Each year there is an opportunity for two Year 4C students from the East Gippsland Regional Clinical School, to undertake an exchange with two students from the University of Otago Rural Medical Immersion Program (RMIP).

Students spend the two weeks alongside the RMIP students and are involved in all aspects of the program, also managing to fit in some sightseeing.

Mary McWatters and Rebecca Craw were the two students from the RMIP program to spend time in East Gippsland as part of the exchange. Their reports are included below.

Medical training in Bairnsdale

Having not been out of New Zealand since I was 12, I was excited about the adventure as one of four lucky RMIP students selected to travel to rural Australia for a two-week exchange.

My first day there was a bit of an intro. The Bairnsdale hospital has four main wards (medical, surgical, rehabilitation and paeds/midwifery) and a bustling ED. The hospital is a GP-run hospital where every patient is under the care of their GP. The GP’s visit the patients daily to organise the plan with the other medical staff.

Junior doctors and senior physicians/surgeons on the wards then carry out the agreed plan and manage anything else that may arise during the day. There is a lot of multidisciplinary support including numerous community-based organisations. Ambulance and air transfers are made for any cases that require ICU-level care to Sale, Traralgon or Melbourne.

There were similarities and differences between their (Australian) course and ours. The main focus of their teaching is clinically based, with whole group tutorials with specialists via video conference once or twice a week.

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Greymouth pier

Greymouth is a town on the West Coast of New Zealand’s South Island, with a population of approximately 13, 300.

Grey Hospital is a 100 bed hospital that provides services such as General Medicine, General Surgery, Orthopaedics, Obstetrics and Gynaecology, Psychiatry, Paediatrics, Geriatrics and Anaesthetics.

During the two weeks at Grey I was able to attend clinics such as Orthopaedics, Cardiology, General Medicine, Endocrinology and Paediatrics. I spent time on the Medical ward and was able to assist the House Surgeons in many tasks and gain great experience seeing both common and rare conditions.

Although Grey hospital is of comparable size to Central Gippsland Health Service (in Sale, Gippsland), it services a much larger geographic area with a diverse patient demographic.

The exchange program enabled me to appreciate the unique challenges that can affect health care, both from the perspective of comparing the differences in procedures and policies from an international viewpoint, as well as from a rural/metropolitan stance.

Although the hospital has a few resident Consultants, the majority of specialist health care is provided by Liaison Consultants who travel from Christchurch on a regular basis.

Greymouth is a rural town that can be quite isolated when access roads to Christchurch are closed due to snow as they frequently are during winter.

This imposes some interesting challenges regarding transporting critically ill patients to a tertiary care hospital. It was not uncommon for patients to be flown in one of the helicopters or in the fixed wing aircraft, even for semi-urgent investigations such as an MRI.

While on exchange I was fortunate enough to experience some of New Zealand’s breath taking sights. From the Canterbury Snow Fields to the spectacular train ride across the coast-traversing plains, high-country, alpine ranges and rain forests to the Glaciers and beaches of the West Coast.

The experience provided a fantastic and unforgettable learning experience that has greatly added to my professional development and interest in both global and rural health.

–          By  Cassie Coetzee

Mt Hutt

Whale watching at Kaikoura, New Zealand

In July I was fortunate enough to travel to the south island of New Zealand for two weeks in exchange for a student from Otago University’s Rural Medical Immersion Program (RMIP). It was a short but busy trip which I thoroughly enjoyed.

A 3 hour flight from Melbourne to Christchurch was followed by a bumpy 40 minute flight to Blenheim.

There I was met by two RMIP students I would be living with, as well as Dr Buzz Burrell, an iconic rural GP in the South Island who put together my itinerary. We wasted no time, heading straight for the pub and sampling some local kiwi beers which were surprisingly drinkable!

The RMIP is for 5th year medical students and is similar to our year-long placement in East Gippsland. Their time is split between a range of isolated rural GP practises, as well as Paediatrics, Obstetrics, Gynaecology, Emergency medicine and Orthopaedics.

During the first week I learnt a lot about how the New Zealand health system operates, spending two days on orthopaedics and three days in the emergency department. The real advantage of this hospital is that there are only four students and no registrars. This allows the students and residents to gain fantastic experience and teaching from consultants.

