The bush GP: what it’s really like working in a remote location

“You’re by yourself, you’re thrown in the deep end and you’ve got to manage that,” says Dr Chris Clohesy, who has spent the last five years working as a GP in remote communities in Northern Territory, after a 20-year career in the city. “There’s the constant threat that something will come up that takes you to the limit and there’s no one holding your hand. You’re asking yourself: am I up to it?”

Dr Clohesy recounts a time when he had to manage a child who had drunk petrol and was fitting.

“I was in a remote community and there was only me and a couple of nurses. We didn’t have much equipment and we were talking to Darwin by phone, with a plane a good couple of hours away. This one had a good outcome, but you remember these things. They’re frightening and challenging situations.”

And then there are the more quirky episodes that a doctor is never going to experience in a suburban Sydney clinic - such as the occasional veterinary intervention, for example.

“Late one day a chap brought in his dog, which had been run over and had a massive abdominal wound, extending from the groin to the belly. Can you do anything, the owner asked. So we sewed the dog up and gave it some antibiotics and incredibly, the dog survived. I couldn’t believe it! So you do have to think out of the square and handle some weird cases.”

The key to working remote, Dr Clohesy says, is to keep your skills and knowledge up to scratch.

“It’s a difficult process finding the educational resources to be able to upskill. I spend a lot of time hunting down courses and clinical attachments to keep me up to date. And it’s a lot of time and money. Rural and remote doctors have the same educational requirements as everyone else, but it’s a lot harder to get them. And for junior registrars studying for exams it’s really hard, particularly if you have a dodgy internet connection!”

Online learning definitely has a big role to play for rural and remote doctors, Dr Clohesy says.

“But it’s got to be good. You can’t just put something up on the internet and say, there you go. There’s still got to be some sort of human contact with that online course where you can actually talk to someone, and an expert you can contact really enhances the course.”

Dr Clohesy recently flew to Melbourne to do an Advanced Life Support course. He says he paid his own airfare, plus the $700 for the course, with the whole trip taking three days.

“That’s so I’m up to speed on the cardiac stuff I need to deal with out here. It’s not about sitting around under a palm tree on the beach; it’s a serious challenge.”

And it’s also important to keep your outside interests and lifestyle ticking over, Dr Clohesy says, whether it’s sport, exercise, fishing or reading.

“At the moment I’m getting my bikes and gym equipment shipped to me by barge from Darwin. Luckily, where I am there is a swimming pool, so I can do my laps which is important to me.”

Keeping in the medical loop and maintaining your networks is also important when you’re working in remote locations.

“I belong to the AMA, I join as many committees as possible, and all that improves my interactions with other doctors.”

The job definitely has its own rewards, Dr Clohesy says.

“Most doctors are out here because they want to help, and they want to look after these impoverished people, and that gives them a huge amount of satisfaction.”

Junior doctors may think if they go rural they’ll miss out on positions in metropolitan hospitals, but that’s not at all the case, Dr Clohesy says.

“These days, as a junior doctor, it’s really positive to have a CV with some rural work on it. It shows you can work independently.”

And there are various incentives, such as the General Practice Rural Incentives Program, which pays doctors an annual amount for working in rural and remote areas, with the amount rising with each extra year of service.

“We have a public health role. I think it would be great if all doctors did a six-month stint in a rural or remote community. We’d overcome a lot of deficiencies if that happened.”

• Are you working in a remote or rural community? Doctorportal Learning has a number of online learning modules that may suit your certification needs.
• Our Cranaplus Advanced Life Support module with can be completed entirely remotely, with an online theory component and a clinical assessment using Skype. This module is the only accredited ALS in Australia that enables you to undertake the clinical assessment via a virtual platform.