I started work in the Gold Coast Health Service District of Queensland Health last May 14, 2007, roughly a year ago.
A lot of things have transpired since then and it's time to do an update of how things have been so far. This will probably help a lot of you out there who have been considering Australia as an alternative working place to the US. I don't claim that my experience so far is representative of the whole system, so reader beware. You might have heard otherwise.
My first rotation when I started was Relieving. Relieving meant that wherever there was a vacant position or a need, I would be there to fill it up (yeah, my body mass tends to fill up a lot of space nowadays!). Sounds scarier than it is, being carted around to whatever vacancy pops up. It was fortunate for me though to have been put into the Infectious Diseases first because the Intern and Registrar there were quite helpful in showing me the ropes. "Daunting" would be an understatement to how I felt during the start - "headless chicken" is more apt.
On my second and third week, I found myself at the Haematology and Oncology Day Unit. Very nice people to deal with, very helpful, and most importantly, fed me well. It was the first time that I encountered a Filipina nurse at the Gold Coast Hospital, and surprisingly, she was a graduate of UP Manila as well.
Next stop was a month with the Respiratory Medicine team of Dr. T
oby Tang. There were many great learning opportunities under him and from our patients. Work was exceptionally tough because of the workload (as compared to my previous postings), but I survived and earned a couple of new friends along the way. The highlight of that one month posting was being invited into Dr. Toby and Jenny Tang's residence for a barbeque. Great food, kayaking and camaraderie were all appreciated.
Next stop was doing a month of nights at the Southport campus. Disturbed sleeping patterns, massive workload (1 doctor to cover more than 150 patients at night?), and very frustrating nurses. It was during that time that I fully understood what "Me, myself and I" meant on a deeper level. I probably did a lot of mistakes, mostly unintentional, but I guess I always tried to use the experience, bad or good, to learn and be a better doctor. I promised myself from then on that I will not subject myself to that kind of emotional, physical and mental torture ever again.
Two weeks of Obstetrics and Gynaecology were not too bad. Lots of antenatal clinics, some assists in theater, and some new learnings. A birthing suite run mostly by midwives was a concept quite alien to me so I had to adapt to the situation. Nonetheless, the exposure to the system was quite a good eye-opener.
The emergency medicine rotation - a few people told me that this was one of the harder rotations to do - shift work, nights, continuous influx of patients. Doing emergency medicine for over five and a half months has actually been the best learning experience for me so far. Yes, the hours are a bit tough on the legs and the constant influx of patients seem like Divisoria* during Christmas season sans the smell. I guess the people that I have worked with in the Emergency Department have been very supportive and helpful to the junior staff. You never feel alone - there will always be someone there to ask and seek guidance from. More importantly, they try to build your confidence as junior doctors by letting you progressively make management decisions on your own. Fortunately, I was a good experience for the consultants and other staff enabling me to be accepted into the Australian College of Emergency Medicine.
(Gold Coast Hospital Ball - October 2007)
Satisfying the surgeon-wannabee side of myself, I was fortunate enough to land the Maxillofacial Surgery team of the Surgery department. 12 weeks of hands-on Maxillofacial patients was really rewarding. It was a good mix of inpatients, ED admissions, outpatients, and operating theater assisting with the bosses. Some of the other surgical rotations bogged you down with ward work - getting stuck with inpatient scut work instead of being in the thick of things inside the theater. "When in doubt, cut it out!"
The final rotation in my Junior House Officer year is Psychiatry. Due to the midyear and midterm start of my contract, I still continue on with psychiatry eventhough I'm officially a Senior House Officer of the Emergency Department (and a provisional EM trainee as well). My psych term initially started as cruisy, but with some developments happening with my Psych registrar at the unit, I had to step up and try to fill in the job of psych registrar and RMO at the same time. Psych isn't exactly my cup of tea (eventhough I my undergraduate degree is Psychology) but as with anything that I do, I try to learn from the experience the best I can. Sufficing to say, I've become more adept at doing mental status examinations, not exactly top-notch, but enough to see me through when seeing psychiatric patients when they present to accident and emergency. But I would still say that it is still quite frustrating to be working in the field of Mental Health because you can only stabilize their mental state to a certain level and discharge them back, just waiting for the time for them to become noncompliant, getting aggressive and end back in the ward, smoking and making funny noises and gestures once again (see, I'm starting to have flight of ideas now!)
In a nutshell, working in an Australian health system has both been a challenging and a rewarding experience so far. There are opportunities here for the taking for those who are willing to take the risk and are well-prepared to take the consequences - good or bad.
