View Guide - AMA WA

32 Pages·2014·3.04 MB·English

Internship 101 –
What You Need to Know
2015

INTERNSHIP 101 – WHAT YOU NEED TO KNOW 1
1
CONTENTS
Welcome to the Medical Profession ...................................................2
Welcome from AMA (WA) Doctors in Training (DiT) Committee ..........3
Welcome from AMA Council of Doctors in Training Chair ...................5
Insight into Intern-al Workings at Charlies, RPH & Freo ......................6
Golden Rules for Interns – From Those Who Have Been There! ........11
Salary Packaging Explained ...............................................................12
5 Reasons to Join AMA (WA) ..............................................................13
Reflections: What it Means to be a Doctor .........................................14
The AMA: A One-Stop-Shop for Doctors in Training –
Professional and Industrial Services ...................................................16
Entitlements – What You Need to Know .............................................17
Doctors in Training – Salary Rates Guide ...........................................19
Your Payslip .........................................................................................20
Prescribing 101 ..................................................................................22
Looking after your Mental Health and Wellbeing ................................25
Weighing up the Benefits – The Value of AMA Membership ..............26
AMA (WA) Junior Doctor of the Year
(Dr Camille Michener Legacy Award) ..................................................27
Contacts ..............................................................................................28
2 INTERNSHIP 101 – WHAT YOU NEED TO KNOW
2
WELCOME TO THE MEDICAL PROFESSION
It has been nearly 20 years since I started as
an Intern in the Emergency Department at
Royal Perth Hospital.
I remember the velour chairs on might just provide the correct The Assocation provides many
the balcony of the north-facing answer to that tough question by a opportunities for Doctors in Training
doctor’s lounge – there were still formidable consultant; play a small, (Interns, Residents and Registrars)
quite a few smokers back then! yet significant part in a patient’s to become involved with developing
I remember sustaining a needle- recovery; or assist at surgery for the policy positions and determining
stick injury on the blood culture first time. our demands of government. There
bottles that I’d never been taught to But there will also be periods when are two Doctors in Training (DiT)
use as a medical student. you question everything that you have seats on our Council. As a former
I remember the fallout from a learned so far. As you become drawn Chairman, I am proud to report
Northbridge brawl between a into demanding rotations, fierce that the DiT Committee is one of
Vietnamese gang and a group of competition, incessant study, and our most vocal, passionate and
Aboriginal men. Thank God the mundane assignments (discharge relevant groups.
combatants didn’t know they were forms, anyone?), exhaustion will grow, Current co-Chairs, Dr Melita Cirillo
only a few cubicles apart that night, patience will shrink. and Dr John Zorbas are the latest to
having their injuries treated. It is at times such as these that the successfully represent the interests
of junior Doctors at both the highest
I recall a great camaraderie with advice and support from colleagues,
levels of the Association itself,
the word Servio emblazoned on our senior doctors and mentors can be
and in representations to hospital
badges and soon-to-be-discarded invaluable. The Australian Medical
administration on a range of issues,
white coats signifying that we were Association (WA) offers you just this.
including access to leave, part-time
all working together, as part of a The Association provides a range
positions, RMO recruitment and
very special institution. I remember of services for members, including
research opportunities.
putting in a lot of drips! expert legal and IR support to help
For me, the AMA is a place
Anyone who worked at RPH in the you deal with any issues that may
where I have struck strong career
’90s will have their ‘Clive’ story; may arise during the course of your
connections and enduring friendships
God rest his soul. I have changed career. Our experienced Industrial
with people from across the country
his name out of respect, but he Officers work hard to lobby
and even overseas. I can assure you
was a delinquent Aboriginal man government for better remuneration
that it will be the same for you.
who lived in and out of the ED, the and working conditions for doctors –
The AMA offers you friendship,
Cathedral grounds and surrounding right from senior salaried specialists
professional support, leadership,
streets. We all, one by one, tended to junior doctors.
the highest standards in health
his many wounds and his many Our member benefits extend to
and social policy, and a constant
troubles. No great city can function professional and lifestyle offers,
reminder that you are valued by your
without an ED in the middle of it, training courses and seminars, the
profession and by society.
and any government who thinks it opportunity to network with your
can, just doesn’t get it! peers, and to become involved with We look forward to engaging with
you and being with you every step
Like mine, your internship will be a our campaigns for a better health
of the way as you begin the path
patchwork of experiences tinged system, a healthier community and
on what will be a most fascinating
with a range of emotions. Whatever the improved welfare of doctors.
journey.
the feeling, I promise you this: it will The AMA (WA) has long championed
Congratulations again, and welcome!
be anything but boring. medical leadership, recognising
There will be times when you that doctors should be involved in Dr Michael Gannon
feel on top of the world – you healthcare delivery. President
INTERNSHIP 101 – WHAT YOU NEED TO KNOW 3
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WELCOME FROM AMA (WA) DOCTORS
IN TRAINING (DIT) COMMITTEE Dr John Zorbas
DR MELITA CIRILLO & DR JOHN ZORBAS – Co-Chairs DiT Committee
Congratulations and welcome to one of the most amazing professions. Dr Melita Cirillo
Attaining your Internship is the first of many achievements you will experience.
