MJATHE MEDICAL JOURNAL OF AUSTRALIA

N U M B E R 5 • 6 S E P T E M B E R 2 0 1 0

Careers

In this issueC1 Getting abreast of specifi c interests

C3 One Day with GP and ship doctor Professor

Max Kamien

C4 NT option to study locally, focus on Indigenous training

Careers

C7 Locums

C8 – C9 University Appointments

C9 – C10 Overseas Appointments

C1IT’S NOT EASY telling someone

they have cancer but, surprisingly, it is

sometimes the lucky ones who don’t have

cancer that need the most reassurance

— with breast cancer on the rise, there is a

heightened anxiety about if and when the

ailment may strike.

So says Dr Sue Fraser, president of the

Australasian Society of Breast Physicians

(ASBP). While this specifi c interest

group — which is involved in diverse

work from interventional procedures to

follow-up care — can be emotionally

charged, it is also extremely rewarding.

Breast physicians can do their work

in combination with part-time general

practice, are involved in each step of the

continuum of breast disease and may

work in their own practices or in teams

in private and public settings. And with

the development of multidisciplinary

breast cancer clinics, patients can have a

consultation, undergo tests and get,

at least, a preliminary result, all in the

one day.

Dr Fraser recently attended the

Australasian Society for Breast Disease

conference in Auckland, which heard

that one in eight Australian women

will develop breast cancer by the time

they reach the age of 82. The incidence

has almost doubled since Dr Fraser

started working in breast medicine in

1989. Lifestyle may be partly to blame,

with risk factors on the rise, including

women having babies later, bearing fewer

children, breastfeeding less and drinking

more alcohol. With most breast physicians

in Australia having fi rst trained as general

practitioners, the approach is very much

a holistic one and work may include

spending time counselling the patient. “I

once had to tell eight patients they had

cancer in one day,” Dr Fraser recalls.

Breast medicine is just one of numerous

special, or specifi c, interests in general

practice — ranging from emergency

medicine to anaesthetics and Indigenous

health. The Royal Australian College of

General Practitioners is in the process of

formalising the way it deals with specifi c

interests and hopes to fi nalise this by the

Getting abreast of specifi c interestsThe good physician treats the disease; the great physician treats the patient who has the disease. Sir William Osler (Canadian physician, 1849-1919)

Editor: Vivienne Reiner vreiner@ampco.com.au • (02) 9562 6666

continued on page C5

Dr Sue Fraser

C10 – C11 Specialist Appointments

C11 Hospital Appointments

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MJA Careers

C3

One Day (in Perth)

6.00 Home-roasted coffee, muesli. Read morning paper,

especially letters to editor, Alston cartoons, comics,

sports pages, court reports and — to check on

unexpected patient outcomes — the death notices. Tend

veggie patch.

7.00 Read medical journals and newspapers.

8.00 Receive day’s instructions from long-suffering wife, cycle

to practice — 10 km along ocean front, stopping in park

for 5 minutes of abdominal crunches. Spruce up.

9.00 Patient consultations, usually with a senior medical

student attached.

13.00 Paperwork, bargaining phone calls with specialists’

receptionists. Hello to staff in WA Faculty of the RACGP.

14.00 House calls.

15.00 Tennis with lifelong tennis friends. (Our fi nest hour was

winning the Australian 60+ teams championship.)

18.00 Dinner. Share cooking with wife. (Or, once a week, dine

out with friends or wife’s friends.)

19.00 Committee meetings once a week. (Or writing medical

history and comment, medicolegal opinion, advising

international medical graduates.) Rarely watch TV, other

than The Bill and Four Corners.

22.00 Listen to ABC Radio National’s Phillip Adams or

recordings of The Health Report, The Science Show or

The Law Report. Usually unconscious by 22.15.

One Day (in the Antarctic)

6.00 Get up. Get coffee in passenger lounge. Read about polar

expeditions.

7.00 Breakfast. Dress in layers, pull on boots and prepare

for transfer to the ice or land. The ship doctor also has

a role as a safety offi cer — useful for controlling the

occasional passenger who does not understand the

word “queue”.

