18 September 2017

The ‘Full Monty’ for junior doctors

General Practice Rural

An influential GP educator has joined one of the country’s largest Aboriginal medical organisations with a mission to give more junior doctors a training experience he calls “the Full Monty”.

Dr Sam Heard has taken the role of medical director of the Alice Springs-based Central Australian Aboriginal Congress, which was established in 1973 as the second Aboriginal health service in Australia. It now employs 380 staff and operates 13 clinics, including six in remote outposts.  

The congress has 35 doctors, with an individual patient list that topped 19,000 last year.  But currently it has only seven registrars, including two doing their FAR GP advanced training.  

Dr Heard –  the RACGP’s 2017 general practice supervisor of the year for the Northern Territory and South Australia – has set his sights on doubling that number. 

“The patient load is phenomenal for learning,” he told The Medical Republic. “You are going to be a lot better doctor if you work here, by a long way. 

 “We’ve got 270 dialysis patients, where most practices would have nought to one.  We do preventative medicine and preparing for transplants.  We’ve got rheumatic heart disease – we listen for heart murmurs and find them.  There’s trachoma, there’s grog. It’s the Full Monty with the volume turned up. 

“And amongst all that, there are the most inspiring Aboriginal people and colleagues. I feel part of the best team I’ve ever been part of.  It’s a very high-calibre group of people.”   

Junior doctors who flourished in this environment were not necessarily high-fliers from medical school but often they had overcome adversity and benefited from the strong collegiate ethic at Congress, Dr Heard said.  

The doctors who work here are massively supportive. They realise what the learning curve is. They want people to ask questions. They worry if they don’t.” 

After more than 20 years in GP education, Dr Heard laments an apparent shift towards timidity in the profession.  

“There’s such a level of fear throughout our lives now, isn’t there?  It’s much more threatening for doctors now. Things that once seemed adventurous now seem scary. Young doctors are told they can’t do that thing or this thing unless they’re a specialist.” 

In his new role, he is heartened to see the “fear factor” fall away and a blossoming of confidence. 

“After they’ve seen a few patients, they realise, ‘I can do this.’ I’ve never seen anyone who was more scared after they started than before.”  

Until late last year, Dr Heard was the principal GP training supervisor at the Palmerston GP super clinic near Darwin, a not-for-profit 24-hour operation where the roster included 16 registrars at a time.  

In his new role, he is intent on building a “learning culture” that permeates the organisation. 

“I’ve done a lot with education. I saw what I could do in Palmerston at the super clinic, and the hierarchy here want me to have a go at doing that here.  

“I know there is a threshold where the registrars begin to feed off each other and thrive, and help each other,” Dr Heard said.

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Max Kamien
Max Kamien
1 year 1 month ago

Bravo and best wishes to Sam, his registrars and their patients

1 year 1 month ago

Hi Sam, it’s not just fear. There is now much less flexibility to fit in the broad range of experiences a registrar might feel they need. There is more “encouragement” to rush through as quickly as possible.