A serious car crash in her final year of medical school led to James Cook University graduate Dr Marishka Shah being enveloped in the care of her adopted community in Mackay.
The head-on collision, on a trip to Airlie Beach on Easter Friday 2021, left Marishka unconscious and then semi-conscious. She awoke in Mackay Base Hospital’s Intensive Care Unit several hours later with shattered bones in her lower left leg, a lacerated liver and a traumatic brain injury. The COVID-19 international travel ban blocked her Canadian family’s desperate attempts to come to Australia to be by her side.
“I was in hospital for a little bit, I was unconscious for a long time, but throughout all of it, I got so much love and support from the Mackay Clinical School and the hospital,” says Marishka, who graduated with a JCU Bachelor of Medicine, Bachelor of Surgery in December alongside her partner, Dr Nickolas Robinson.
“To this day, I'm still moving through the departments on my way to recovery, but it's given me that drive to give back to the community that’s helped me. I had to remediate my studies, but everything worked out in the end. I got so much support from my supervisors, the academic coordinators, the clinical staff – everyone came together and helped me as a team to get it done and get back to recovery as soon as possible.
"I was on crutches for eight weeks and everyone was so kind and caring at the clinic and JCU. I guess I can relate to my patients. I passed through several departments and played patient to all my supervisors, which makes for a very interesting experience as I now work with them.”
Marishka and Nick have started their internship at the Mackay hospital, where they were based for their last two years of medical school. For Nick, it was the culmination of a long road to a JCU medical degree, via a Bachelor of Biomedical Science in Newcastle, triage nursing for his local GP in his rural New South Wales hometown of Macksville, and applications over several years.
“I always knew my Year 12 marks were probably not up to scratch in terms of getting into medicine so that’s why I focused on getting the GPA up in the biomed degree,” Nick says. “There were times when I thought, ‘Look, I've been applying for a few years and it hasn't worked out so do I really want to do this?’ But then, when you least expect it, something good can and does come your way. What I've taken from it is that persistence and effort over time do pay off.”
The way to JCU
Marishka: I was born in India and my family moved to Canada when I was four. I chose medicine because I was interested in doing Doctors Without Borders. I applied to a few different unis, but I chose JCU because they had such a strong focus on Aboriginal and Torres Strait Islander and tropical health. I thought that would be good, especially if I wanted to go to developing countries and help out. We learned so much more about rheumatic heart disease and snake bites and all those things that you see in tropical regions. Ultimately, I enjoyed my experience so much, I recommended it to my brother, Parth, and he's starting this year. I've already told him he has to come to Mackay in four years.
Nick: I did three years at Newcastle Uni studying Biomedical Science. The classes I enjoyed most were where we interacted with people and where communication skills and establishing rapport were key. During summer holidays, I'd do some work at my family’s longstanding GP, who was really supportive and gave me whatever type of work I wanted, giving injections, getting a history from the patients before they saw the GP. I knew of JCU’s strong focus on rural remote, tropical and Aboriginal and Torres Strait Islander health. That appealed to me because the town I’m from has a strong Indigenous representation so I thought it was the right fit. I did apply straight out of high school but then the grades weren't too great. I started applying after the second year of biomed, both undergraduate and postgraduate. Postgraduate meant going through the GAMSAT examination, which is a marathon in itself – a six-hour examination over two sessions on the same day. But it was JCU who gave me one of the best phone calls I have ever received, I believe in part because their mission statement reflected my lived experience so well. JCU was definitely the best fit for me. If you want to pursue a career like this, I would say exploring all your avenues is worth it because that persistence and effort does pay off.
Mackay and discovering a passion
Marishka: I’ve loved Mackay. I was able to meet my mentors. I started fifth year doing mental health with Dr Veronica Stanganelli and I found my passion, which was child psychiatry. It’s team based and multidisciplinary. You’re working with social workers and nurses, and there's so much potential to help the child early on. There's an intersection of the humanities and medicine and you're bringing it all together. It's fascinating. My next rotation was at a GP practice and I was working very closely with one of my mentors there, Dr Nicole Higgins. I found that the clinical environment in Mackay was so tightknit, you could really develop meaningful connections with your preceptors. It's a reason I would recommend anyone come to Mackay and it's partly why I decided to stay, to be close to the people I’ve developed these connections with. I love the hospital. I like that you can just walk down the hall and say hello to everyone and everyone knows you. I also like that it's still big enough that you can explore all the larger departments that you'd like to. Mackay is a beautiful place, lots of beaches, good weather.
