Top End GP takes off

I did my last two years of medical school in Mackay. I loved the Mackay Clinical School – the lecturers there were wonderful, and the doctors at Mackay Base Hospital were so lovely and keen to teach. Being in a smaller hospital meant getting a lot of clinical experiences that those in larger hospitals inevitably miss out on. Being down the road from the Whitsundays wasn’t bad, either! I look upon those days fondly and am grateful for the education I received there.

I completed my junior doctor years on the Gold Coast, then locumed for a few years around Australia as an ED doctor. I then undertook general practice training in Perth. I spent one year in private practice as a registrar and wasn’t in love with it, and so began feeling a bit unsure about my future in medicine and general practice, which was a bit disconcerting as I'd wanted to be a GP since my earliest days of med school.

Somewhat fortuitously, I saw a job advertised on Facebook for a GP registrar for an organisation called Homeless Healthcare in Perth. I spent a wonderful and eye-opening year there, where I finished my training, and I realised that disadvantaged population care was the kind of work I really wanted to do. After obtaining my GP Fellowship, I looked for work in First Nations health and stumbled upon a job at an urban Aboriginal Medical Service called Yerin on the NSW Central Coast, so I packed up and drove 4000km to start there. Working at Yerin cemented my feelings about this area of medicine, and after 18 months I decided I wanted to work in a remote community.

I was fortunate to find a job in Arnhem Land that was perfect for me, allowing me to live in northern Australia again and experience the incredible beauty of the Northern Territory. So I jumped in my car and drove (another) 4000km to start my new life here in the Top End. I have worked in Maningrida for over a year now and love it. In Maningrida, I work alongside other GPs, remote area nurses, midwives, Aboriginal Health Workers, and community workers.

Maningrida is the largest remote Aboriginal community in the NT and so the clinic is often busy. The chronic disease burden in Maningrida is high. It has the highest known rates of rheumatic heart disease in the world. Delivering care in a remote Indigenous community has obvious challenges, but the medicine is interesting, you are constantly learning, the work is deeply rewarding, and it is ultimately a privilege to be able to look after the traditional custodians of our land, witness cultural traditions, and hear Aboriginal languages spoken every day. Every patient you see has their own special story to tell. I also continue to relish being back in the tropics again – my true home. I missed the spectacular thunderstorms. And crocodiles!

I'm a bit of a juggler with my ‘extracurricular’ activities. I got my private pilot’s licence while living in WA, so I obviously love aviation very much. I have my aerobatics endorsement but have yet to convince anyone around me to let me take them up for a few loops and stall turns. Their loss, I say! I also love everything to do with space and am excited that I get to apply these interests in my role as the RACGP Chair of Aerospace Medicine. I hope to do further training in this area.

I feel honoured to be the Northern Territory Chair for Doctors for the Environment Australia (DEA). I am passionate about environmental issues, and DEA is a wonderful group, full of committed and lovely people. I am a member of the working committee of the RACGP for recognition of Advanced Skills in Developmental Disability. The college is creating a special advanced skill pathway for GPs interested in developmental disability. I feel thankful to be playing a role, as disability health is an area I feel strongly about. I’m also working towards my Master’s in Healthcare in Remote and Extreme Environments and am about to be awarded the Graduate Diploma. It represents a confluence of many personal interests and has given me some cool experiences. For instance, I got to study space medicine, where I met an astronaut!

Expedition and wilderness medicine is another discipline I enjoy. It’s an exciting field and one that is continuing to evolve in Australia and around the world. It usually means being in a resource-limited and often isolated environment and has overlaps with many other branches of medicine. Occasionally it means having to manage a trauma or a seriously ill person and having to make complex decisions, perhaps even coordinate an evacuation. Many times, though, it requires only treating simple issues like gastrointestinal upset or abrasions. And, of course, being a source of morale boosting to your group!

I am the secretary of the Australasian Wilderness and Expedition Medicine Society and a volunteer doctor/team leader for a company called Inspired Adventures, where people sign up and raise money for charities before they trek. However, due to COVID, I've been on only one trek this year. Mind you, it was a rather epic one, in Tasmania, where it snowed in April! I value this field because it means getting to combine two things that I love: being immersed in the natural world and delivering medical care.

I love writing. I have written pieces for The Medical Republic, and just had a book released by Melbourne publishing company Smith Street Books called The Penis Book/The Vagina Book. The purpose of the book is to teach others all about their reproductive systems: how they work, how things can go wrong, how to best look after yours, and how to best have fun with it all, too! The aim was to create something that educates and dispels myths in a way that is accessible and fun.

Dr Ah Shay shares more about practising in Arnhem Land in her article Storm and splendour in the Top End. She has also written about COVID-19 amplifying social inequality, Australia’s record on disability and environmental issues in the NT.