On the first night I was told to go to a nearby pub with one of the other students and await a call from Buzz who, in collaboration with the local fire brigade, had orchestrated a simulated car crash scenario where we were to employ first responder emergency medicine.  It was bitterly cold and pitch black, requiring us to triage patients based on severity of injury in difficult conditions. It was an invaluable experience.

The most striking difference that the healthcare system in NZ has compared with ours is the Accident Compensation Corporation (ACC). This is essentially a no-fault compensation scheme for accident and injury to anybody hurt on New Zealand soil, regardless of the mechanism of injury, excluding natural aging.

I had no choice but to learn how this system worked, as a large proportion of patients presenting to emergency required ACC forms to be filled in (absolutely the student’s job!)

I spent the rest of the week on orthopaedics, great experience as I was the only assistant. This meant I was frequently able to suture, and in one case perform a procedure myself, cutting, popping and draining an elbow cyst, which although disgusting was great fun!

Blenheim residents are very proud of the fact that their town of 30,000 people is the sunniest place in New Zealand. The downside of clear days is clear (and freezing) mornings.

The coldest was minus 3 … cold!

However the upside to ever present sunshine is perfect conditions for wine making. Blenheim is right in the middle of the Marlborough region, which many Australians will have heard about for its famously delicious Sauvignon Blanc.

On the weekend I got my tourist on and went on a winery tour. We visited six in total, the most famous of which was Giesen. It was a great day, and after about 40 samples we were in good spirits to continue the Trans-Tasman cultural experience and watch some AFL.

On the weekend we also visited some surrounding towns. Nelson is a town of 60,000 people about 100ks from Blenheim. It is surrounded by national parks and nice beaches.

Picton is a small town half an hour from Blenheim that offers stunning views of the Marlborough Sounds, an extensive network of sea-drowned valleys at the top of the south island.

Week two was road trip time, heading 130ks south to a beachside town of 3,000 people called Kaikoura. With the ocean on one side of the road and snow capped mountains on the other, it was a highly enjoyable and picturesque drive to work!

In Kaikoura the medical students stay in the house of one of the town GPs. Not sure what to expect, this only heightened the overall experience, with delicious home cooked meals, table tennis games, as well as ocean and mountain views from the kitchen.

The practise is attached to a small 20 bed hospital run by the GPs, all highly skilled  generalists, as the nearest tertiary hospital is more than two hours away.

This, coupled with a volunteer ambulance service, means the GPs are called to many 111 (000) calls, including car crashes, heart attacks, births etc. and as the student you are called as well. I saw some interesting chest pain and seizure presentations throughout the week.

During the days at clinic I saw every second patient by myself, and the GP would then wave consult. It was a very flexible and laid back set up, allowing student consultations to run for as long as required; five minutes in the case of a common cold, up to 40 minutes in one case with an interesting Type 1 diabetic patient.

I saw a number of Maori patients in Kaikoura and was able to learn a bit about their culture as well.

Kaikoura is also a tourist hub, so I took an afternoon off to do a whale watch, which is an industry that helps keep the town going. We saw two sperm whales, a unique and enjoyable experience. There was also a waterfall just out of town with 40-50 baby seals swimming around in the pool of water at the bottom.

I returned to Blenheim and flew home amidst scenic views of snowy mountain ranges and clear blue ocean.

Overall it was a wonderful two weeks, both for my education, being able to learn about another health care system and to gain such hands on experience, and also to have some time to be a tourist.

I’d like to thank the East Gippsland Clinical School for the opportunity, as well as everyone in Blenheim and Kaikoura who made the trip so memorable. The exchange is a fantastic initiative between the two universities and I hope it continues into the future.

–          By Chris Ward

Magnificent New Zealand mountains

Each year there is an opportunity for two Year 4C students from the East Gippsland Regional Clinical School, to undertake an exchange with two students from the University of Otago Rural Medical Immersion Program (RMIP).

Students spend the two weeks alongside the RMIP students and are involved in all aspects of the program, also managing to fit in some sightseeing.

For the two East Gippsland students, Cassie Coetzee and Chris Ward, it was a memorable and packed trip.

Fellow Year 3B student, Willian Bay, congratulates Steve Xu on his permanent residency.