Nick: I'm interested in general medicine and becoming a physician. I tried getting some placement experience in different fields of that, such as cardiology and gastroenterology. Then I did a couple of weeks of anaesthetics just recently and I think that's a good mix of understanding the physiology but also a lot of practical skills as well. So that also appealed to me. I'm a bit more indecisive, but I'm leaning towards those two. There’s some good continuity in that we know a lot of the people here at Mackay hospital. We’ve got a few good support people in a couple of departments we can bounce things off and get some advice from so in that respect, we’re set up as well as you can be for the challenge of internship.
Marishka: I chose to go to Mareeba in fourth year and sixth year, and I loved it. Mareeba is beautiful. I made Nick come along in sixth year with me because I wanted to show him how lovely it was. We both worked hard and it was tough at times, but it made us better clinicians and prepared us for internship, which is the main function of sixth year. We had such a positive experience. Because you're stretched thin, sometimes you are forced to go out of your comfort zone which is good in terms of picking up skills. We both got to assist with caesareans and help in the ED, especially after hours.
Nick: In second year I went to Sarina and the placement experience was really good. In fourth year, I went to Cooktown. Fourth year is a fair bit of theory with a little bit of clinical stuff sprinkled on top. The placement was right at the end of the year and that was great because it reinforced a lot of the stuff that I'd read in all of those textbooks in terms of clinical examinations and investigations throughout the year. I spent the first 10 weeks of sixth year in Mareeba with Marishka. I've never been up to the Tablelands. Rural placement experience gives you a lot of opportunities to go see new areas, which you probably wouldn't ever pass through normally. You integrate as a community member and you start to get recognised around town.
Deadly Choices in Mareeba
Marishka: We both did Deadly Choices in Mareeba for a little bit and enjoyed that so much we're looking to go back and help more. It’s focused on educating young Aboriginal and Torres Strait Islander children about healthy practices in a positive way. We went out to the high schools a few times and we would teach them how to cook healthy foods in the cafeteria. Nick was playing basketball with the kids in the evenings.
Nick: We were keen to fill out that placement experience with other opportunities. Deadly Choices was really rewarding. I spent time with the Men’s Group, which was a weekly social gathering of Mareeba residents who would come together, sit in a circle and share their stories. I took a lot of valuable life lessons from the experiences the Men’s Group would share and felt privileged that I was welcomed into that community.
Learning and trying new things
Marishka: As Nick said, the JCU learning model was good in stepping up. We started learning, for example, cardiology in second year, and then each year we would add to it, learning about the medications involved and then finally in fourth and fifth year, integrating it into our practice. When it came time to do our final exams in fifth year, it had all come together. In sixth year, it was so good to have a year where you didn't have the stress of too much responsibility, but also the freedom to pursue whatever you were interested in. If you need to get your cannulation rates up, you could go to ED or ICU and do as many as you can. You have that time to explore and build up those procedural skills and not feel like you need to get home and study right away. Starting internship, I feel so grateful to be familiar with the hospital and the people already.
Nick: The first three years, focusing on the physiology and pathophysiology and the theoretical aspects, gives you a good grounding to take that into the clinical years. I find it hard to compare myself to where I was in first year because of the breadth of what we’ve done over the six years. Ultimately, I'm a much better communicator just because of all of the experiences and assessments that we've gone through since then.
Thank you to Marishka and Nick for sharing their inspiring journey. Find out more about how the values-aligned James Cook University Bachelor of Medicine, Bachelor of Surgery has helped graduates like Dr Annabelle Faint, Dr Joshua Liaw, Dr Kathrin Orda and Dr Visai Muruganandah make a difference to rural and tropical health.