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GP training on a tropical island – a registrar shares his story

31st October 2017

Thursday Island - the place to be, according to GP registrar Dr Marlow Coates, who has become a ‘Jack of All Trades’ thanks to his placement.

Dr Coates moved to the Island this year as part of his GP training with James Cook University (JCU).

He said he uses a full spectrum of patient care practices due to the limited medicine available.

“It’s your responsibility to deal with patient stabilisation, workup, management, ward care and discharge planning and then follow-up after discharge in the community and ongoing healthcare. It's wonderful to be involved at every level.”

Dr Coates said Thursday Island provided him with many memorable experiences, including working with the aeromedical retrieval service.

“We retrieved a very sick Papuan infant from one of our northern islands. The child required intensive management and eventual intubation in the helicopter on the tarmac prior to further retrieval to Townsville.

“The whole case from initial phone call to handover to Royal Flying Doctor Service took all night. I felt privileged to be able to provide the service and be a small part of a team that saved this child life. They flew home a week later, completely well. Not many jobs provide that opportunity,” said Coates.

Dr Coates said he learns something new every day.

“You have to navigate the logistics of phone consults with patient’s miles away on other islands, who may require retrieval to Thursday Island for workup and care, or GP management from a distance.”

Dr Coates Fellowed with the Australian College of Rural and Remote Medicine (ACRRM) and the Royal Australian College of General Practitioners (RACGP) in 2017, and is staying on to work as a GP on Thursday Island.

Prior to his placement on Thursday Island in the Cape and Torres Strait region, Dr Coates worked at the Mackay Base Hospital where he completed Advanced Skills training in Anaesthetics.

“I tailored my Advanced Skill with Thursday Island in mind as my next location. I knew that anaesthetics was in demand because anaesthetic skills provide both outpatient and inpatient benefit.”

In his spare time, Dr Coates likes to immerse himself in the friendly island community and spend quality time with his family.

“Work keeps me busy. But as soon as there's some downtime, there's always something fun going on.

“Despite the long hours, I get to spend quality time with my wife and daughter, and seeing her grow into an island girl has been amazing. She's already got a long list of Aunties and Uncles who are helping raise her in our small community.

“Perhaps, the most relaxing activity is sitting around our homemade fire pit, on summer evenings, looking out over the water with family and good mates,” he said.

Dr Coates grew up in Mackay, he said he thinks his regional upbringing sparked his interest in rural and remote medical practice.

“I'm not a city boy, and remote doctors are GP 'Jack of all trades' who still get to practice a great breadth of medicine.”

Dr Coates said his rural and remote training placements inspired him to practice as a rural and remote GP.

“I got to go to rural locations that had solid teams and great support. It consolidated my desire to become a rural and remote doctor.”

Dr Coates said medical students thinking about becoming a rural and remote GP should go for it.

“There are only a few specialties that provide the level of rewarding experiences a GP gets.

“I think all the rural and remote health services in Queensland offer a job, a lifestyle, and a beautiful location. Queensland has such a great range of climates and landscapes, and as doctors, we have the option to not only visit, but live and work and become part of those communities if desired.”

Dr Coates said the support provided by JCU was extremely helpful.

“JCU is working practically with registrars to get them through training, and helping to overcome sometimes arduous roadblocks.

Dr Coates said he will continue to learn new skills and strives to be the best rural and remote doctor that he can be, by continuing to give back to the Thursday Island community.

 “The training has been fantastic and continues still. Working remotely is complex and often difficult, but very rewarding. The skills required rurally are broad and there's always something new to learn whether it be office-based, procedural, cultural, or logistical.”

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