“OMG how was your ‘Barns-dale’ placement!?”

A much anticipated component of the second year curriculum, the two week rural program offers students a taste of country clinics and culture. Students participate in tutorials, placements and excursions with a focus on rural health at various sites around Victoria – Bendigo, Mildura, Warragul, Traralgon, Sale and Bairnsdale. Tushar Goyal writes about his rural placement with the School of Rural Health in Bairnsdale, East Gippsland!


 

Until now, Pakenham is probably the most rural place I had been in my entire life. So, receiving the placement email to find out that I would be heading to Bairnsdale, a town more than 280km away, incited a level of anxiety and excitement at the same time. Although I received numerous presentations on “how amazing rural is” and “how much fun placements are”, I have to admit that the experience itself is invaluable.

The best way I could describe Bairnsdale is warm. Not just because the weather was ideal, but the inclusive, welcoming and comfortable environment that the residents make for all guests and students. Upon my arrival, I was constantly greeted by strangers, from the conductor on the platform to pedestrians on the street – almost as if I was already part of the community. Immediately, our supervisor for the fortnight, Dr Angelo D’Amore, welcomed us and gave a brief rundown on the activities we would participate in during our placement (with occasional discussions on the best bars and clubs in town). As the day concluded, we were given a quick rundown on basic clinical skills, realising that no health professional would let me perform these on a real patient at a second-year level… but boy was I wrong.

The next day, we were thrown straight into placements 7:00AM sharp. I was ready at the GP clinic, expecting to sit-and-watch the patients come in and out of the consulting room, but instead, I found myself taking histories, conducting physical examinations, analysing blood films and having detailed discussions about differential diagnoses with the GP. It felt odd to know that after 2 years of sitting in lectures, I was finally able to use some of the content taught at university in a clinical setting – even the citric acid cycle! But my clinical experience did not end there; I had numerous other placements:

  • Medical imaging – where I did not get grilled as hard as I do in anatomy tutorials
  • Wound management – where I finally learnt how to hold a scalpel properly
  • Dialysis – where I learnt that putting the blood pressure cuff on backwards can be a problem
  • Medical ward rounds – where I found out how fast interns walk around the hospital
  • GP clinic – where I discovered that writing patient notes is so much easier if you can touch-type
  • Aged care – where I experienced the pleasures of morning tea every hour

And of course, in addition to these life-lessons, I uncovered a whole new type of medical education, one that is more clinically-based and patient-focused. Attending rural placements lets you truly appreciate the complexities of medicine and multitude of layers of knowledge that are embedded within the health sciences.

However, the placement also helped me realise that there is a distinct and crucial cultural aspect of this town that cannot be ignored. I had the unique opportunity of working in disability support services and attending the local school to encourage children to study medicine. We were even invited to the Bairnsdale Keeping Place, a building that houses various Indigenous artefacts that hold deep cultural and traditional value to the Indigenous population. Such interactions give you a deeper insight into community values, attitudes and truly highlights the social cohesion that keeps this community so close-knit. Being able to converse with the residents reveals the strengths and weaknesses of their community, but at the same time, helps you become part of the society they have built so delicately.

Nevertheless, Angelo made sure we did not miss out on quintessential rural activities either. On Friday, all students on the placements received a chance to explore a farm for a clinical and social insight about workforce in Bairnsdale and workforce-related injuries. It was the first time I have ever been to a farm, and I certainly hope it isn’t the last. Patting adorable farm animals and exploring the “tractor museum” was indeed an exclusive experience, but this was superseded by the morning tea hosted by the farmers themselves. They invited us into their home with as much as affection as I had seen throughout the rest of my placement, and openly discussed how their lives contrasted from those who lived in metropolitan settings.

It was evident during my placement that there are significant health challenges faced by rural communities – lack of resources, remote locations, tensions between Indigenous and non-Indigenous populations and reduced health literacy. I have the utmost respect and admiration for all the healthcare staff I worked under at Bairnsdale because their role in their rural community is integral to saving the lives of regular Australians. As future doctors, we have a responsibility to ensure that health outcomes improve for disadvantaged communities, and currently, towns like Bairnsdale still show a significant disparity in health outcomes when compared to metropolitan locations such as Melbourne. Attending Bairnsdale for my placement was both an honour and a privilege that taught me more than any lecture ever will.

I can safely say that now I genuinely understand what all those presenters meant when they said “how amazing rural is” and “how much fun placements are”.

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