8.00 Join various species of penguins, seals, albatross and

petrels, and marvel — as Charles Darwin did — at the

survival of the fi ttest, or the luckiest.

9.00 Lock elbows with the oldest, most physically unstable

female when traipsing in the snow. I reason that four

legs and her walking stick are more stable than my two

legs or hers alone.

11.00 Make our my way back to the ship. Supervise scrubbing

of boots to remove penguin poo. Remove cold gear.

12.00 Lunch. All conversation is about what we have seen and

experienced.

13.00 See four or fi ve patients. Main problems are Australians

and Americans with pre-existing but usually stable

illnesses. Europeans are much more self-suffi cient and

rarely consult. New presenting problems include severe

sunburn and sea sickness.

14.00 Attend a lecture or fi lm about Antarctic wildlife or

exploration.

15.00 Make another landing on the Antarctic continent

(weather permitting). There is also scuba diving and

kayaking. I have to be on hand with resuscitation gear.

One of my charges once fl ipped his kayak and was in

the 0ºC water for about 3 minutes. I rushed him into my

hypothermia bath. (When I took him back to his cabin,

I found seven empty bottles of cognac.)

17.00 If there are lots of icebergs, we lower the infl atable boats

and cruise around them. At least once on each trip we

get close up to whales of the humpback, minke and

killer varieties. Graceful leopard seals are more common

and not to be trifl ed with. Three years ago, a young

English biologist was snorkelling and got taken by a

leopard seal.

18.00 Dinner, followed by a briefi ng about the next day’s

activities. If the passengers are mainly Australians,

there is a convivial and ribald “concert” to which I am

expected to contribute medical jokes and also take the

basso profundo parts of the singalongs. If there are few

Australians, the evenings are much quieter.

21.00 Most passengers are asleep.

Professor Kamien, currently at sea until late September, will report on his fi rst trip to the Arctic in a future issue of MJA Careers.

One DayWHAT do doctors do all day? One Day gives a glimpse into one doctor’s life:

PROFESSOR MAX KAMIEN is offi cially “semi-retired” but

in effect holds several positions — recently adding “ship doctor

on polar voyages” to his repertoire. He is Emeritus Professor

of General Practice and Honorary Senior Research Fellow,

University of Western Australia; Provost Fellow and Corlis

Fellow, WA Faculty of the RACGP; Senior Sessional Member,

State Administrative Tribunal, WA; and Locum Buddy, Ord Valley

Aboriginal Health Service (3–9 weeks per year).

Professor Kamien has undertaken three trips to the Antarctic

and is currently on his fi rst trip to the Arctic. Here, he describes

a typical 24 hours in his home town, Perth, as well as a day

working as ship doctor.

www.mjacareers.com.au • Number 5 • 6 September 2010MJA Careers

C4

NORTHERN TERRITORY residents will be able to undertake their entire medical training in Darwin, rather than studying the fi rst 2 years of their degree in Adelaide.

Applications are being assessed for next year’s intake to the new NT Medical Program (NTMP) offered by Flinders University in partnership with Charles Darwin University. Construction of a $14 million building is underway to house the additional students. NT residents will receive fi rst preference. The program aims to recruit and train Indigenous Australians to become doctors in the territory, and to prepare doctors to work in rural and remote communities.

The new Bachelor of Medicine and Bachelor of Surgery (BM BS) degree will be offered HECS-free and will see up to 40 doctors graduating each year, with 24 students in the fi rst intake. Doctors will be required to stay in the territory for their fi rst 2 years’ work after graduation. Professor Michael Lowe, Clinical Dean of the NT Clinical School, says because of the NT’s relatively small population and the small number of people wanting to study medicine, it would not have been possible to offer such a program without government support. “We have had a very positive response,” Professor Lowe says.

During the development of the 4-year program, it was decided that Indigenous Australians would be given the option of an alternative to sitting the Graduate Australian Medical School Admissions

Test. Potential students can instead complete an application form, an interview and a bridging program. Professor Lowe says, as a result of this, Flinders University has also modifi ed the way it selects Indigenous students in Adelaide.

