Tuesday, 27 March 2018

A different kind of Rural Medicine.....

We seem to have had a PE epidemic recently (admittedly the one with the ragingly, apparently diagnostically high D-dimer turned out to have no PE but a genuine anaphylactic allergy to exercise, but I digress). It doesn't do much for your confidence when you're about to embark on a trip to rural Thailand. 4 plane journeys out; and 3 plus an overnight bus on the way back - for the first time I actually tried to stave off the clots.  

The rural idyll I was heading for? A refugee camp on the Thailand/Burma border, home to about 40,000 refugees for the last 30+ years. And interloping among them were 40 students, ethnic Karen from inside Burma who've crossed the border for three months of their training as village healthcare workers and medics. Some have finished primary school, some secondary; all of them work unpaid to provide healthcare in their communities. 

I'm among them for a week, with another GPST from Brighton (who seriously considered Orkney for her training) and a retired Singaporean doctor. We're a good team: Emma and I do solid, practical, interactive sessions ranging from poisoning to calculating medicines administration, finding patients in the camp hospital for them to clerk and examine, and teaching them to inject and cannulate; Seet covers the pharmacology that we've forgotten. By the end of the week they can safely give insulin and vaccines to bananas, and  most can cannulate real live people. Steff and his team from Hope 4 the World have created a curriculum with the Karen Department for Health and Welfare and we stick to it carefully. There are different trainers every week, some new ones each year - so hopefully this attention to detail means each new group of students will come out with the same basic knowledge. It's my fourth time teaching the course, my sixth visit to the border - I've worked in one of the clinics for 4 months altogether - and after a few years' absence with my travels it feels like coming home.  

I remember: this is why I do medicine. Each trip back to the border reminds me of the struggles the ethnic groups still face, hidden behind a heat haze, miles of jungle, and media disinterest. It isn't a 'sexy' struggle; the border camps are going nowhere; the village voices are restricted - but I'm a small cog in the team that plants well trained medics among them, training them a little more reach year. Maybe one day I'll even get to visit some of their clinics and train them there - I can dream. 

For now, it's back to Orkney again. From 35°C back to 0°; From cool showers to cool me down back to cold water swims to... um... freeze me? 

2 'homes', 2 loves. 

This, too, is rural medicine. 

This, too, I love.
Dr Alison Lievesley,
GPST, Orkney

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Tuesday, 13 March 2018

GP Speciality Training Committee Meeting

Hello everyone,

My name is Uma, and I am a GPST1 currently at Inverurie Medical Practice. I volunteered for this meeting which was advertised via email. I had no idea what it was all about!

On the day of the meeting, I turned up and was surprised to see that I was the only 1st-year trainee in the room. The rest of the people were all the “who's who” of the GP training world in the North of Scotland! I greeted everyone and took a seat. I think it is safe to say all the most influential people involved in the chain of organisation for training were present. 

My responsibility at this meeting was to represent trainees and share their opinions regarding training. I am unsure how well I did in this regard as it was quite unfamiliar territory. 

Despite this, I was excited to be there and listen to the plans and effort put in to ensure our training runs smoothly. I soon realised that running the GP Programme is quite a complicated and daunting job!

At the same time, it was reassuring to see the competent people working in our interest. 

There were significant benefits of attending the meeting. I got to learn about opportunities after training, information commonly shared with ST3s, and we ended up agreeing this could be very useful for ST1s, as it affords people better opportunity and time to make up their minds about what they envisage their career after training to be.

I guess one of the most important things I want to say is that the Training Programme Directors are very approachable and open to ideas. They encourage trainees to share their thoughts on how best the programme can be run.

If you have any suggestions to improve the program in North of Scotland, please do not hesitate to contact me (uma.abelega@nhs.net), or your program directors: Vicki Guthrie and Monica Milne for Grampian Programme, Rod Sampson for Caledonian Programme and Calum Urquhart for the Rural Track Programee. I am confident that your suggestions and opinions will be given adequate consideration.

The next GP STC meeting is on the 20th of February 2019. I would be delighted to forward your opinions or concerns to the board for discussion or perhaps I might see you there!

Dr Ngu-Uma Abelega
ST1, Inverurie Medical Practice