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Remote work – wider horizons
As a city girl from Logan, near Brisbane, third-year medical student Sonya Manwaring did not quite know what to expect when she ventured to the south-west Queensland town of Charleville for her rural rotation.
“I had never spent more than a few days in a town that small,” she recalled. “But my first impression was how keen everyone was to get you involved, both in the hospital and the community.
“I was allowed to tackle work at the hospital that I probably wouldn’t have been able to do in a bigger centre, and the community straight-away wanted to know what they could do to make my stay enjoyable.”
Her experience prompted her to join the James Cook University General Practice (GP) training program. She returned to Charleville as a senior medical officer in February this year, after completing advanced skills training in anaesthetics at Ipswich Hospital.
Dr Manwaring is relishing the scope of learning opportunities available to her through her work in the remote community, which has a population of around 3,300 people.
“That’s the whole point of this training pathway,” she said. “It's well recognised that as a rural doctor, because of the lack of available services, we actually have to be able to deal with a wider variety of challenges than doctors in major cities.
“We receive a wonderful breadth of experience; between doing the GP work and the emergency work, the work up on the wards and – in my case – some anaesthetics as well.
“I get to do so much and I find that awesome, because I love continuously learning and doing new things.”
Dr Manwaring believes the tyranny of distance is honing her professional skills at the modest-sized hospital, which contains 15 beds in the main ward and four in the Emergency Department (ED), as well as a small maternity unit and an allied health section.
“We don't have access to a lot of hi-tech investigative equipment, such as CTs and MRIs” she said. “Our closest CT is in Roma (more than 260 km away). We have to rely much more on our clinical skills to evaluate whether it is worth transferring a patient away from their family and friends to get an investigation. It’s a long round trip.”
Dividing her time between the hospital and general practice enables the young doctor to see the end of every patient’s story.
“You get to follow everything through to completion,” she said. “You're not left wondering what happened to that patient you sent up to the ward from the emergency department.”
Dr Manwaring’s advanced skills training also makes her one of only two doctors at the hospital who are qualified to administer anaesthetics.
“My colleague and I are the ones that everyone comes to,” she said. “So we have the lead in an area that we probably wouldn't have the opportunity to take in the city.
A heavy on-call burden means that she and her colleagues must regularly monitor their stress and fatigue levels.
“But when you're well supported, with the good team that we have in Charleville at the moment, then that is quite easy to do,” she observed. “Because we are all very mindful about how everyone else is going and what each other's on-calls have been like of late.”
Hectic work schedules are more than offset by the depth of appreciation from a community that does not take access to quality healthcare for granted.
“Charleville has really welcomed us with open arms and open hearts,” Dr Manwaring said. “The community is forever showing their gratitude and saying ‘thank you’. The patients say how nice it is to have permanent doctors. A number of women also appreciate being able to visit a ‘lady doctor’.
“They all want us to stay, so they go out of their way to make us feel comfortable and help us find ways to follow our interests.”
She has been playing a little touch footy, which she loves, and also indulging in other favourite pastimes, such as cooking and sewing – although these are taking a back seat to exams at present.
Dr Manwaring has no plans to leave Charleville after she completes her last year as a registrar and is fellowed. She is confident others will quickly fill her shoes as a remote trainee GP.
“When it comes to remote area training, really the world is your oyster,” she said. “You get to choose the size of the town where you work and your preferred advanced training skills. And depending on where you want to work, you get to decide the ratio of hospital-based to GP-based work you do. You really get to do whatever you want to do.”