Biggest test of all

C1MJA 202 (9) · 18 May 2015

MJA Careers

Editor: Cate Swannell • cswannell@mja.com.au • (02) 9562 6666

CareersMJA

Editor: Cate Swannell • cswannell@mja.com.au • (02) 9562 6666

continued on page C3

DR David Rimmer is an emergency physician with a preference for working in rural

and remote areas.

These days he is the executive director of medical services for Central West Health in Queensland, for which Longreach is the main hospital and town centre.

In his days as a fly-in fly-out emergency doctor with the Royal Flying Doctor Service (RFDS), Dr Rimmer learned the realities of remote emergency situations.

But ask him about the worst situation he’s ever flown into and his answer may surprise. Rather than telling of huge motor vehicle accidents or other large events, it is one woman’s tragedy which sticks in his mind.

“We were called in to do a small hospital retrieval of a patient with a very severe head injury”, Dr Rimmer tells the MJA.

“The patient was very drug affected and had fallen backwards off a balcony.”

The woman was morbidly obese and intubation had failed. Her lung pressures were very high. In the end, the head injury proved to be unsurvivable.

“It was a huge knock to my self-confidence”, Dr Rimmer says.

“It’s the reason I continued to push for as much training as I could, to maintain the highest standards.

“The review of the process found that we’d handled it well, that we’d done everything we could, but it’s a very bad feeling to walk away from that situation without [saving the patient].”

Family history

It was almost inevitable that Dr Rimmer would become a doctor of one kind or another. Both his parents, Betty and Bill, were general practitioners in a rural setting — St George in southern Queensland.

“My father did the surgery and caesareans, and my mother ran the birthing suite and did the anaesthetics and anything else my father didn’t want to do”, Dr Rimmer says.

After training in Queensland, Dr Rimmer spent 5 years in hospitals before deciding to “go rural” and acquiring the extra skills needed in surgery, obstetrics and adult medicine he felt he needed to be a successful country GP.

“I had planned to go back to St George and work with my parents, but my brother, who was also a doctor, had settled in Toowoomba and wanted me to go into practice with him. My wife said yes”, he laughs.

Dr Rimmer spent 17 years in Toowoomba. As more specialists came to town, he diversified, becoming involved in the division

In this section

C1FEATURE

Biggest test of all

C4

Calendar of events

movement, and running an adolescent health program in eight secondary schools, using drama classes as a way to demystify doctors, and giving teens the skills to talk with their doctors and better access health services.

Along with Dr Denis Lennox, now director of Rural and Remote Medical Support (for Queensland), operating as Queensland Country Practice, Dr Rimmer set up the first rural training program in an Australian hospital, attracting “really good doctors who wanted to go bush”.

“I’d always said that when they stopped me doing obstetrics I’m leaving town”, Dr Rimmer says.

“Eventually every other GP in Toowoomba gave it up and we got caught in the middle of the midwives versus specialists argument.”

The combination of emergency medicine and a rural, remote setting provides the ultimate challenge, according to Dr David Rimmer

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C2 MJA 202 (9) · 18 May 2015

MJA Careers

Medical Offi cer Opportunitiesin the Northern Territory

nt.gov.au/health

If you want your career to go places then join Department of Health in the Northern Territory. The challenges and opportunities in health and community care in the Territory are like no other in Australia, from remote Aboriginal health to tropical health and urban tertiary care. Continued investments in Aboriginal health, remote health, acute care and community services offer many opportunities for health professionals who want to be part of making a difference.

CENTRAL AUSTRALIA HEALTH SERVICERURAL MEDICAL PRACTITIONERSPrimary Health Care Central Australia offers a range of unique opportunities to participate in delivering medical services in Indigenous Health throughout Central Australia.

Primary Health Care Central Australia prides itself on providing fl exible work arrangements to suit the needs of medical practitioners willing to provide this valuable service to remote Northern Territory (NT).

Successful candidates would join a team which currently includes 9 GPs based in Central Australia.

