Tuesday, 20 September 2016

Rural study leads two graduates to practice in Traralgon

The two newest faces at Traralgon’s Breed Street Clinic are proof that studying medicine rurally motivates students to opt for rural futures. Doctors Lisa Gilbert and Danielle Winkelman-Stothard have commenced a six-month GP training placement at the Traralgon clinic, with both expressing the intention to stay local once their training is complete.

Support network critical to young doctor

Dr Danielle Winkelman-Stothard: rural support has been invaluable.
Danielle is no stranger to the Latrobe Valley. Raised and schooled in Morwell, she attended secondary school at Kurnai College before completing a science degree at Melbourne University. When Monash University introduced its graduate entry medical program in Churchill back in 2008, the self-confessed “country bumpkin” jumped at the chance to leave Melbourne behind and return home, to the fold of her family, and embark on studying medicine.

“After four years living in Melbourne, I knew I wanted to come home,” the accomplished mother of twin toddlers said. Danielle undertook most of her ‘rotations’ in rural settings while completing medical studies, embracing the “hands on” and supportive nature of her placements in hospitals and clinics all over Gippsland. "I think things would have been immensely harder for me had I not been studying rurally,” she said. “Everyone locally has gotten to know me, they know my twins and they have gone above and beyond to support me.”

An initial GP training placement at Heyfield medical centre convinced Danielle that general practice could “offer me the best of everything”. “I was interested in respiratory, cardiology, paediatrics and the holistic nature of medicine, getting to know patients,” she said.

Danielle’s enthusiasm for learning has seen her complete numerous additional diplomas covering areas including obstetrics and gynaecology and child health – and she has no intentions of stopping there, citing dermatology and sexual health as other areas of interest.

Danielle has firm plans to stay in the Latrobe Valley. She said the personal and professional support offered to her through a local doctor’s Mums network had been invaluable in helping her to cope with the competing demands of motherhood and general practice.

An aspirational message

Dr Lisa Gilbert: it's important to live near where I work.
A series of fateful events lead to Melbourne-born and Albury-raised Lisa Gilbert arriving in Gippsland to study medicine back in 2001. Lisa is passionate about spreading a message of aspiration among students who fear their previous schooling experience or own lack of opportunity prevents them from exploring medical studies.

“My high school was a ‘poor performer’ and my ENTER score would not have allowed me direct entry to medicine but that doesn’t mean I didn’t have the aptitude or intelligence required,” she said.

Initially, Lisa completed a biomedical degree at RMIT. “I never thought I could be a doctor but I really liked science and the idea of research,” she said. Despite having no previous awareness of the Graduate Medical School Admissions Test (GAMSAT), Lisa decided to join her RMIT peers in studying for, and sitting, the test - with no expectation of a positive outcome.

Post-graduation, while working as a medical scientist, her career direction shifted gears upon news of a good GAMSAT result – but not before she headed overseas with her British partner for 12 months to work a series of unskilled jobs while they waited for his permanent visa to come through. Returning to Australia, Lisa attended an open day at Monash Rural Health Churchill and was immediately won over. “The campus is beautiful, everyone was so welcoming – they really care about who you are, your story and how they can support you,” she said.

Given the rigours of life as a medical student, and young doctor, “it became very important to me to live near where I work,” said Lisa. “I like the simple life, I hate traffic and commuting – it makes everything so much harder.”

A series of supportive local placements during her studies, particularly at the Heyfield hospital, coupled with the opportunity to specialise in GP in Gippsland convinced Lisa and her partner to establish their lives in the region. “We have put down our roots here and we are happy to stay,” she said. “GP is a great fit for me, I love the variety, independence, responsibility and the feeling that we are building relationships and making a difference.”

As she continues her training next year, Lisa hopes to spend more time working locally and will undertake a stint in Latrobe Regional Hospital’s emergency department.

