Don’t forget your toothbrush

Evan has found himself retrieving patients with the Royal Flying Doctor Service (RFDS) out of Mount Isa, working in an Indigenous Health practice in Rockhampton before jetting off for five weeks to London’s busiest trauma centre, St Mary’s Hospital.

“It’s been a busy year. When people ask where I have been living this year, I tell them I am of no fixed address,” he joked.

Growing up in Melbourne, the decision for Evan to head north for his degree was an easy one.

“I chose JCU because of the commitment to Indigenous health and addressing the barriers of access to health for rural and remote Australians. That really appealed to my sense of social justice.”

Six years on, with many rural and remote placements under his belt, Evan is confident he made the right choice.

“The rural placements have been far more engaging and hands-on than I expected – which has been brilliant. They have been fantastic learning experiences where we were given a large degree of autonomy and responsibility under the supervision of close mentors.”

“In my experience, rural medicine is the kind of multi-skilled medicine that every TV doctor practises but no urban doctors get the chance to.”

Evan recently experienced this during a 10-week placement in Emerald, Central Queensland.

“A woman presented at the emergency department and I was the first one to see her. She was admitted, so I saw her on the morning ward rounds and then when a visiting specialist came in from Rockhampton, I scrubbed-in and assisted in theatre,” he said.

“That patient really highlighted to me how rural placements allow students to be significantly involved in a patient’s treatment and experience a continuity of care that is rarely experienced in a major urban hospital.

“And it was terrific to be mentored by the incredibly supportive doctors in Emerald - many of whom are JCU graduates. They reinforced to me the decision to ‘go rural’ was right for me.”

While out in Central Queensland, like at all his rural placements, Evan was also able to get a taste of life in a country town.

“I liked Emerald. There was a really good sense of community,” he said. “We had a great time out there, forming a trivia team in the local pub competition and a number of us from the hospital even made our way out to a couple of country races - it was fantastic.”

Reflecting on his final year at JCU, Evan said there were many highlights.

“The RFDS placement was brilliant,” he said.

“From Mount Isa, we went all the way up to the Gulf. One day we were up in Normanton on a retrieval and the next day we were as far south at Birdsville doing an outreach clinic.”

Evan learnt a valuable lesson on one particular flight – don’t forget your toothbrush.

He was on a retrieval with two patients onboard when the flight was diverted to a remote cattle station, near the Northern Territory border, where an oven had exploded.

“The flight nurse and doctor turned around said `if this patient can’t walk onto the plane we’ll have to leave you behind’.”

Luckily for Evan the patient was mobile!

On other rotations during his final year, Evan was on the receiving end for retrieval patients in a large referral hospital. “At the Cairns Hospital emergency department we saw the other end of the process,” he said. “A lot of patients from the Cape and Torres Strait were flown to us.”

Cairns also allowed Evan to solidify other important skills.

“We are not only well taught but we are also able to practise our intercultural communication with both Aboriginal Australians and Torres Strait Islanders,” he said.

“You learn from your patients - it’s really fascinating. There are a lot of strong ongoing cultural practices still undertaken.”

Evan knows a number of medical students in other parts of Australia and believes his experiences eclipse those available in larger cities.

“Everyone seems to know JCU is a very practical university that graduates work-ready interns,” he said.

“A lot of my fellow students studying elsewhere seem quite envious of how involved we get through our multiple rural placements.”

Next year, Evan will spend his intern year in Rockhampton and from there continue to work towards his rural medicine career goals.

“I have been accepted onto the Queensland Rural Generalist pathway and next year I am planning to apply to ACRRM (Australian College of Rural and Remote Medicine) – which is a speciality college to attain a General Practice Fellowship. ACRRM is renowned for rural practice,” he said.

“Being a Rural Generalist means being a jack-of-all-trades. It encompasses a host of capabilities from general practice to critical care (because country doctors often also cover local emergency departments). Rural Generalists typically train in additional skills, including mental health, which is vital in the bush, or upskill in obstetrics or anaesthetics so women can deliver their children safely in their home towns.”

Evan’s best piece of advice for anyone considering studying medicine, especially rural medicine is:

“Be brave and throw your hat in the ring. You get so much more out of life that way. And don’t be scared to volunteer and spend time with the most vulnerable in the community – they are often the best teachers.”