Further, if you don’t wish to relocate to the NT at all, opportunities exist to participate in emergency medical services where you can provide telephone and/or videoconferencing advice on a shift basis (On Call RMP) remotely from anywhere in Australia or even overseas. This work is suited to candidates with experience in emergency medicine.

If you are looking for a new challenge or want to make a difference to Aboriginal health fi nd out more at www.remoterecruitment.nt.gov.au

Primary Health Care Medical offers the following range of remuneration packages. The advertised positions could be based in a Community or fl y in / fl y out of Alice Springs. Several fi xed contracts available on a full-time, part-time and casual basis for up to 5 years.

RURAL MEDICAL PRACTITIONER (RMP) RL3.1 – RL3.5 Remuneration Package Range $156 217 - $201 950(comprising salary $136 155 - $176 378, superannuation, leave loading and the value of 2 weeks extra recreation leave)Potential total Remuneration Package of $243 000 which includes the above Package Range and in addition; attraction allowance, retention payment, professional development allowance, salary sacrifi ce, potential medicare revenue activity incentive payment of up to $75,000

The successful applicant will have a Medical degree eligible for full registration with the Australian Health Practitioner Regulation Agency. RL3.3 – RL3.5 are required to hold a Fellowship of either the RACGP, ACRRM or AFPHM together with appropriate rural training or equivalent training and  experience.

SENIOR RURAL MEDICAL PRACTITIONER (SRMP) RL4.1 - RL4.4 Remuneration Package Range $210 181 - $234 353 (comprising salary $183 618 - $204 878, superannuation, leave loading and the value of 2 weeks extra recreation leave)Potential total Remuneration Package in the vicinity of $331 000 which includes the above Package Range and in addition; SRMP allowance, attraction allowance, retention payment, professional development allowance, salary sacrifi ce, potential medicare revenue activity incentive payment of up to $75,000

ON CALL RMP has two telephone shifts per 24 hours, which attract remuneration in the range $2,000 to $3,000 per shift (depending on the time and day). Initial training is provided in Alice Springs.

Quote Vacancy Number: 72150383

For more information please contact Dr Cameron Edgell on 08 8951 7034 / 0477 312 382 or email cameron.edgell@nt.gov.au or Christine Seth on 08 8985 8132 or email christine.seth@nt.gov.au

Closing date: 8 June 2015

Appointments of the successful applicants are based on their qualifi cations, skills, knowledge and experience.

An attractive salary is offered depending on experience and qualifi cations. Accommodation at remote sites is provided. Relocation Allowance may apply. Salary and conditions are determined by the Northern Territory Medical Offi cers Enterprise Agreement, full award details can be accessed on http://www.ocpe.nt.gov.au/working_in_the_ntps/agreements__and__awards/current_enterprise_agreements

APPLICATION INFORMATIONApplicants should address the selection criteria, provide a current CV, contact details for 2 referees (preferably an email address) and complete the Credentialing and Scope of Clinical Practice Application Form for Remote Health. To obtain the credentialing paperwork contact Christine Seth (details above). For a copy of the Job Description and to apply online please visit www.nt.gov.au/jobs Further information about these positions can be obtained by phoning TOLLFREE 1300 659 247

Information on the Northern Territory and its great lifestyle is available at www.theterritory.com.au

Note: The preferred or recommended applicant will be required to hold a current Working with Children Clearance notice / Ochre Card (application forms available from SAFE NT @ www.workingwithchildren.nt.gov.au) and undergo a criminal history check. A criminal history will not exclude an applicant from this position unless it is a relevant criminal history.

Department of Health is a Smoke Free Workplace

CENTRAL AUSTRALIA HEALTH SERVICE

APPLICATION INFORMATION

D E P A R T M E N T O F H E A L T H

NT1

6076

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C3MJA 202 (9) · 18 May 2015

MJA Careers

So Dr Rimmer moved to Brisbane where he set up private emergency practice at the Mater Hospital and “did all the courses I could”.