Monday, 19 September 2016

Student volunteers time in Tonga

Bendigo medical student Katie Blunt will pursue her interest in global health after her first taste of volunteering overseas. Katie, in her first clinical year with Monash Rural Health Bendigo, spent two weeks on the Tongan island of Vava’u with TeamMED, a student-led organisation providing Monash University students with a chance to experience and contribute to global health. TeamMED makes health trips to Tonga, Uganda and Nepal every year.

“I have wanted to go on one of these outreach programs since my first year of medicine,” Katie said.
She joined three fourth year students, a second year student and a first year student on the island which had a 40 bed hospital for the population of 15,000 people. Tonga has an endemic of obesity and the chronic diseases that come with it,” Katie said.

“Food is a large part of the culture. People grow their own food and have wonderful feasts but there is little health promotion or understanding about what constitutes a healthy diet. There are also a number of barriers to health care for those affected by chronic disease, including lack of education, geographic isolation and financial restraints.  Our aim was to develop an awareness and appreciation for chronic disease like diabetes and high blood pressure, as well as to promote healthy living in a culturally-sensitive manner.”

Katie and the TeamMED team visited the Prince Wellington Ngu Hospital’s general, maternity and children’s wards as well as conducting free health clinics in and around the town of Neiafu. The language barrier was difficult with the older generations however Katie said younger people spoke English which made communication with patients much easier.

“At times the experience was confronting but very rewarding,” she said. “We are a fortunate country and while we hear about many global health problems, we often don’t realise that our Pacific neighbours need help too.”

Katie, from Melbourne, is relishing her year in Bendigo, spending time in the Bendigo Base Hospital as well as the Monash Rural Health clinical school. “This is the best year of my course,” she said. “I’m finally working in a hospital and getting hands-on clinical experience which is invaluable.”

Although Katie grew up in Melbourne, she lived in America for five years until her teens. Her interests “aligned” and pointed in the direction of medicine as a career. “It always felt like a natural fit and I’m loving it,” she said.

A keen water polo player, competing at a high level, she gave it up which freed up time for other interests, including global health. And while she hasn’t decided on a medical specialty yet, more volunteering is definitely on her agenda.

Friday, 16 September 2016

Health & human rights links explored by medical students

Medical students at Monash Rural Health have been challenged to explore the links between health and human rights in a unique way during recent seminars. Moral philosopher and Adjunct Professor, Dr Dean Cocking, addressed the local students as part of their personal and professional development curriculum.

Dr Dean Cocking: health care and human rights promote one another.
The freelance academic and author from Castlemaine has been talking to medical students in the local area for the past four years about the relevance of ethics in medical practice. Dr Cockings said his approach was underpinned by the principle that treating patients and consumers with respect leads to professionals practising good judgement and investigation, ultimately making them better at their jobs.

The philosopher, whose background includes working with the Australian Defence Force Academy, Australian National University and the Victorian Police Academy, takes a grounded approach to his teaching.

“I think it is really important when you are teaching professionals about their ethical responsibilities that what you say is relevant to their everyday practice rather than asking them to focus on the most unusual or extreme cases,” Dr Cocking said. “What I emphasise is that health care and human rights promote one another and that if you respect people – patients, clients, the public – that should be the rule of thumb; but then it’s important to explore what is this notion of respect and what does respect mean to them as health professionals?

“Because of the demanding workloads medical professionals face, they can become jaded and miss certain things so I tell some everyday true stories from a range of areas of professional practise about how remaining open minded, paying attention and not assuming too much are not only markers of respect but they lead to good investigation as well, hence, in the case of medicine, better patient outcomes,” Dr Cocking said.

“I am presenting values as a means of getting better, technically, at their jobs - and this seems to resonate. As a medico these students will not be the patients’ friend or family member but they will not be a complete stranger either; they will have an institutional role and body of knowledge and it is important how they use this – I try to show them that what they are doing in everyday practise is a moral enterprise.”

