Director, Associate Professor Joseph Tam – who also spoke on the night – said the synergy between the university and the local community was evident at the event, as was the support for students.

Guest speaker at the dinner was new Monash Rural Health Head of School Professor Robyn Langham. She was joined by fellow speakers, MC Dr Paul Brougham and Indigenous Elder Linda Mullett who did the Welcome to Country.

West Gippsland Councillor Debbie Brown, Latrobe City Councillor Kellie O’Callaghan and Federal Member for McMillan Russell Broadbent all welcomed new students on behalf of the community while Latrobe Regional Hospital Chief Medical Officer Dr Simon Fraser extended a welcome on behalf of two local public hospital executives.

Dr Joseph Tam and Head of School, Prof. Robyn Langham, with Year 3B Academic Achievement Award recipient Deepika Gunda.

The Year 3B Academic Achievement Award was presented to Deepika Gunda.

The event also saw the inaugural presentation of the Dr Robert Hall Memorial Academic Award, presented to the highest achieving Year 4C student Tiarni Templeton.

Dr Tam with Dr Robert Hall Memorial Award recipient, Tiarni Templeton, and award presenter, Janneke Hall.

Dr Hall, who died in 2014, was well known and respected for his contribution to rural medicine and medical education. The public health physician, who taught at Monash Rural Health, held many senior positions over a 35-year career in public health, including in Indigenous, community and environmental health.

Dr Hall was one of the four foundation member of the Centre for Rural Health which was not only the first Rural Health Unit in Australia and probably was also the first in the world. It has grown over time to the current Monash Rural Health with foot print over the North West as well as the South East of Victoria.

His contribution to medical education included serving as a member of numerous Australian Health Ministers' Advisory Council and National Health and Medical Research committees (NHMRC).
Dr Hall served on the Council of the NHMRC and supervised candidates for Fellowship of the Australasian Faculty of Public Health Medicine. Dr Hall also chaired the Technical Advisory Group on Immunization and Vaccine-Preventable Diseases for the Western Pacific Region of the World Health Organization.

Postgrad training the key to rural doctor shortages

The three Victorian Universities who oversee education in Victorian rural medical schools have formed an important collaboration in a proposal to the Federal Government to set up regional postgraduate medical training networks across Victoria.

Lack of specialist training opportunities in rural and regional Victoria is the main cause of a shortage of doctors.

The goal of the Victorian Regional Medical Training Network (VRMTN) is to improve the distribution of doctors in regional and rural Australia by expanding rural and regional postgraduate vocational medical training.

Head of Monash Rural Health, Professor Robyn Langham, said the three universities (Monash, Deakin and Melbourne) recognised the importance of regional post graduate training.

She said rural and regional Australians continued to suffer worse health outcomes than their metropolitan counterparts.

“Many medical graduates who train in rural and regional areas wanted to remain there but rurally based postgraduate training opportunities are extremely limited,” Professor Langham said.

“After five years of study, medical students move into their intern training and then need a further two or three years of training to become competent independent practitioners. This might be in surgery, paediatrics, obstetrics or psychiatry. At present, there is limited opportunities available.

“Students are forced to return to metropolitan areas to get this specialist training and many end up staying there when we know anecdotally, they would prefer to study and live in the bush.”

Commenting on a plan by Charles Sturt and La Trobe universities to develop a new medical school in Victoria and New South Wales, Professor Langham said more medical schools was not the answer to the shortage of doctors in rural and regional areas.

“We need to focus our energies in the postgraduate training space,” she said. “This is what our students are telling us too.”

The Federal Government has already committed $150 million to set up 30 postgraduate training hubs Australia-wide but is yet to announce the locations.

“A truly collaborative approach between university and community, encompassing federal and state government responsibility should be recognised as the optimal way in which to harness limited resources to deliver more rurally trained doctors. ” she said. “This is an opportunity to set up a pathway that will ultimately have a positive impact on the health and wellbeing of people across regional Victoria.”