To enable Territorians to study medicine straight from high school, the 4-year BM BS graduate entry course will also be offered as a double degree with a Bachelor of Clinical Sciences course through Charles Darwin University. Students who have successfully completed 2 years’ study can then move on to the BM BS.

Dr Della Yarnold, Indigenous Academic Facilitator for the NTMP, says the ability to study locally is crucial for attracting a greater number of Indigenous students. Dr Yarnold says the option of an interview — rather than an exam for the graduate medical degree — is also signifi cant. “An interview allows the panel to get to know you. It can be hard to quantify on paper ... that you are ready to study medicine.”

Dr Yarnold says when she was going through school, it was generally expected that Indigenous students would drop out by Year 10. Dr Yarnold completed high school and went on to gain experience in a variety of areas, spanning policy work at the federal Department of Health and the Aboriginal Development Commission (later known as ATSIC), and time as an offi cer in the Army Reserve. She was later accepted into a medical degree at the University of Newcastle through an Indigenous entry program.

Dr Yarnold says, “As an Aboriginal doctor, you can impact on the clinical environment and the policy and the community, so you can have a really broad impact on Aboriginal health. Especially when you’re asking them [Indigenous patients] to modify life factors, you can put it in context.”

Territorians given option to study

locally for fi rst timeIndigenous, rural pathways a

focus of new NT Medical Program

What’s shaping medicine now

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www.mjacareers.com.au • Number 5 • 6 September 2010MJA Careers

continued from page C1

end of the year. RACGP Vice President Dr

Morton Rawlin was involved in work on

a discussion paper a few years ago that

has culminated in this new approach (the

paper can be found at http://www.racgp.

org.au). Dr Rawlin says the paper, which

looked at the advantages of specialising

while also considering possible

disadvantages such as fragmentation of

general practice, has been well received.

The paper chose to use the term “specifi c”

rather than “special” interest, noting some

GPs view the term “special” as connoting

greater importance, rather than specifi city.

The RACGP paper cites independent

studies that evaluated the impact of GPs

with special interests (GPwSI) in England.

These showed, among other advantages,

that up to four in 10 patients referred to

secondary care “could have been seen by

a GP with special interests”, that clinics

using GPwSIs cost about half as much

as usual secondary care and the rates

for patients not attending their GPwSI

appointments was very low.

With breast cancer incidence increasing

and survival improving, it is little wonder

breast physicians are in short supply. The

ASBP is hoping that as the profi le of this

specifi c interest group is raised, more

doctors will train in this area and help

ease the workload of specialists such as

radiologists, who suffer chronic workforce

shortages. There are currently only about

50 fully qualifi ed ASBP fellows, as well

as some 25 members and 10 associate

members of the ASBP, which is only some

30 years old. Practitioners are mostly

located in Sydney, Brisbane and Auckland,

where the multidisciplinary breast cancer

clinics that offer training are based.

Breast physicians, whose role sits

somewhere between the GP and the

radiologist and surgeon, may be gaining

recognition within the medical profession,

but getting equivalent remuneration for

some of the specialist aspects of their work

continues to be a longer-term — although

possibly not too far off — aim. Breast

physicians, in the main, bill GP item

numbers, including for consultations.

While they do have access to a separate

item number for breast biopsies, breast

physicians are yet to gain access to the

same item number as specialists for other

similar work such as diagnostic imaging,

including ultrasounds.

“Ultimately our aim is to have our own

item number for consultations — like

sports physicians,” Dr Fraser says. The

Society has doubled in size in the past fi ve

years but, when it last applied for special

consideration, it was rejected. Dr Fraser

says they were considered too small a

group at the time but were encouraged to

reapply at a later date. Another submission

may be made next year.

In other moves, talks were held last

month regarding advanced credentialling

in Queensland Health for senior medical

offi cers. If successful, breast physicians

there will be employed as Staff Specialists.

Dr Fraser is hopeful of a positive outcome

but says change has not been fast: “The

process has been going on for 6-8 years.”

In New South Wales, breast physicians

already have Staff Specialist appointments

in some area health services.