In 1998 he began working locums for the RFDS, work he continued until 2012. It meant 6 weeks a year, spread across the 12 months, working in every RFDS base across Queensland.

That time included a 3-year stint flying into Kowanyama — an Indigenous community on the west coast of Cape York Peninsula — on a 2-week-in, 2-week-out basis.

So how does it feel to be flown into an emergency situation, in the middle of nowhere, with only yourself to rely on?

Self-reliant

“I always quote my mother”, Dr Rimmer says.

“You have to step back and think. There’s nobody else better qualified than you around and the patient has a significant problem.

“All you can do is your best, so get over yourself and get on with it.”

His life has had its dangerous moments.

“We were flying a patient who was on a ventilator into Brisbane when the plane hit an eagle and cracked the windscreen”, Dr Rimmer says.

“There was no visibility but the pilot said that wasn’t a problem because they could do an instrument landing, but it did cross my mind to wonder what would happen if the window fell out.

“In the end I took a fatalistic approach and made a joke of it with the nurse, saying if the cabin depressurised we’d take it in turns with the patient on the ventilator.”

In the end, the RFDS plane was given priority to land and made it safely to ground.

The differences between emergency medicine in the city and that in the country are stark, Dr Rimmer says.

“If there’s a major motor vehicle accident in the city, then the emergency would be dealt with by teams of 14 or 15 people really organised in a ballet, with one person whose only job is to direct traffic.

“In a rural setting you’re the one who has to do the thinking while intubating, organising retrieval — multitasking.

“In the city, if you’re in private practice you’re seeing captains of industry, famous figures and the like.

“If you’re in the public sector your patients tend to come from the lower socioeconomic demographic.

“But in the bush you get it all. You have to deal with a broader spectrum of patients.”

In his role as executive director of medical services for Central West Health, Dr Rimmer is responsible for health care across a vast area.

Central West Health covers the health care needs of 0.3% of the Queensland population spread across nearly a quarter of the land mass of the state. The region has major health inequalities, such as understaffing, limited resources and geographically isolated service access.

Dr Rimmer is now a graduate of and advocate for Emergency Life Support (ELS) — a comprehensive, not-for-profit course that teaches pivotal skills and knowledge to doctors to help manage medical emergencies safely and effectively.

Lifelong learning

The first ELS course was held in Tamworth, New South Wales, in 1997, according to a spokesperson for the company.

“By the end of 2014, 234 courses have been held in various locations through

Australia and New Zealand and over 4500 medical practitioners have participated in the course.

“The ELS course became an incorporated association in 1999 and, as such, operates as a non-profit organisation, is self-funding, and continues to operate on the strength of its instructors who donate their time and expertise for free.”

Dr Rimmer has attended the ELS course over the past few years and strongly believes that it “supplies an innovative toolkit for doctors and nurses in rural areas”.

As a result, the 14 doctors and seven nurses from the Central West Hospital and Health Service, together with colleagues from surrounding areas such as Emerald, will attend an ELS course held for the first time in an isolated outback town.

Dr Rimmer is delighted that the course is being held in Longreach as it “allows the instructors to experience the towns whose doctors they teach”.

“Usually, our doctors would have to travel over 1000 km to access training.”

Before he took the ELS course, Dr Rimmer says he would get “very quiet” during an emergency.

“Now I talk everything out methodically”, he says. “It instils calm in the people around you — who are usually more junior doctors.

“Learning to talk in moments of stress has been very important for me.”

Emergency medicine, he would tell medical students, is challenging.

“You have to be realistic, well organised, you have to be careful of yourself, and you must be well rounded.”

Working in rural and remote Australia adds another level of challenge, he says.

“The more you want to test yourself, the further you need to go from the mother hospital.

“You can’t beat the community and the sense of belonging in the bush, and being accepted as a person.

“[Emergency rural medicine] is one of the last bastions of real medicine.”