Monash Rural Health Bendigo lecturer Pam Harvey said student feedback following Dr Cocking’s seminars was positive. “He challenges students to think about ethics on a deeper level and provokes reflection in a way that I think will stay with them as they embark on their careers,” she said. “We always talk about the uncertainty of medicine and how you never find a textbook case of anything so you need to learn to cope with the uncertainty and stay open minded,” Ms Harvey added.

Dr Cocking is the author of two books, Virtue Ethic and Professional Roles, (with Justin Oakley), Cambridge University Press, and Evil Online, (with Jeroen van den Hoven), Wiley-Blackwells, which is forthcoming at the end of this year.

Thursday, 15 September 2016

Passions & Pathways introduces students to health professions career

A group of local year six students became familiar faces around Monash Rural Health’s Bendigo site as part of an innovative primary school and workplace partnership program. Passions & Pathways, an initiative of local businesses, paved the way for a seven young Eaglehawk Primary School students to spend time at Monash Rural Health over four weeks.

Eaglehawk Primary School students suit up for a session in the simulation lab.

Goldfields Local Learning and Employment Network (GLENN) Executive Officer Anne Brosnan said Passions & Pathways helped to raise the aspirations of students from disadvantaged schools by immersing them in workplace environments and “teaching them new things.”

While the program relies on the co-operation of industry partners such as Monash Rural Health, Ms Brosnan said participation also provided benefits to employers of the workplaces involved.

“The industry partners who have come on this journey with us say that they love the chance to engage with these students before they transition to adolescence,” she said, adding that as the program progressed it was attracting increased attention from Bendigo employers.

Monash Rural Health Bendigo Lecturer Pam Harvey said this was the second year the clinical training site had been welcoming students and in 2016 participation in the program has been embedded into the paediatrics curriculum of its medical students.

“This program opens the primary students’ eyes to job and career opportunities but it also provides valuable teaching moments for our own students,” Ms Harvey said.

The primary school students’ visits to Monash Rural Health included time spent in its simulation laboratory, where they ‘suited up’ in appropriate medical attire and learn about identifying germs, bodies and the tools of the doctoring trade, as well tours of the training site and Bendigo Health.

Pam Harvey at the students' expo
“We hope that, through having these authentic experiences in local workplaces, students can see that these employers care about them and that this, in turn, helps students to value the ideas of learning, training and employment,” Ms Brosnan said.

During their time at Monash Rural Health students collected information for a presentation at their school in mid-September, attended by industry partners. “The feedback we hear is that this is a highlight for our own staff who attend,” said Ms Harvey. “This provides evidence of the connections and relationships which are formed as part of the program.”

Wednesday, 14 September 2016

Summer scholarships offer regional students a taste of research career

A research scholarship program  run by Monash University over the summer break offers tertiary students from any university the chance to try out a career in research.

Monash Rural Health summer scholarships coordinator, Associate Professor Rebecca Kippen said deciding whether to pursue a research degree is hard when you’re not sure if you’ll enjoy a research career. “These scholarships are rather like a work experience placement – you work with real data, on real research projects with real researchers to see if it’s a career option you want to choose,” said Associate Professor Kippen.

“We have a number of projects on offer in Mildura, Bendigo and Gippsland for students interested in rural health research,” she said. Projects include looking at:

  • how to retain rural GPs
  • how to reduce unnecessary presentations to regional emergency departments 
  • community awareness of cancer risk factors
  • sports injury prevention in cricket
  • improving medicine information for lactating women about infant risk
  • presentations and clinical outcomes of patients at a rural early psychosis team

Scholarship students are trained in a particular aspect of research and spend two or three weeks working under the supervision of a researcher. Projects run between December 2016 and February 2017 with students paid a weekly stipend of $200.

“It’s as genuine an experience of research as we can make it and we provide a lot of support for students,” said Associate Professor Kippen. Associate Professor Kippen knows well the value of summer programs like this – she decided to pursue a PhD in demography after attending a summer school in Canberra.

The scholarships are open to undergraduate and coursework postgraduate students at any Australian university and are awarded based on academic merit.