Training of breast physicians is

currently under review but, for the past

14 years, doctors wanting to become

breast physicians have had to undertake

on-the-job training for the equivalent

of 3 years full-time, followed by an

exam. Physicians wanting to keep up

their RACGP membership can focus

a substantial part of their continuing

professional development requirements

on breast medicine. The role of breast

physicians differs in the various states in

Australia, but may include working in

diagnostic and breast screening clinics,

doing mammogram reads in association

with a radiologist or independently, and

combining skills such as oncology and

general practice. Breast physicians have

been able to take on some of the work

traditionally done by radiologists and

surgeons, while being ideally placed to

offer continuity of care.

Sydney-based breast physician and

academic Dr Meagan Brennan says it’s

an interesting time to be

working in breast cancer

treatment and diagnosis,

with numerous new

treatments and diagnostic

technologies becoming

available. Dr Brennan

encourages breast physicians

to undertake academic

research because this plays

a crucial part in gaining

recognition for the specialty.

Dr Brennan is currently

completing a PhD in breast

cancer survivorship and

is investigating ways of

improving follow-up care for

women after breast cancer

treatment. She is evaluating

a survivorship care plan that

could be used by specialists,

breast physicians and GPs

to deliver long-term care to

women after treatment.

Dr Brennan remains

passionate about breast

medicine after more than a

decade and says the job is as

varied as it is fulfi lling.

“I fi nd it inspiring how many

patients cope so well and

use it as an opportunity for

positive change in their life.

It reminds me to keep

my own problems in

perspective,” she says.

Dr Morton Rawlin, RACGP Vice President

MJA

Care

ers

C5

Next issue: breast physician Dr Meagan Brennan features in our Q&A

Breast physicians may be gaining recognition, but getting equivalent remuneration for some of the specialist aspects of

their work continues to be a longer-term aim

C7

MJA Careers

LOCUMS

MJA Careers

C8

UNIVERSITY APPOINTMENTS

C9

MJA Careers

OVERSEAS APPOINTMENTSUNIVERSITY APPOINTMENTS

www.bartsandthelondon.nhs.uk

We are seeking to appoint locum and substantive full-timeconsultants into newly approved posts within one ofLondon’s busiest and most innovative Emergency MedicineDepartments. Barts and The London is the home to London’sAir Ambulance Service and houses a dedicated PaediatricEmergency Department. It is a leading centre for traumaand emergency care; our specialists treat some of London’smost seriously ill and injured patients.

You will work at the Royal London Hospital which attendsto 150,000 patients each year; there is a diverse andcomprehensive case mix. The ability to work independently,as well as part of a team is as important as being able to cope under pressure whilst remaining calm. You willenjoy being part of an innovative team, have a passionfor clinical medicine and be prepared to meet the presentand future challenges of the emergency care agenda.

There may be an opportunity to become involved in areasof special interest in the department which includepaediatric emergency medicine, pre-hospital care, intensivecare medicine and major incident planning.

Applicants must possess MBChB, FCEM (or equivalent)and be eligible for entry to the GMC’s Specialist Registeror be within six months of obtaining your Certificate ofCompletion Training.

For further information please contact Dr Ian Morrison,Lead Clinician Emergency Medicine/Pre Hospital Care on 020 7377 7728 or e-mailian.morrison@bartsandthelondon.nhs.uk or Dr SimonWalsh, Consultant in Emergency Medicine by e-mail onsimon.walsh@bartsandthelondon.nhs.uk

Please e-mail victoria.meli@bartsandthelondon.nhs.uk for an application form quoting job reference number259-EME1134LC for the Locum Consultant post and 259-EME1134C for Substantive Consultant.

Closing date: 3rd October 2010.

Interview date: Week commencing 22nd November 2010.

Committed to equal opportunities.

Brin

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Locum and Substantive Consultantsin Emergency Medicine

DISCOVERYOPPORTUNITYEXCELLENCE

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More career opportunities at www.jobsatUQ.net

To apply: Go to www.jobsatUQ.netto obtain a copy of the position description and application process. UQ is an equal opportunity employer.