Cate Swannell

“The more you want to test yourself, the further you need to go from the mother hospital”Dr David Rimmer

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C4 MJA 202 (9) · 18 May 2015

MJA Careers

Calendar of events

ALM = active learning module

ASM = annual scientifi c meeting

CPD = continuing professional development

CT = computed tomography

ECHO/echo = echocardiography

EMAC = eff ective management of anaesthetic crises

MRI = magnetic resonance imaging

OSCE = objective structured clinical examination

SAT SET = supervisors and trainers for surgical education and training

▲ = conferences in Australia

MAY

19-21 Royal College of Ophthalmologists Annual Congress, Liverpool, UK

20-22 1st International Congress on Controversies to Consensus in Primary and Outpatient Care, Tel Aviv, Israel

21-22 2nd International Emirates Conference on Minimally Invasive Surgery and NOTES, Abu Dhabi, UAE

22-23 4th Annual UAE Epilepsy Congress, Dubai, UAE

23-26 17th International Symposium on Atherosclerosis, Amsterdam, Netherlands

24-27 RACP Congress 2015: Breaking boundaries, creating connections; Cairns, QLD ▲

24-27 National Rural Health Alliance 13th National Rural Health Conference, Darwin, NT ▲

24-28 14th Conference of the International Society of Travel Medicine, Quebec City, Canada

25-26 AHRO International Ebola Forum, Accra, Ghana

25-29 15th International Congress on Radiation Research, Kyoto, Japan

27-29 Activity Based Funding Conference 2015, Adelaide, SA ▲

28-30 7th World Congress Abdominal Compartment Syndrome Society, Ghent, Belgium

29-31 International Cardiovascular Nutrition Healthcare Conference, Chicago, USA

30 May-5 Jun International Society for Magnetic Resonance in Medicine 23rd annual meeting

31 May-4 Jun 10th International Symposium on Pediatric Pain, Seattle, Washington USA

JUNE

2-4 International Cancer Screening Network Meeting, Rotterdam, Netherlands

3-4 International Conference on Antioxidant and Degenerative Diseases, Kuala Lumpur, Malaysia

3-6 24th Asian and Oceanic Congress of Obstetrics and Gynaecology, Sarawak, Malaysia

3-6 17th Annual Conference of the International Society for Bipolar Disorders, Toronto, Canada

5-6 Singapore Hepatitis Conference, Singapore

5-7 Combined Congress of the 12th Hong Kong International Orthopaedic Forum, the 10th Asia Pacifi c Spine Society, and the Asia Pacifi c Paediatric Orthopaedic Society, Hong Kong

6-9 6th World Glaucoma Congress, Hong Kong

6-11 International Neuromodulation Society 12th World Congress, Montreal, Canada

7-11 2015 International Symposium on Recent Advances in Otitis Media, National Harbor, USA

9–12 ANZCA Ultrasound in intensive care, Gold Coast, QLD ▲

10-12 The Human Microbiome, Heidelberg, Germany

11-13 31st Fetus as Patient Congress, St Petersburg, Russia

11-13 International Congress on Obesity Management, London, UK

11-14 5th Asian Vaccine Conference, Hanoi, Vietnam

14-18 17th International Symposium on Recent Advances in Drug Delivery Systems, Salt Lake City, USA

14-18 21st Annual Meeting of the Organization for Human Brain Mapping, Honolulu, USA

14-19 Infections of the Nervous System: Pathogenesis and Worldwide Impact, Hong Kong

16-18 Digital Health and Care Congress, London, UK

16-19 International Society of Ocular Oncology Biennial Meeting, Issy-les-Moulineaux, France

18-19 4th International Conference on Interventional Pain Medicine and Neuromodulation, Torun, Poland

19-23 9th World Congress of the International Society for Physical and Rehabilitation Medicine, Berlin, Germany

20-25 International Society on Thrombosis and Haemostasis 2015 Congress, Toronto, Canada

21-23 8th International Symposium on Focal Therapy and Imaging in Prostate and Kidney Cancer, Noordwijk aan Zee, Netherlands

