Can you tell me about why you became an Ear, Nose, and Throat (ENT) surgeon?
When I first started my medical training, I initially thought about becoming a physician, but I decided to become an ENT surgeon because I really liked the combination of medicine and surgery. There are also a lot of sub-specialties within ENT to choose from. I specialise in rhinology and facial plastics surgery.
One of the aspects I particularly like about of being an ENT surgeon is that you take someone through the whole treatment process – from consultation, diagnosis, and surgical intervention. It’s exciting and interesting to work with patients throughout the entire journey.
ENT is also a specialty where you are the only port of call for people; there aren’t other specialists working on that part of the body. It means you get to see a wide range of cases and people.
Why did you decided to live and work in a regional area?
My family and I initially moved to Mackay for one year in 2012. An opportunity arose in a chance meeting with a surgeon from Mackay, who was looking for someone to take over his practice while he took a one-year sabbatical. We moved up after I graduated, but I have to say after that first year we couldn’t wait to leave. My wife and I were both born and raised in Melbourne, so it was a big adjustment for us.
After that year we went and worked in the United Kingdom. While we were there I was contacted by the other ENT surgeon in Mackay and asked if I wanted to buy his surgery because he was retiring. Our plan had been to go back to Melbourne, but we could see there were benefits in raising our children in Mackay instead of a big city. We decided to give it another go and see how we liked it.
We were really welcomed back when we arrived. It felt different the second time around and we have now been here for 5 years. We are very much part of the community here. People always say that Mackay is a great place to raise kids and we used to scoff at the idea, but now we realise that it is!
What are the top three challenges you face working in a regional setting?
One of the biggest challenges I find is the professional isolation. Another is the lack of a medical eco-system around me. It takes time accessing other specialists when I need another set of eyes to look at a problem, such as allergists or immunologists, or I need investigations done. The good thing is that Mackay is slowly growing and there are a lot more services occurring in town.
Distance is another challenge. While many patients can be treated in town, sometimes cases need to be referred. It’s very important to have good relationships with other practitioners in Brisbane and Townsville. It takes time for build and foster these connections. When things change, for example someone retires or moves on, there is an impact up the chain which I think specialists living in urban areas don’t fully appreciate.
What are some of the professional benefits you get out of living and working in a regional area?
One of the biggest things I’ve come to appreciate over the last five years is being part of the community and feeling like a valued member here. I think people sometimes discount how important and fulfilling it is to feel connected to a place and the people living there.
Another benefit of working in a regional area is that I am exposed to a wide range of presentations. This makes for a rich clinical experience because I see everything that is related to ENT.
I also think that regional Queensland patients are the best you can have! They appreciate you, they generally adhere to their treatment plans, they love that you live and work in their city and provide them with the highest Australian standard of care.
How did you find out about the SRSA program?
I’m part of the rural section of the Royal College of Surgeons (RACS) and I saw the SRSA program posted on a list of funding scholarships and opportunities.
Why did you decide to apply for funding from the Support for Rural Specialists in Australia (SRSA) program?
When I found out about the SRSA grant I thought it would be very helpful to defray the travel costs with position I have with the Royal Victorian Eye and Ear Hospital (RVEEH) in Melbourne. There are no other grants available that support me to do this.
Can you tell me about the Continuing Professional Development (CPD) activity you undertook with the SRSA grant?
I have an ongoing position at the at the RVEEH where I originally trained, as a visiting Rhinology Consultant working with the Rhinology and Facial Plastics/Head and Neck Units. I have doing this for over three years now. Through this position I am able to fulfil all of my CPD requirements for the RACS.
My position at the RVEEH helps me to up-skill, maintain skills and professional relationships. I am actively involved in the teaching of advanced surgical/ENT trainees and with the unit’s prospective audit. There aren’t any opportunities for this in Mackay.
Can you describe how the CPD activity improves patient outcomes/benefits the community
Mackay is a town of 90,000 people and a district of 130,000 and I am the only full-time ENT surgeon in the area. It is very far from other regional and metropolitan centres; Townsville and Rockhampton are both about 5 hours away and Brisbane is an 11-hour drive. Flying means an extra layer of cost from $400 – $1000. It’s a big deal for people to have access to quality care, and be treated well, in their home town.
For the first 18 months I worked in Mackay, before starting the position at RVEEH, I felt very professionally isolated. I began to feel a little bit irrelevant and rusty. Even though I was getting a lot of exposure with the patients coming through, I only had myself to compare to and couldn’t see what other specialists were doing. In a craft profession like mine, it’s important to be around other people that are doing the same thing. You learn a lot that way; it keeps you sharp.
To do something well surgically you also need to do it all the time. The more times you do something the better you get at it. This is particularly important for complex operations. If you are only doing certain procedures 3 times per year, then you’re not going to be any good at it. This is something I take this very seriously. If I am not Australian standard in any procedure, then I will refer the patient to someone that specialises in that area.
When I come to Melbourne for example, and I’m working with advanced trainees, I will do about 20 septorhinoplasties per year with many requiring rib grafts as part of the reconstruction. This is great exposure and training for the trainees, but also important for maintaining my skills. I bring all this back to Mackay with me and everyone benefits.
Would you have done this CPD activity without a SRSA grant?
Yes. While the grant makes it much easier, it is a valuable educational opportunity and worth the expense.
What are your plans for the future?
My family and I are happy in Mackay. We are part of a great community and are settled here. Our plan is to stay for the foreseeable future
Do you have any advice for other rural specialists?
I encourage other rural specialists to maintain relationships with people that have trained and mentored you, and a connection to the place you have an affinity with, be that a metropolitan or regional city. This could be through teleconferencing or phone calls, but nothing beats face-to-face. Maintaining these relationships really pays off because it addresses all the issues that makes rural practice difficult – professional isolation, lack of colleagues and lack of resources to look after your patients.
I also suggest more people apply for the type of activity I am with the SRSA grant. CPD is about maintaining a commitment to life-long learning. I believe embedding yourself into a tertiary institution and maintaining an ongoing relationship is much more beneficial than attending a course or workshop.