Preparing for liftoff with rural generalist training

General practitioner and rural generalist training provide unique opportunities for aspiring doctors to receive unparalleled training while experiencing the beauty of regional WA.

For Western Australian General Practice Education and Training GP registrar Dr Anthony Rengel, who wants to be a retrieval doctor for the Royal Flying Doctor Service (RFDS), the grandeur of regional WA is one of the benefits of the job.

Anthony chose to become a GP because he enjoys multiple areas of medicine and wanted the flexibility to practice across many areas while also pursuing his interest in aviation.

He said that training rurally gave him a greater exposure to being a practising GP.

“In the metro system, junior doctors are used more for service delivery; you’re there to help things flow, and often the more menial tasks get passed to you,” Anthony said.

“I was lucky that my first term of my medical career was rural, where I had fantastic physicians as my bosses and was actively involved in helping examine the patient with the consultant.

“Overall, I gained much broader hands-on experience being involved in patient care.”

He said working rurally also gave him exposure to diseases and injuries that were not seen as often in metro settings.

“You see some of the most severe possible cases: a patient with the worst renal failure; the worst diabetic control; the worst emphysema, all in the one patient. You have to manage that,” he said.

“There are also cases specific to rural. The tropical infectious diseases you don’t see in the city. As a student I saw leprosy.

“In the Kimberley I saw post-streptococcal glomerulonephritis and rheumatic heart disease. These are often just footnotes in our textbooks.”

Anthony said working rurally helped him combine his career as a GP with his passion for flying so he can pursue his goal to become a retrieval doctor for the RFDS.

“I remember the first time I flew up to Useless Loop, breaking through the clouds and just seeing Shark Bay open up in front of me. Every time I went up there it was the same feeling of amazement,” Anthony said.

However, it was not just the beauty of rural WA that made these visits special for Anthony; it was also the chance to make tangible changes within the communities he visited.

“Some of the towns I went to held less than 500 people, so you quickly get to know all the families, politics, rumours around town, and how everything works,” Anthony said.

Patient tracking and assessment over time showed that treatment plans were working.

“We had hard data to show that having a consistent GP within that town with good support in place made a difference in people’s health outcomes and made a huge difference to that community,” he said.

Anthony would like to use the experience he is gaining as part of his training with the Australian College of Rural and Remote Medicine (ACRRM) to one day move into space or Antarctic medicine.

“Space and Antarctic medicine are essentially forms of remote medical work, and particularly have a lot in common with working as a rural and remote doctor in WA,” he said.

“Working as a solo doctor is incredibly rewarding but challenging. You have to be able to manage everything from the more mundane health concerns to quite serious emergencies with critically unwell patients.

“This is why I chose to complete my fellowship with ACRRM. It’s mandatory to gain experience in all areas of medicine, not just general practice, as well as specialising in an advanced skill.”

Anthony is in his final year as a GP registrar specialising in emergency medicine with WAGPET.