Hi, I'm Neil Beaton. I'm a Rural Generalist, Senior Medical Officer at Atherton and Mareeba
Hospitals. I work in Advanced Practice in Emergency Medicine and Anaesthetics and I'm
also the GP Mentor for GMT for Anaesthetics Training and Advanced Skills Training.
Anaesthetics training is a core part of training to be a rural doctor. I find it very useful
because it gives you confidence in managing acute medicine, perioperative care, emergency
department, dealing with airways etc, so it is a core part of fellowship, it's not a standalone
qualification. It blends in very well with the team and the great thing about it is you're
a core part of an essential service.
The anaesthetics training pathway is governed by the JCCA which is a joint committee between
three colleges, The College of Anaesthesia, The College of GPs and The College of Rural
and Remote Medicine. That's been in place for many years, the curriculum is basically
overseeing by the JCCA and it's implemented in accordance with that set of rules so that's
available to have a look at.
The panel will be looking for somebody who is a confident and capable clinician, somebody
who's a competent clinician, who has good situational awareness and good risk management
and the ability to solve problems quickly on their feet.
The training takes for most people twelve months and the idea is to get sufficient case
load during that twelve months and sufficient support and part of the role of a GP mentor
is to assist the department in making sure that all the skills and covered off. Some
people have had to do fifth-teen months but the majority of people complete within twelve
months.
A lot of the posts in Queensland are managed by the Queensland Rural Generalist Pathway
and they go through a state wide selection process and that's almost certainly the best
way to go about it if you want to be a rural generalist through Queensland Health. For
private doctors it's important to go through your local node and allow the node to help
negotiate posts with you.
Generally the anaesthetics department follow the ANZCA program, so you'll get similar to
what the registrars in ANZCA get but it's compressed into a year. At three months, three
to six months, generally there's an introductory assessment so you can go on call that, that's
an important one. But it's not actually formal part of JCCA. What JCCA recommends is some
case reports which should be rural oriented, also there needs to be assumptive assessment
by your supervisor which is signed off which then allows you to take a formal exam, usually
in December or January. And that's arranged by the department.
What most of us do are regular courses in courses such as the MST and APLS. We will
also go in and do up skilling posts for at least a week every year. Most people do that.
There are a range of other options. Things like three sixty feedback which is important
in teamwork and so it is fairly comprehensive and the requirement in order to maintain your
credentials. It's not onerous and there are grants now for people to be able to maintain
their skills to cover some of the costs of some of the courses and some of the up skilling
posts. My strong recommendation is to stay in touch with your training post and to return
their for up skilling from time to time and keep in touch with them by phone and try to
organise some feedback sessions with them.
Training in anaesthetics for me has been has given me the confidence to be able to manage
the recess room and critical care very well. So anaesthetics skills crosses over into critical
care, high dependency retrieval. There's a lot of emergency medicine. So generally speaking
it gives you more confidence and ability to be able to manage the critical ill as well
as elective provide an elective service so it maintains services within your town. Particularly
obstetrics and if you're in a level three hospital, you can't run obstetrics without
an anaesthetist, and epidural service and all the other bits that go with the tool kit.
So you're really part of the toolkit. So you are genuinely part of the team and that creates,
for me that's allowed me to have a degree of credibility in the team and take some leadership
role in critical care with my colleagues but basically it builds friendships and great
teamwork.
Anaesthetic training is a very useful set of skills for any doctor but for a rural generalist,
it's kind of core business. Surgery and anaesthetics clearly were the first focus of rural doctors
and there's a reason for that. At the end of the day you can maintain safe obstetric
services if you're got a safe anaesthetist on your team and so you're really, the big
sell is that you'll maintain services which otherwise wouldn't be there and I think that's
the most important thing.