SCHOOL OF MEDICINE, DISCIPLINE OF SURGERY & PRINCESS ALEXANDRA HOSPITAL

EXPRESSIONS OF INTEREST – CHAIR IN OTOLARYNGOLOGY HEAD AND NECK SURGERYThe role To provide academic leadership in the discipline of Otolaryngology Head and Neck Surgery across the School and the University; to work with the Head of School and other members of the School to develop and implement School and Faculty strategic plans; and to build and maintain a vibrant research program. This position will focus, in particular, on developments in the planning, delivery and evaluation of undergraduate teaching. As Head of the Department of Otolaryngology Head and Neck Surgery the appointee will contribute signifi cantly to the clinical leadership of the Princess Alexandra Hospital. Remuneration A remuneration package will be negotiated with the successful candidate that is in line with that provided by Queensland Health. Full-time, fi ve year fi xed-term appointment at Level E (Professor). Subsequently there will be an option for reappointment according to mutual agreement. Applications close 26 Sept 2010Reference No. 3000539

MJA Careers

OVERSEAS APPOINTMENTS GP OPPORTUNITIES

Worldwide reachHuman touch

DOCTOR, MEDICAL ASSISTANCE SERVICES

International SOS is the world’s leading provider of medical assistance and international healthcare. Our unique expertise enables organisations to manage the health risks facing their international travelers, expatriates and global workforces.

Our International Medical Assistance service operates 24-hours a day and is staffed by our qualified professionals who can respond rapidly to any type of international emergency or call for assistance. In the event of a medical or security emergency we assist our members around the world by providing immediate advice and medical assistance, including international evacuation and repatriation through our network of 26 emergency assistance response (Alarm) centres. We have over 6,000 dedicated professionals and 70 sites world wide.

The team of doctors based within our Dubai regional alarm centre provide medical and clinical leadership and direction to our international emergency response team within our medical assistance operations. The key responsibilities of the position are to support our 24 hour emergency medical response, oversee international medical evacuations and transportation of patients, medical case coordination and monitoring of treatment outcomes for our members when they are traveling, working or living overseas. This position is based within a contemporary corporate environment where team work is essential.

THE PERSON Full registration to practice medicine Medical Doctor with solid experience in hospital/emergency medicine or general practice Further qualifications and experience in travel or aviation medicine is advantageous A customer service ethic and understanding of the needs of a corporate organisation Work effectively with non-medical staff and clients Confident clinical decision making skills Cultural awareness Fluent in Arabic & English language skills

In return we offer a competitive expatriate salary package and benefits, relocation services to Dubai and the opportunity for continued career development within our global organisation.

TO APPLYPlease go to our corporate website at www.internationalsos.com/careers and follow the careers link to the “International Medical Career Opportunities” section to apply.

Bla

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DOCTORS REQUIREDwith high ethical standards,

good manual dexterity and an eyefor beauty,

to train and work asCosmetic Physician or Cosmetic

Surgeonat busy, well equipped and appointed,

ACHS accredited,Cosmetic Day Surgery in Adelaide.

Experienced Cosmetic Practitioners arealso welcome to apply.

Hospital privileges nearby available.Successful applicants may proceed toFellowship through the Australasian

College of Cosmetic Surgery.

For application form:

mjhiggs@esc.net.au

or

Medical DirectorParkside Cosmetic Surgery

7 Unley RoadParkside SA 5063

Applications close: 30 September 2010

Fellow In Upper GI/Bariatric SurgeryFixed Term, Full-time for 12 months (76 hours per fortnight)

Web Search No: CG002245

Level/Salary: Department of Health Medical Practitioners (Metropolitan Health

Service) AMA Industrial Agreement Level 12 -13 $116,993 - $122,842 pa

Job Description: The General Surgery Department at Sir Charles Gairdner

Hospital invites applications for a 1 year Fellowship position in GI/Bariatric

Surgery. The Fellow in Upper GI/Bariatric Surgery is attached to the Upper GI

Surgical Service (General Surgical Unit) and is directly answerable to the three

Specialist Surgeons. The Fellow will:

To be successful in this role you must be registered as a Vocational Trainee with

the RACS, Section of Upper Gastrointestinal Surgery, or must be registered with

an equivalent training program

Conditions of employment are in accordance with the Western Australian

Government Metropolitan Health Service / AMA Medical Practitioners Industrial

To Access Detailed Information:

No. to access detailed information or Ph: +0061-8-9480 9307 to be mailed an

For Further Job Related Information: Please contact Amiee Moores on

Ph: +0061-8-9346 3381.

