Training ‘with, in and for’ underserved communities

James Cook University’s GP training program supports registrars to live, learn and work alongside inspirational educators, supervisors and mentors in diverse regional, rural and remote locations across Queensland.

On Thursday Island (Waiben), JCU GP Training has a team of five registrars and 11 supervisors who exemplify JCU’s sustained efforts to provide a quality, fit-for-purpose medical workforce for underserved communities. The rural generalists of the Torres Strait Islands play an important role in shaping the next generation of doctors, overseeing JCU Medicine students on rural placements that range from four weeks to 10 months.

Drawn to the breadth of interesting medicine, laid-back lifestyle and the unique culture of the islands’ traditional owners, JCU’s GP supervisors and registrars are part of a culturally safe GP workforce invested in the health of the 18 Aboriginal and Torres Strait Islander communities. “It’s a great place to live and a great place to work – very fulfilling, professionally and lifestyle wise,” says GP registrar and Thursday Island Medical Superintendent Dr Adam Holyoak, for whom general practice will be his third specialty.

Tropical medicine in the waters between Far North Queensland’s Cape York Peninsula and Papua New Guinea can mean treating everything from crocodile and shark bites to spear wounds, tuberculosis and rheumatic fever. “One of the interesting parts, but also one of the challenges, is that Thursday Island is the base for 17 different outer islands that all have primary health care clinics,” Dr Holyoak says.

“Every week or two, we run clinics on those outer islands, but most of the time there’s only a remote area nurse and Aboriginal and Torres Strait Islander health worker on the island. This means any acute problems that come up need to be managed from afar. Trying to manage things remotely and use the resources that you have to retrieve them back into the hospital on Thursday Island or refer them onwards to city specialist care is a challenge and also one of the interesting things about working here.”

He says the geography of the Torres Strait Islands makes for a unique training experience for GP registrars. “You start working in their general practice on Thursday Island and as you get experience you can then go and work out on the outer island clinics, which are a lot more independent and have remote supervision rather than necessarily direct person-to-person supervision,” Dr Holyoak says.

“You’re getting to work in the hospital, doing some hospital-based medicine and in the emergency department. There’s a wide breadth of training and experience that you can get here because of the link to the hospital.”

JCU is Australia’s only university delivering both undergraduate medical training and postgraduate general practice training. The end- to-end pathway of medical training is being used to develop a skilled, fit-for-purpose health workforce to address the shortage of doctors in regional, rural and remote communities.

Sixth-year JCU Medicine students Georgia Bulley, Claire Hu and Visai Muruganandah did extended placements on Thursday Island and loved the experience of working with the community. An aspiring rural generalist, Georgia is excited about the level of clinical skills she attained during 10 months embedded in the Bamaga (Ichuru) and Thursday Island communities. “I love that here you can really make a difference in people’s lives,” Georgia says. “The relationships I have been able to build with the doctors here add so much to the experience.”

Claire extended her final-year placement on Thursday Island from 10 weeks to six months. “It’s been so enriching to work with Aboriginal and Torres Strait Islander peoples and see how their culture is celebrated, as well as gain insight into their unique health issues,” Claire says. “The doctors here really make us feel like we’re valued team members and that we contribute to their work.”

Visai was on the island for his final term after a 10-week research elective working as part of a tuberculosis vaccine development team in Cairns. “The opportunity to experience a part of the country that is so remote yet has so much culture and beauty to offer is invaluable,”

Visai says. “The community has been incredibly welcoming, and the hospital is a friendly place to work. There is a broad range of clinical experiences, including primary care, ward medicine, emergency medicine and even outreach clinics to some of the other islands in the Torres Strait. I couldn’t think of a better way to finish medical school.” 

Dr Holyoak says students get experience at one of the outer island clinics and see all aspects of care provided on Thursday Island, from emergency medicine to allied health and community-based care. “We try to give any of the students who come up here a good, broad introduction and immersion in rural and remote medicine,” he says.

JCU GP Supervisor Dr Jennifer Wharton, the Acting Director of Medical Services at Thursday Island Hospital, worked in the Torres Strait as a junior doctor and returned when her oldest daughter was nine months old, intending to stay for a year or two.

She completed her GP training with JCU, gave birth to her second daughter on the island, gained her advanced specialised skill in Aboriginal and Torres Strait Island medicine, and trained as gastrointestinal endoscopist through the Rural Generalist Endoscopy Training Program.

“It’s one of those communities where the longer you stay, the better it gets, so seven years later, we’re still here with no plans of moving on in the future,” Dr Wharton says. “One of the better parts of the job is supervising medical students, junior doctors and registrars. It’s really great to be involved in being able to shape and grow the next generation of practitioners.”

Dr Allison Hempenstall did her general practice training in the Torres Strait with JCU before completing a Master of Public Health remotely as a Fulbright Scholar with Harvard University in 2020 when the COVID-19 pandemic ruled out in-person study in Boston.

Dr Hempenstall is back on Thursday Island, dividing her work week between training as a public health specialist and working as a GP. “We’re lucky that we have a small, tight-knit group of clinicians here,” she says. “It’s a unique place with a unique culture and unique medicine. It’s a real privilege to be able to train in the region where you have exposure to an incredible number of interesting people and pathologies that you may not see if you trained elsewhere in Australia,” she says.

JCU is making rural health matter. We believe everybody deserves access to a doctor, no matter where they live. Learn more about GP training with a difference.