Gippsland Year 3B student Steve Xu had some good news recently, having been granted permanent residency in Australia some three years after first applying.

Steve is now looking to become a true blue Aussie in about 12 months when he can gain citizenship.

Steve came to Australia some 11 years ago as an international student to complete his Year 10 studies. He did very well at secondary school, gaining entry to the Australian National University and completing a Bachelor of Biomedicine with honours.

Steve spent two years working full time and in 2010 applied for permanent residency, with his application approved just last month.

In 2012 he was accepted into Medicine at the Gippsland Medical School and this year is studying at the West Gippsland campus of the Gippsland Regional Clinical School.

Steve is very pleased he can stay in Australia to practice medicine. We also know he would be more than welcome to remain in Gippsland! He has completed the majority of his training in the region while working part time for Gippsland Pathology.

The Monash University Ultimate Frisbee team, with Martin Chan fourth from right in the back row

One of Gippsland Medical School’s Year A students, Martin Chan, qualified to compete in Monash University’s Ultimate Frisbee team at the recent Southern Uni Games– and came home with a bronze medal.

Ten universities competed at Ballarat and the Monash team, with Martin in the key position of ‘handler,’ managed to beat the University of Tasmania for the bronze.

This was Martin’s first full campaign, having played Ultimate Frisbee sporadically for two years prior to 2013. His role as the ‘handler’ is similar to a quarterback in American football. Handlers are responsible for maintaining possession of the disc, making smart, decisive and accurate passes to find receivers to move the disc and score goals. Games are 80 minutes long and with overtime can run for more than 100 minutes.

The tournament spanned four days and after winning five out of the six pool games, the Monash team came up against University of Melbourne team in the semi-final with Melbourne winning 9-5. Martin’s team beat the University of Tasmania team for the bronze medal.

Martin found the experience amazing and is now trying out for selection in the Monash team for the Australian University Games. He would love to make the squad to play with Australian representatives and the best university players in Australia, and to be on team that takes the ‘Gold’ back to Monash University from the current champions, the University of Melbourne.

One by one, masked beauties trickled into Traralgon’s Premiere function on the night of Friday July 12th.

The venue was wonderfully decorated with local nature, simulating some sort of fairy’s forest – and the guests looked the part. Glitter, sequins, feathers and (sloth) fur covered the faces of Gippsland Medical School students, perhaps hiding the stress-lines incurred after a busy first semester.

But the GMS masquerade ball was about celebrating the year thus far (the cause of said stress-lines). And that we did.

Quickly, the masks came off in order to better enjoy a few beverages and quality local food, as well as some cheeky sweets from the candy bar. Guests paraded their attire in a photo booth, photos from which became more colourful as the night progressed.

Best dressed awards were awarded to coordinating couples and fancy femmes, and three GMS students dropped their stethoscopes in exchange for musical instruments, showcasing their hidden talents to the cohort.

Thanks to all those who played even the smallest role in organising the GMS masquerade ball, memories of which are now as faint as the remnant glitter on the floors of our bedrooms, with the end of the year seemingly equally as far away.

Look forward to a welcomed repose in semester two, when we can spend an evening on Facebook after the evidence from the photo booth has been uploaded for public viewing (surprise!)

–          By GMS students Julia, Tiarni and Jess.

Year 4 Bendigo-based medical student, Saada Malouf, has just returned from several weeks in Uganda, part of a team on a visit organised by Monash medical student global health group, TeaMMEd.

Before she went, Saada, who is originally from Gippsland, spoke to the Bendigo Advertiser and what she hoped to achieve on the trip. (Read the article).

The team originally had a choice between Tonga and Uganda, but Saada chose Uganda because it appealed to her more.

The group took numerous medical supplies to help out the local people and to leave supplies once the trip had ended. In a country where people live on $A1.25 a day and a box of band-aids costs about $4.00, the group decided the medical supplies would be valuable.

Saada approached several business and Rotary clubs in Bendigo as well as in her home area of Gippsland to support purchase of the supplies and was delighted with the response.

Catching up with past students is one of joys of working in the School of Rural Health, especially when they take the time to drop into one of the campuses. That was the case with Raffy Halim, who recently popped into the East Gippsland Regional Clinical School at Sale where he was a student eight years ago. He tells here what he has been up to since his student days.

