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Australia Coronavirus leads medical student to forge a career in regional Victoria

03:16  29 september  2020
03:16  29 september  2020 Source:   abc.net.au

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a person wearing a hat and sunglasses posing for the camera: Final year medical student Crystal D'Souza says training in a regional hospital allows working with a smaller team. (ABC Gippsland: Jarrod Whittaker) © Provided by ABC Health Final year medical student Crystal D'Souza says training in a regional hospital allows working with a smaller team. (ABC Gippsland: Jarrod Whittaker)

Medical student Crystal D'Souza was struck by the difference in the quality of care received by metro and rural patients when she moved to Gippsland to study medicine.

"I saw for the first time the huge inequity between the medical service that my dad received when he was hospitalised for a heart attack a couple years ago, and the difficulty of even seeing a cardiologist when you're so far out [of Melbourne]," she said.

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Ms D'Souza is now in the final year of her course, a time when she should be undertaking a variety of hospitals across Melbourne and regional Victoria and gaining an insight into areas she could specialise in.

But the outbreak of coronavirus meant she was forced to choose between spending the entire year at one hospital in Melbourne or regional Victoria.

In the end, she said the choice to spend the year at Warragul's West Gippsland Hospital, south-east of Melbourne, was easy.

"Rural health is just really interesting ... when you're a GP you're more than just the first point of contact before a speciality referral," Ms D'Souza said.

"You become that central part of a person's health journey."

Surprised by regional disadvantage

Ms D'Souza spent the first year of her course at Monash University's Gippsland campus, where she met patients who had to travel for treatment. It is also where she completed a non-medical placement.

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"I did mine with Quantum Support Services, who provide homeless shelters and help with domestic violence survivors," she said.

The year also included a stint in South Gippsland where she gained an insight into the challenges regional people faced accessing specialist services.

"I talked to patients who had to travel up to four hours sometimes to get to The Alfred (hospital in Melbourne)," she said.

"I realised that I wanted to work out here ... and it just isn't fair that people in the same state could live in such a different area and [have] such a different healthcare system."

'Adventurous' students wanted

Rural Doctors Association of Australia Victorian vice-president Rob Phair said the difficulty in attracting medical professionals to regional areas was a complex issue.

He said part of addressing the problem included recruiting more regional people into medical school and characteristics suited to working in rural and regional areas.

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"We've got to have people who will not just be motivated by their earnings, and that will have a sense of social justice ... and that are looking for a bit of adventure, looking for a challenge," Dr Phair said.

But he said he was pleased with the development of the five-year Victorian Rural Generalist pathway program, which would begin next year and will include general practice training as well as the opportunity to specialise.

"So it might include emergency medicine, and obstetrics or surgical skills," Dr Phair said.

"So that's that's the exciting development in Victoria for next year."

Opportunities in the regions

For Ms D'Souza, part of the attraction to staying in regional Victoria is the training environment at the West Gippsland Hospital, where she has rotated through general medicine, general surgery and the emergency department.

"I've had a chance to talk to heaps of doctors in different training fields — endocrinologists and oncologists, and neurologists," she said.

In metropolitan hospitals, it is common for medical students to form part of a 15-person team, but going regional allowed Ms D'Souza to take on a more prominent role.

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"We are a part of the team and we really get to know the doctors and I think that's one of the other great things about doing a rural placement," she said.

"You get into it just smaller and it's more personal in a lot of ways."

Opportunities for rural students

Monash Rural Health Bendigo director associate professor Chris Holmes said the opportunity to study medicine and do internships in regional areas was attractive to country students.

"There's been a significant uptake of medical education in high school students of rural origin, they see the ability to study locally as achievable," Dr Holmes said.

"Many see actually the expectation to go to metropolitan Melbourne as a significant disadvantage — they don't have any family connections, they don't have any accommodation."

But he said the students received the same training, no matter where they were from or where they studied.

"At the end of the day, a medical student still studies the same course and has the same assessment hurdles," Dr Holmes said.

"But there are differences in the way the curriculum is delivered and the clinical experiences they get in clinical training and some students prefer one style of learning over another."

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