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Written By

Andrew Cramb

College of Medicine and Dentistry

College of Medicine and Dentistry

Publish Date

29 October 2021

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Georgia's JCU Extended Rural Placement

Sixth-year JCU Medical student, Georgia Bulley, had a feeling she would enjoy rural generalism. So, she committed a year of her life to find out for sure.

For almost the entirety of 2021, Georgia is undertaking a Longitudinal Integrated Clerkship (LIC), an extended placement offered by JCU that is based in northern or western Queensland rural or remote town.

Based on a recent study, published by JCU researchers, these extended placements have tremendous value for the communities in which these students serve. The study found that every $1 invested produced a $7.60 return in social value.

Georgia recently shared with us some of her thoughts from her experiences, the contribution she is making to remote health and how the extended placement has profoundly changed her life.

Georgia Bulley with fellow JCU medical students on the TI helipad
Georgia Bulley with members of the TI community
Left: Georgia (right) with fellow JCU medical students Claire Hu and Visai Muruganandah. Right: Georgia talking to Rusia and Bethalia Bann from the Thursday Island community.

Giving rural generalism a proper go - The motivation for choosing an extended placement

I was born and raised in Townsville and spent the first five years of my degree there. It got to the point where I just wanted to get out to experience somewhere different. I had an interest in the rural generalist pathway and an extended placement was a good fit for that. I knew it would show me that if I loved it, then it was something I could commit to, and if I didn’t love it then I had given it a pretty good go!

Applying was a simple process; you just select the extended placement option and your preferred location. I had the option of Cloncurry, Longreach, Mareeba (which was my second choice), Emerald and Thursday Island. I thought, ‘how can you not put down one of the most beautiful places in Queensland?’ So I chose Thursday Island and here I am!

‘What have I done!?’ - Initial thoughts on the placement and location

I was very nervous coming to Thursday Island. I don’t think I knew much about it or just how remote it is! After my first week of being here, I was like ‘Oh God, what have I done!?’ There was not much in terms of shops or facilities there was a sense of isolation (the closest places are an hour and a half by plane!). The culture shock hit me hard, but I think I adjusted quite quickly. Turns out, it’s been the best decision I’ve ever made.

‘100% ready for internship’ - The skillset and confidence gained through an extended placement

The level of clinical skills I've gained by being in the same region for this amount of time is insane. I don’t think it would be the usual experience sixth-year med students get in metropolitan hospitals. I’ve performed cannulations, phlebotomies, contraception insertions, finger blocks and I’ve assisted with other minor procedures like removing toenails and reducing fractures. I’ve also assisted with anaesthetics which was exciting. I got to essentially run a sedation procedure myself, under the supervision of a doctor. When you’re on an extended placement, it’s more than just a taste of various tasks. You’re getting the opportunity to put skills into practice over and over, so you become really comfortable with them.

I am also doing history taking and performing examinations to do a management presentation to the doctor. I do that nearly every day. It’s helped me improve my clinical judgement and patient assessment. The whole experience is really fast-tracking my development. I feel 100% ready for internship now.

Georgia at a waterfall with friends
Georgia spear fishing
Georgia with friends 4Wdriving
Left: Georgia and friends at a watering hole on Thursday Island with friends. Middle: Georgia experiences spear-fishing for the first time. Right: Georgia and friends exploring the island.

A trust that comes with time - Being around longer builds stronger relationships

The relationships I have formed with the doctors here adds so much to the experience. I think it’s that trust that has led to me being able to do more of the complex medical and clinical work. There are fewer doctors here and I know they’ve appreciated me being here for the whole year because they don’t have to continuously build up the rapport and provide the same training again after 10 weeks. I think they’re at a stage now where they’re happy with me and trust that I know what I’m doing.

Boils and diabetes - The benefit for the community

People here really appreciate it when you’re here for a longer period. They’re more like to open up to you after they’ve seen you in the community for several months. I think that relationship facilitates a preventative health care approach. Just recently, I had a patient come in with boils and in that presentation I flagged underlying issues including type two diabetes. We spent 20 to 30 minutes talking through diabetes and how to address it.

To me, this is what rural generalism is all about. You go into these areas, where there are poor health outcomes, and they don't have the same access that people do in the cities. There are people who haven't been seen by doctors for years, or who have all these significant comorbidities. You feel ecstatic when you can get them on to something like a diabetic medication and have a small impact on their life. I love that here you can really make a difference in people’s lives. It gives me a lot of satisfaction.

“They gave me their car keys” -  Extended placement means you’re embedded in the community

It’s been a good place for me to develop personally. You’re forced out of your comfort zone professionally and personally. The people are just so beautiful up here. I’ve had to learn to be better at accepting help or kindness from others. People just want to give you things and look after you. They cook for you and take you out all the time.

When we were in Bamaga, we met this beautiful family who invited us over dinner. It came up that we hadn’t explored much because we didn’t have a car. They just gave me their car keys and said keep the car for a week! It's just incredible how people go out of their way for you here.

‘Opportunities don’t come to you if you sit in your room…” - How to make the most of the experience

I know there are students who have come up and not enjoyed the placement at all. Everybody just sees the beautiful pictures of these islands and they don’t see how isolated it is. If you’re used to the city comforts, it can be daunting.

It’s the classic ‘it is what you make it’ experience. You need to be the type of person who is willing to put yourself out there. These types of opportunities don’t just come to you if you don’t go out and you talk to people and make friends, community members. If you do get out of your comfort zone, you might find that this experience will change your life.

"The LIC has changed my life quite drastically. It’s making me a better person and a better doctor. It's just a great experience and I would not do it any other way."
Georgia Bulley, 6th-year JCU medical student

Extended placements are a part of JCU’s commitment to making rural health matter. Students like Georgia are not only making a valuable contribution right now, they are also gaining the experience and passion to become doctors who serve our regional, rural and remote communities.

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