22-23 Transfer of Care Conference, Sydney, NSW

22-24 5th International Regional “Stress and Behaviour” Neuroscience and Biopsychiatry Conference, Miami, USA

23-24 2nd Annual Microbiology and Infectious Diseases Asia Congress, Singapore

23-24 World Non-Small Cell Lung Cancer Summit 2015, Boston, USA

23-25 International Scientifi c Conference on Probiotics and Prebiotics, Budapest, Hungary

24-27 World Psychiatric Association 2015 Bucharest Congress, Bucharest, Romania

24-27 International Society for Stem Cell Research 2015, Stockholm, Sweden

24-27 Computer Assisted Radiology and Surgery – 29th International Congress and Exhibition, Barcelona, Spain

26-28 Global Viral Hepatitis Summit – 15th International Symposium on Viral Hepatitis and Liver Disease, Berlin, Germany

27-30 International Symposium on Cerebral Blood Flow, Metabolism and Function & 12th

International Conference on Quantifi cation of Brain Function with PET, Vancouver, Canada

28-30 5th International Meeting: Challenges in Endourology and Functional Urology, Paris, France

29-30 2nd Annual Southeast Asia Healthcare Summit 2015, Bali, Indonesia

29 Jun-2 Jul Childhood Obesity Conference 2015, San Diego, USA

29 Jun-2 Jul International Congress of the Royal College of Psychiatrists: Psychiatry at the Forefront of Science, Birmingham, UK

30 Jun-3 Jul 6th Congress of the Federation of Immunological Societies of Asia Oceania, Singapore

JULY

1-4 8th Frontiers in Immunology Research International Conference, Albufeira, Portugal

6-10 NAIDOC

7-11 International Stereotactic Radiosurgery Society 2015 Congress, Yokohama, Japan

8-10 Infectious Diseases World Summit, Boston, USA

8-11 4th World Psoriasis and Psoriatic Arthritis Conference, Stockholm, Sweden

8-11 5th World Congress of the International Academy of Oral Oncology, Sao Paolo, Brazil

12-17 Staphylococcal Diseases 2015, Lucca, Italy

19-31 13th International Course on Epilepsy, Venice, Italy

25-27 International Academy of Cardiology, Annual Scientifi c Sessions 2015, 20th World Congress on Heart Disease, Vancouver, Canada

26-27 6th International Neuroscience and Biological Psychiatry Regional ISBS Conference, “Stress and behaviour”, Kobe, Japan

26-28 Australasian College for Emergency Medicine Winter Symposium, Alice Springs, NT ▲

26-30 6th International Conference on Applied Human Factors and Ergonomics 2015, Las Vegas, USA

30-31 ASEAN Neuroscience 2015, Singapore

AUGUST

1-7 World Breastfeeding Week

8-11 HGSA 39th ASM: Rare diseases and Indigenous genetics; Perth, WA ▲

10-13 Translational Medicine 2015, Cairns, QLD ▲

10-14 Brain Injury Awareness Week

23-26 Congress of the Asian Society for Transplantation, Singapore

This calendar will be updated each month. If you have an event you would like to add, please include relevant details in an email to cswannell@mja.com.au

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When you need to contact another doctor … you need a directory you can trust!When you need to contact another health professional, you need accurate contact information. Often you need information about languages spoken, qualifications, etc. The Medical Directory of Australia (MDA) is provided by the publisher of the Medical Journal of Australia and is the directory most trusted by doctors.

Listing is free!

The MDA allows you to search by name, location, classification, languages, etc. It is online and updated daily.

Not all online information is reliable, however. Which is why the MDA has a large team of researchers to validate every entry.

To check your entry or to contact us, go to www.mda.com.au or call 02 9562 6666

A simple free search is available at www.mda.com.au

To subscribe to the full directory email subscriptions@mda.com.au

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MJA Careers Classifi eds

C6 MJA 202 (9) · 18 May 2015

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