2017 ACEN Work Integrated Learning Scholarship Reflection
I had the privilege of completing my entire fourth year as a medical student rurally in the East Gippsland community in Victoria. I was predominantly based at a General Practice in Bairnsdale, however travelled to hospitals and community sites over the entire region. During this time I worked in the maternity ward, theatre, outpatient clinics at Bairnsdale Region Health Service, did a term at the local Aboriginal Co-operative GEGAC and visited Central Gippsland Hospital and Latrobe Regional Hospital for specialist terms.
Looking back over the 42 weeks of my work integrated learning (WIL) placement in East Gippsland, I have grown considerably both professionally and personally.
Placement in East Gippsland is under the “wave consulting” model whereby as a student I have my own case load in order to develop my clinical knowledge, diagnostic skills and management plans under the supervision of an experienced GP. Over the year I became more confident in taking a thorough history and competent examination and then discussed investigations and management plans with my supervisors. From this experience, I have begun to address not only the current reason a patient is presenting but to also look more broadly at areas such test results to review or screening to follow up; in other words to look at the past, present and future health issues such as screening for similar patients. I also regularly ask patients for any concerns or questions at the beginning of consultations to allow for their consultation to address their health concerns and expectations, as well as the issues that we as health professionals think are important to address.
Confidentiality in this region is critical as unlike a metropolitan hospital setting, many patients in a rural area have personal, professional or familial connections with their GP and other patients.
Confidentiality in this region is critical as unlike a metropolitan hospital setting, many patients in a rural area have personal, professional or familial connections with their GP and other patients. Maintaining professionalism and protecting patient confidentiality is much more complex and challenging in a rural setting. I have quickly learned to navigate these situations that would rarely arise in a big city. Further discussions with my GP supervisors about how they maintain confidentiality in a small town, I have become more comfortable with politely redirecting questions regarding patients I have seen.
Cultural knowledge and safety is another area I felt this placement really provided in terms of skill development. Helping at the health checks at primary schools run by the Aboriginal Health Co-op really improved my skills – particularly with communication. I was surprised to discover how stark the health inequalities between the indigenous and non-indigenous population were even in an area where a targeted programme had been formed to provide an adequate health service specifically for the indigenous community. The annual health checks provided at both the primary and secondary schools aimed to prevent health issues from the ground up and ensure children in the area were up to date with vaccinations, dental check ups and general health checks on a regular basis.
Coming towards the end of my degree, this placement has enabled me to consolidate my critical thinking, clinical skills and communication. I have gained a sense of self confidence that I certainly did not have when arriving for my work integrated placement. During the year I have seen many patients independently and also performed procedures such as skin lesion excisions, cannulation and pap smears. These skills are vital to learn and be confident to perform as an intern. I am grateful that this particular placement has allowed me to feel competent in independently gathering information about a patient and the steps of how to move forward with their treatment.
Being a community based programme, placement in Bairnsdale had a profound affect on me personally as well. As a small group of students we were really embraced by the community and given the opportunity to participate in a number of activities and events outside of our placement. I feel incredibly fortunate to have been able to get to know the community on the sporting field, at the local markets and by enjoying the amazing surrounding.
As a consequence, I have reflected often on the importance on rural health services and have begun considering working in a rural area when I graduate. I believe rural placements are vital in giving students the experience and insight to consider work in a rural area.
Immersing yourself in the community is such an important part of a rural placement and being awarded an ACEN scholarship allowed me not only to complete my placement but fully participate and learn within the local community, both from an educational and social perspective. I thank them for the invaluable experience I have had in the East Gippsland health service and community.