Location: Sir Charles Gairdner Hospital, Nedlands, Western Australia

Closing Date: Monday, 20 September 2010 at 4:00pm

Government of Western AustraliaNorth Metropolitan Area Health Service

adcorp F45546

SPECIALIST APPOINTMENTS

Looking for GP (VR) for long

standing practice (30yrs) with an

established, loyal patient base.

We offer 3, modern, well equipped and computerised

consulting rooms.Hours currently Monday - Saturday 9am - 6.30 pm,

but negotiable.After hours Nursing home

and on call available.Opportunity for equity

share.

Please see www.mmcsurgery.com.au for more details or phone Serena on 0407946612.

MJA Careers

SPECIALIST APPOINTMENTS

GastroenterologistsGastroenterologistsGastroenterologistsGastroenterologists2 Full time equivalent and/or VMO

Lead roles in the development of an existing serviceSupportive clinical team with research and teaching interestsClose working relations with key Metropolitan referral

centres

An exciting opportunity exists for appropriately trained and qualified Gastroenterologists tojoin Ballarat Health Services (BHS).

BHS is an expanding multi-service regional teaching hospital, based in Ballarat, a thrivingprovincial city of 100,000 people. Located 110km west of Melbourne, Ballarat is a lively andprosperous regional centre, with first-class schools and universities, excellent recreational andentertainment facilities.

BHS is significantly expanding its Gastroenterology service and is seeking to appointA full time unit head of Gastroenterology and Endoscopy able to supervise AdvancedTraineesA second full time Gastroenterologist to provide expanding service capacityAdditional VMO Gastroenterologist capacity

The unit currently provides inpatient and outpatient services, including a Liver Clinic and hasa growing clinical research program. A busy endoscopy service led by Gastroenterology isjointly provided with surgeons. Subspecialty interest including interventional endoscopy andhepatology would be most welcome.

Applicants must have a primary medical qualification fully registrable with the Medical Boardof Australia, hold an FRACP or equivalent in Gastroenterology and have or be eligible forspecialist recognition under Medicare.

A competitive remuneration package is available to the successful candidates, including rightof private practice, superannuation, long service leave, continuing medical educationalallowances, study leave and assistance with relocation expenses.

Interested candidates are invited to contact Dr. Mark Yates, Clinical Director - InternalMedicine on +61 3 5320 3704, email: marky@bhs.org.au or Mr. Philip Reasbeck, ActingExecutive Director Medical Services on +61 3 5320 4278, email: pgr@bhs.org.au for furtherinformation.

Applications must address the key selection criteria, include at least three professionalreferees and be submitted via the Ballarat Health Services website.

www.bhs.org.auwww.bhs.org.auwww.bhs.org.auwww.bhs.org.au

ENDOSCOPY POSITION WANTED

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HOSPITAL APPOINTMENTS

Work + Life = Mercy Health

Werribee Mercy HospitalCareer Medical Offi cers

The Werribee Mercy Hospital Emergency Department is seeking

enthusiastic and highly motivated Career Medical Offi cers to provide

quality emergency medical services to our growing community.

Located approximately 15 minutes from the West Gate Bridge in

Melbourne, the department offers a diverse case-load (excluding

trauma) and currently has an annual census of over 36,000 with the

number and complexity of patients expected to increase rapidly in the

coming years.

The department is well staffed with emergency physicians and

is accredited with the ACEM for 6 months advanced training in

emergency medicine. In late 2010 a 4-bed Adult Short Stay Unit will be

commissioned, with the addition of a 4-bed Paediatric Short Stay Unit to

follow in mid-2011.

National medical practitioner registration and recent experience working

in an emergency department within an acute hospital in Australia

(or equivalent) is essential. Competitive remuneration will be offered

commensurate with relevant experience. Salary packaging is also available.

Dr John Pasco FACEM, Director – Emergency Services,

9216 8498

WMH 71

Friday 15 October 2010

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