Applications are currently open and close on Friday 7 October 2016.  See the summer scholarships website for details.

Policy signals from 5th Rural and Remote Health Scientific Symposium

The 5th Rural and Remote Health Scientific Symposium in Old Parliament House of Canberra on 5-7 September 2016 was an excellent event which brought together leading voices in rural health policy and research. The opening address by Matilda House of the Ngambri-Ngunnawal clan introduced the Hon Dr David Gillespie, the new Assistant Minister Rural Health, who provided a strong overview of the Australian government’s shaping agenda in rural health.

Dr Belinda O'Sullivan presented a Lightening Talk  about models to deliver specialist services in rural and remote Australia. (5:36 mins)
The government’s agenda is clearly focused on getting the right mix of health workers with relevant skills in rural and remote Australia, focusing on delivering accessible, cost-effective and sustainable health care to rural and remote people.

A new Rural Health Commissioner signals the government’s commitment to improve rural health. Research and evidence are emphasised as critical to help shape the government’s agenda, specifically informing Medicare reform, the use of overseas-trained doctors, workforce programs, commissioning via the Primary Health Networks and healthcare homes. The government is committed to expanding the use of technology for more convenient and efficient care, not replacing services on the ground.

Other presentations spanned policy, practice and research. Prof Duckett overviewed research from the 2016 Grattan Report Perils of Place which diverged into a range of discussion about place-based amenity and indicators to signal medical workforce need, service gaps and the need for better planning.

The five minute lightning talks are a very digestible format to get the flavour of work being done in rural health nationally. (View Dr O'Sullivans's talk 5:36 mins.) Excellent panels and plenaries went into more depth as to indigenous health research, the use of small hospitals, re-instituting rural maternity services and building rural health research capacity.

Dr Matthew McGrail and Dr Belinda O’Sullivan enjoyed the chance to present emerging research from their work using MABEL data. This symposium was short, sweet and perfectly pitched to enthuse passion in rural health policy, practice and research. See the presentations on the National Rural Health Alliance website.

Monday, 5 September 2016

Taste of research life in Bendigo

Three students spent time at Monash Rural Health Bendigo in December 2014 and January 2015 working with Senior Research Fellow, Dr Bernadette Ward, on current research projects.

Jarrod Verity

I want to thank Dr Bernadette Ward and staff at the School of Rural Health for making my time there so enjoyable and valuable.

Being able to actually apply the skills I’ve been taught in classes to real research was extremely satisfying, and my proficiency in SPSS has greatly improved as a result. Being able to live in another city was also a highlight, and something I’m sure many students would love to have in the future.

Finally, the chance to go to Mildura fulfilled one of my biggest goals for the trip; to go out and see the countryside and life away from Melbourne.  I won’t ever forget that trip, even if it was for only two days.  I’ll definitely be telling my friends to keep their eyes open once new scholarships are released next year - many of them were quite amazed a program like this was available.

Kate Xu

My research experience at the School of Rural Health in Bendigo provided me with a great opportunity to get involved in analysing survey data using SPSS software; I have learnt a lot from the hands-on experience under the supervision of Dr Bernadette Ward and Dr Rebecca Kippen. It was exciting to reveal some interesting results.

The research environment at Bendigo was very supportive and inspiring, allowing me to extend my professional network. Besides academic support, my supervisors and the team also hosted me warmly throughout my stay. I stayed at a big, modern student resident house close to Monash University. In summary, the Summer Research Scholarship provided me with invaluable experience of researching, learning, travelling and networking. I truthfully wish to join the team again in the future.

Hannah Punton

My project involved cleaning and analysing secondary data. It was the second biggest excel sheet I have ever seen! Yet with the help of Dr Bernadette Ward and another student, I was able to power through while developing some keen skills on the number pad.

I very much enjoyed my time here, I met great people, and learned more about the School of Rural Health, which I hope to remain a part of for some time. Furthermore, this experience has enabled me to get involved in a medical research project at my placement in Traralgon.