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College of Medicine and Dentistry

Publish Date

21 June 2021

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Renowned rheumatologist & esteemed educator's extraordinary medical career journey

Rheumatologist and rehabilitation specialist, UK trained medical educator and now academic coordinator for clinical electives at James Cook University’s Cairns clinical school, Associate Professor David Bossingham has had a multi-faceted and illustrious career.

“I did my undergraduate training at St Mary’s Hospital in London, which was then part of London University and is now part of Imperial College. The rest of my general medical training was done in London where I started my rheumatology training and then moved onto Oxford to specialise further in rheumatology and rehabilitation science.

“Training was very different then. As a medical registrar I was initially on a one-in-two roster then moved to a one-in-three roster. That meant being on-call for alternate 24-hour periods with just an intern and a consultant in tow.

“Everything was learnt ‘on the hoof’. I remember a particularly nerve-wracking early experience of having to insert a temporary pacing wire when faced with a patient in complete heart block who started fitting each time his pulse rate dropped. Thankfully, the patient survived to have a permanent pacemaker inserted two days later.”

David Bossingham Teaching
David Bossingham in Bamaga
Left: Dr Bossingham teaching in the classroom. Right: Examining a child's knee in Bamaga, in the early 1990s

Unusual and unexpected medical situations

Training and working in Oxford saw Dr Bossingham get involved in some unusual and unexpected medical situations.

“Working in Oxford in the 1970s provided many unique experiences, including being involved with the National Disabled Living Research Unit in Oxford. It was while I was working there that I was approached to act as a technical advisor in the production of three films about fishing for the disabled (called ‘Able to Fish’). My boss at the time knew I was a keen angler and had recommended me for the job upon being approached by the Royal Association for Disability and Rehabilitation.

“Being involved with these films meant I got to meet regularly with the organising committee which included famous anglers whom I knew by name and reputation only. I was in heaven being able to discuss my favourite hobby in such elevated circles! I even got to meet Princess Caroline of Monaco who became the patron of these films.”

Dr Bossingham’s teaching career was also developing at the same time and began to take a central focus with a new medical school opening in Nottingham.

“Working in Oxford meant that my teaching interests were honed on the very hard surface of Oxford undergraduates. Then at the ridiculously early age of 31, I was appointed as a consultant and clinical teacher at the new medical school in Nottingham.

“My rheumatological interests were also further developed while based in Nottingham, with laboratory immunology; liaising with the research unit of the Boots pharmaceutical company; and the use of biometrics to better measure joint function.”

David Film Launch
David Fishing
Left: Dr Bossingham in his role as technical advisor at the film launch of 'Able to Fish'. Right: A keen angler proudly displaying his catch

Blazing his own trail in sports medicine

An interest in sports medicine further developed, even though it was not yet recognised as a medical specialty area, and saw Dr Bossingham become medical advisor to various sports clubs and sports players.

“My interest in sports medicine led me to becoming an advisor to Nottingham’s premier rugby club, the Trent Bridge county cricket club and later with the Marylebone Cricket Club at Lord’s cricket grounds. Until quite recently I continued to be medical advisor for the touring English cricket team.

“I was also sports medicine advisor for a pair of local ice dancers at the time, Jayne Torvill and Christopher Dean who later achieved huge international fame.”

After 12 years in Nottingham, Dr Bossingham began looking for his next challenge and decided to take a gamble half-way around the world to take up a position as physician and rheumatologist at Cairns Base Hospital.

“After declining the suggestion to apply for senior university posts in both the UK and Australia, I noticed an advert for a physician and rheumatologist in Cairns. And so in January 1993, I became the first and only such specialist in Cairns and continued as such first as a Visiting Medical Officer and then as a staff specialist right up until 2015.

“In 1993 Cairns only had seven physicians on the on-call roster; a generalist director, a cardiologist, a thoracic medicine specialist, a gastroenterologist, an endocrinologist, a generalist/nephrologist, and myself."

“We had just three medical registrars and when on-call the registrar would cover not just medicine but would also rotate with the registrars of paediatrics and psychiatry as well. So as you can imagine, it was a steep learning curve for both the juniors and myself.

Just a few years later saw Dr Bossingham take up the newly-created position of Director of Clinical Training.

“I became the first Director of Clinical Training in Cairns in 1995 when we had just eight interns. I am proud to have seen some of our junior doctors from those early years become leaders in their field. For example, one is now the director of health care for the aged in Cairns, one is the director of dermatology at Oxford and another a clinical geneticist also at Oxford.”

Meanwhile Dr Bossingham continued to expand his own specialist medical practice by conducting outreach clinics in North Queensland’s Cape and Torres Strait Island regions.

“At the suggestion of the then Cairns Hospital Director of Medicine, I started an outreach service for rheumatology in the remote communities and towns of Weipa, Bamaga and Thursday Island.

“This introduced me to some new conditions and some very old rheumatology at the same time, particularly in relation to the diagnosis of rheumatic fever. I was also exposed to some new immunological syndromes which were still to be characterised and also saw patients previously treated for leprosy and subsequently diagnosed a new case myself.

“In the early years, we also watched as the prevalence of gout soared in the communities of the Cape and I collected information in an attempt to understand the high prevalence of lupus (SLE) in the Indigenous population.

“I then ended up writing about all of these outreach experiences in an article entitled ‘Bush Rheumatology or Rheumatologist gone Bush?’ which was published in the British Journal of Rheumatology.

Fishing at the Bamaga Jetty is exceptional

A wide-ranging research interest

Research has been an ongoing feature of Dr Bossingham’s work since the early days of his medical career, resulting in some remarkable developments both in diagnosis and treatment of rheumatology related diseases.

“I was just 28 when I gave my first research paper and my first international conference saw me chairing a session. My research interests are wide-ranging and have included clinical immunology, biomechanics, rehabilitation, psychology, virology, epidemiology as well as clinical rheumatology.

“I have been fortunate in my career to have witnessed huge changes in treatment and outlook for patients with severe arthritis. I have been successful in seeing the treatment method that I used early on for these arthritic diseases now being universally accepted. I was also one of the first specialists to use methotrexate for treatment in the UK and helped to show how effective a drug it is for these types of conditions.

“Another highlight of my career was being involved in enabling patient access to the new generation of biologic drugs that were being developed not just for rheumatoid arthritis but also for psoriatic disease, ankylosing spondylitis, gout and lupus (SLE). This was back in the late 1990s when my team set up a clinical trials unit to ensure that at least some patients would have access to these new medications which would otherwise have been unaffordable.

“The clinical trials unit also led the way in recording accurate regular disease assessment which is now central to arthritis management worldwide. The Unit followed patients with rheumatoid and osteoarthritis, defining the associated increase in cardiovascular morbidity and mortality and the advantages and disadvantages of non-steroidal anti-inflammatories.

In 2015, Dr Bossingham left Cairns Hospital to take up a teaching position at James Cook University’s Cairns Clinical School.

“From being an occasional, but passionate lecturer and hospital-based teacher, I was offered a part-time position at the Cairns Clinical School and then went on to become academic advisor, coordinator for the clinical elective term, examiner, and research mentor on top of all the other the routine stuff!

“I would say that taking the gamble to relocate from the UK to Far North Queensland has certainly paid off. My experiences both with Cairns Hospital and with James Cook University’s Cairns Clinical School have offered me professional opportunities that could never be beaten.”

Dr David Bossingham, JCU Associate Professor, Medicine

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