It seems in many ways so long ago, yet in other ways only like yesterday. It was 2005 and I was starting as a new clinical medical student at Sale Hospital.

It was my first “proper” clinical experience and after a few encounters in the city, I was pleasantly surprised at both how welcoming both the faculty and the patients were to being examined and questioned. I’m sure my patients now blame Sale for me being fairly relaxed around them and occasionally even dropping a bad pun!

I visited the hospital about a month ago and the friendly faces were still around and updating me on all the …erm… updates.

I hope the new students appreciate the huge new area that they have near the library! Back in my day (am I allowed to say that?) we were upstairs and the library was our hangout. So anyway, here’s my story since Sale, eight years ago.

Med School finished almost in the blink of an eye. Fourth year was fast and furious: covering GP/Psych/Paeds & O+G is quite a task and there seemed to be never enough time and always too much to do, especially as someone with a part-time job!

But then came final year, the reward for essentially completing Uni. I spent the first month or so on an elective in Nepal, assisting in theatre in Kathmandu, then later exploring the National Parks and Annapurna Ranges. After a brief rotation back in Australia, I was off to Malaysia for another rotation, where I finally found my specialty: Anaesthetics.

My holidays were also spent overseas in New York and I arrived exactly two and a half hours before my graduation ceremony. Final year was fun (and expensive!)

Internship saw me starting at Eastern Health, though my first rotation was not too far away from Sale, in Bairnsdale.

I recommend that others interns do not copy me; my first patient died within 10 minutes of me starting as a doctor! I actually had just picked up the patient in ED when he arrested. After that baptism of fire, things improved markedly. How could they get any worse?

As a resident, I did a critical care year and again did more Anaesthetics, now determined to pursue it as a career. This led me to Monash Health as an Anaesthetic SRMO and then a Registrar.

Now, I’m in second year, having just finished my Primary Exams and once again discovering that life does, indeed, exist outside the library and finally seeing old friends and familiar faces (like those in Sale).

Other than work, I’ve also travelled somewhat – Japan and Iceland are the standout countries – helped start a medical journal, JMTM where I’m the News and Media Editor and recently started a small online store.

But wherever I go, the bad puns follow…

–          By Raffy Halim, Year 3 Sale 2005

Elliot Anderson (centre) takes delivery of a load of supplies from Mildura Base Hospital Director of Corporate Services Ms Julia Morgan, and Supply Manager Rod Moore.

Students from Mildura travelled to Tonga during their mid-year break to take part in a volunteer medical program.

Mildura-based Elliot Anderson (Year 4), and Fleur Muirhead (Year 3) together with other Monash students Andrew Long and Olivia Wells, joined the program run by TeaMMED, a student-driven, not-for-profit organisation.

It provides an avenue for Monash University medical students to become involved in medical volunteer initiatives world-wide, including medical resource collection and fundraising events in addition to local volunteer opportunities.

TeaMMed has been sending small groups of volunteers to the island of Vava’u, Tonga for three years.

As volunteers the students help alleviate the problems of limited resources and medical staff, and implement an educational approach to problems of obesity and increasing diabetes.

Elliot and Fleur visited schools located on Vava’u, holding workshops/lectures to teach children about the importance of exercise and healthy eating, and how they can avoid risk factors.

The team also headed to rural towns and villages to offer free “health checkups,” that included brief talk about the importance of healthy living, measurement of blood pressure and blood glucose level, a body mass index (BMI) calculation, and the distribution of brochures regarding diabetes and healthy lifestyle.

Another aim of the program is to aid in the treatment of those who have been previously diagnosed with diabetes, particularly those who suffer from diabetic wounds. This is a largely undervalued part of diabetes treatment, particularly in developing nations. Diabetic wounds are very common complications that often go unnoticed due to their painless nature and the fact that they are often hidden on the soles of the feet.

Appropriate dressing and treatment of these wounds are vital so that they do not become infected and potentially life-threatening.

To tackle this issue, the team helped increase local access to appropriate dressings by purchasing these and making them available for free administration within the Prince Wellington Ngu Hospital.

Before their trip Elliot and Fleur did some fundraising to help the cause; Mildura Base Hospital donated essential supplies and equipment and Nuttelex also provided generous financial support.