Tuesday, 21 November 2017

Warragul paediatrician heads new push to keep young doctors local

As a young paediatrician, Michael Nowotny, and his new wife Jo, wanted to do something fun. So they moved to Darwin.

Dr Michael Nowotny
It’s perhaps not so surprising a decision given his peripatetic childhood. With his diplomat father, Michael spent years travelling between the UK, Switzerland, and Thailand where he went to school with the children of American service personnel during the Vietnam war.

A long way from Vietnam, Darwin still had its own challenges. While Jo studied law, Michael worked as one of three junior registrars at the Royal Darwin Hospital. “It was a very busy unit and in the wet season it was crazy because we had really, really sick Aboriginal children come into the hospital all the time. We worked really hard, but developed good independence, problem solving skills, and learnt how to deal with finite resources.”

Stemming the doctor drain

It’s those sort of learning opportunities that the Warragul-based paediatrician wants available to junior doctors in Gippsland. It’s why he agreed to head up the Gippsland Regional Training Hub, one of Monash University’s two new regional training hubs that are working to create clearer pathways for medical graduates to do their specialist training in rural and regional Victoria. “Despite being fully committed, I couldn’t pass it up,” he said.

The drain of junior doctors from regional areas takes place between their second and fourth years after graduation he explained. “That's where we really lose most trainees. There are really good opportunities for interns in Gippsland through a couple of well set up intern training programs.” But after that training opportunities all but vanish.

“Junior doctors who would like to stay in a regional area can't because there aren’t many training opportunities for them. These are really, really committed young doctors who have often have come from the region that they're working in, who would like to stay, and who would potentially like to work in the region long-term. Unfortunately once they're attracted out of the region and move to alternative regions, meet people in the region and partner those people, it's very hard to get them to come back.”

A passion for rural practice

It was an opportunity twenty years ago – and family ties – that eventually drew Michael and Jo to Warragul from Darwin after seven years. With Charles Hamilton, Michael established a paediatric practice that quickly grew from the two of them to five practitioners. Education was an important focus of the practice right from the start.

With his practice co-located with the Warragul hospital he teaches in both his rooms and the hospital. Monash University medical students in their second clinical year, advanced trainees, two senior registrars, a general practice trainee and a rotating basic trainee from the College of Physicians are all there gaining experience in a “really busy training space”.

“I think it's important to try and encourage young doctors to come to rural places because the experience and enjoyment of being in a rural place is just wonderful. It's very different to working in the city. I'm really passionate about that component of what I do.”

As well as teaching in his practice and the hospital, Michael is head of paediatrics assessment with the College of Physicians. “I felt that it was important to be involved in the college because it has given me a lot over my training. And mentoring young doctors is really important to me particularly in the rural space. I am trying to be a rural voice to assist in making people understand how good it is to be working in a rural area.”

It’s an enjoyable lifestyle as well. Squeezed around his paediatric practice and teaching commitments, Michael plays the odd game of golf, and runs cattle on a 40-acre farm near Warragul where he and Jo raised their three children. The farm might see a little less of him as he sets the foundations for the postgraduate training hub.

Training hub to draw networks together

The initial phase has established a number of new advanced training positions in the region, but Michael sees the hub’s role as much greater: attempting to draw together existing groups who have been working to set up regional training networks. “That's what I feel is probably my most important role if we can do it: to try and get all the various groups around the table and see what we can do to advance networking of – not only existing training opportunities – but trying to create new ones.”

Education at all levels is close to his heart. “My son is a Monash medical student and I have tried to instil in him and to my students how important it is for them to pass on their knowledge to the next generation. I was beautifully mentored when I was a student and a trainee, and hope that my trainees feel mentored and supported. I want the next generation to feel that is part of their role.”

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