Jonathan Felthun and Alec Hope, University of NSW medical students based in Wagga Wagga, recently completed a six-week placement in Nhulunbuy, based at Gove District Hospital. They shared a number of take-aways from their placement with the local Flinders NT Campus Administrator, Gemma Porteous.
Transitioning between their third and final year the two explained that they found what they were looking for when they chose Nhulunbuy as their preferred elective placement; exposure to Indigenous health care and rural and remote health care. They also gained some understanding of the whole Australian health care system.
“The biggest fear when you are going into a placement or based in a large hospital is not being able to be an active participant, not being part of a team, not seeing patients and not undertaking procedures”, explained Alec.
But the students were able to do a mix of Emergency Department, general medicine, paediatrics, theatre time with GP anaesthetists and specialist outreach clinics plus some highly prized remote homelands service delivery with Laynhapuy Health. They also got to appreciate that Nhulunbuy acts as a health service delivery hub for East Arnhem Land and some of the complexities associated with that.
So, now to the take-aways.
“It has been pretty eye-opening to see that perhaps some things in our health care system have been designed for white people, people who can afford it and people who have the resources to access it. Patients don’t have fridges or certain things that we require them to have in order to deliver the health care we have designed”, said Jonathan.
“We just came off months of studying a biomedical, science-based exam and this has been a really good opportunity to apply some of that in a clinical setting and learn some of the practical skills of being an intern, making calls, helping write discharge summaries and notes, and seeing patients”, said Alec. “This has been the best experience I have had since joining medical school from a practical perspective”. He continued saying, “Nhulunbuy is well resourced. Today I was being taught by a FACEM (Fellow of the Australasian College for Emergency Medicine) about venous gas interpretation. It was amazing to get teaching from a high-level clinician”.
In terms of cultural take-aways the students learnt a lot about cultural considerations and the environment they were discharging patients home to. It has been in the seeing by visiting some communities and listening, that understanding is coming which will hopefully inform the student’s future clinical practice.
Jonathan said, “I will never get to the bottom of the intricacies of all of the culture within this area. I needed to constantly seek out guidance in directing treatments etc, so it was good to know and understand my limitations as a non-yolngu person.
“When we first arrived we were given a tute and the person said, ‘Imagine, you are not in the Australia you know anymore, but in a foreign country in the middle of nowhere’. “We didn’t understand that imagining but now we do.
“It would be great to aim to make some small contribution in the future. We don’t know where we will end up in our careers, but I will definitely remember coming here and learning that these good people need something and need to be kept in mind when we are choosing our career paths.”
“When I look back I think I will realise that this placement has been crucial for me”, said Alec.
Jonathan finished by saying, “If you’re looking for your placement to be mainly a holiday then this is not necessarily the place for you. Depending on the time of year, the weather can be challenging with high humidity and heat. Day tripping is not without its potential dangers and it depends on your level of bush skills and comfort.”
“But if someone wants an elective where they will learn something pretty amazing about Australia, where the medical teaching is good and the cultural experience authentic and unique to the world then I would say they should come”.