In recent years the prospect of Via CDT there are opportunities The effect of this is that the AMA
being offered an Internship has to provide input to various (WA) wants to ensure that Australian
become increasingly tenuous organisations including the training practitioners are employed
and the AMA (WA), in conjunction Australian Medical Council. before there is a need to recruit
with the Federal AMA and of In addition, the AMA (WA) DiT overseas trained doctors. There is
course AMSA and the WA Student Committee provides representatives also a need to assess the impact
Representative bodies has been to the Postgraduate Medical Council of the timing of when OTDs are
working hard to achieve placements of WA’s Executive, its Education employed and the length of their
for all. Further challenges lie ahead Committee and its Accreditation contracts to ensure that the current
for us in lobbying Governments and Standards Committee. perpetuating cycle of needing to
to secure future Internship recruit OTDs part way through
The DiT Committee has been
placements and ensuring that the year is diminished over time.
working on a broad range of issues
the WA Government provides Going forward, the DiT Committee
including the Centralised RMO
for fully funded and resourced expect to confront a raft of issues
Recruitment Process, Access
prevocational and vocational concerned with the burgeoning
to Leave for Junior Doctors,
training opportunities. Further, that medical training pipeline.
Membership Engagement and Part
the Federal and State Governments
Time and Workplace Flexibility 2014 saw the registration of new
ensure that there is a proper and
options. In addition, the Committee Industrial Agreements. The AMA
extensive review of the medical
has been engaging with both Fiona Industrial Agreements provide
workforce before increasing medical
Stanley Hospital and St John for your salary and employment
graduate numbers.
of God Midland to ensure that entitlements for the next three
The AMA (WA) Doctors in junior doctors have a voice during years. A summary of your industrial
Training (DiT) Committee is your the commissioning phase of the entitlements can be found on page
representative group. The DiT new hospitals. 17 and 18.
Committee is open to all DiTs
Further, in 2014 the pressure on In 2015, the DiT Committee will
i.e. Interns through to Senior
the training pipeline has begun continue to advocate for all junior
Registrars who are members of
to have very real effects on the doctors in WA on a wide range of
the Association. The Committee
recruitment of RMOs. The AMA issues and it is likely to be a very
meets monthly to discuss issues
(WA) and the DiT Committee were busy year. We encourage you to
directly affecting DiTs and Medical
successful in achieving a range of take part in the DiT Committee or
Students. The Committee has a
changes to the RMO Recruitment other representative committees
number of representative roles
Process in 2014 but more work available such as your RMO
on both internal and external
needs to be done in this area. Society and the JMO Forum
committees to ensure that there is a
Current concerns include the timing to ensure that you can take an
DiT voice being heard. At the local
of Registrar appointments, and active part in advocating and
level we have DiT Representatives
the discontinuation of the Area representing yourselves as well
on the AMA (WA) Council, the Inter-
of Need defined within the State as your colleagues. Once again
Hospital Liaison Committee, and the
for RMO and Registrar positions. congratulations, and we wish you
Council of General Practice. We also
well in your Intern year.
provide representation to the AMA
Council of Doctors in Training (CDT).
AMA(WA)
Intern Cocktail Function
Tuesday 24th February 2015
6pm
INTERNSHIP 101 – WHAT YOU NEED TO KNOW 5
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WELCOME FROM AMA COUNCIL OF
DOCTORS IN TRAINING CHAIR
AMACDT: MAKING THE VOICE OF
DOCTORS IN TRAINING HEARD!
On behalf of the Australian Medical Association’s Council of Doctors in Training (AMACDT),
congratulations on completing your medical degree and welcome to the beginning of your
prevocational training!
The AMA is the peak representative As Chair of the AMACDT, my The AMA is only as strong as its
body for medical practitioners in role is to ensure that Doctors in membership. With a ‘tsunami’ of
Australia, with issues concerning Training are recognised as crucial medical graduates in every State
Doctors in Training (DiTs – that’s stakeholders in the Australian health (especially WA), increasing pressure
you!) forming a large part of its system and that your AMA remains on prevocational and vocational
agenda. The AMA also speaks out connected with you, its members. training places and stretched health
about important public and global budgets, it is a critical time for junior
AMACDT’s advocacy activities
health issues, including climate doctors and the medical profession
focus on improving medical
change, the social determinants of in Australia. Now, more than ever, is
workforce planning, quality in
health and alcohol-related harms. the time for the voice of Doctors in
medical education and training,
AMA Members get full benefit Training to be heard. I urge you to
and workplace conditions, such as
from our organisation’s powerful join your AMA, and in doing so, help
safe working hours and doctors’
advocacy, industrial support and shape and improve the future of the
wellbeing. The strength of the
a range of benefits tailored to the Australian health system.
AMA’s membership provides a
professional, educational and
platform on which we can work Good luck for your internship, and
lifestyle needs of junior doctors.
with other key stakeholders, meet in the future career you choose.
with policy leaders and politicians, The AMA knows that you will
and engage the media about these make an important contribution
important issues. to the health of your patients and
their communities.
The AMACDT also produces
I urge you to join your
useful resources for DiTs, often in Dr James Churchill
AMA, and in doing collaboration with AMSA. You may Chair
have seen the AMA’s Online Guide AMA Council of Doctors-in-Training
so, help shape and
to Social Media and the Medical
improve the future of Profession or the Guide to Working
Abroad for Australian Medical
the Australian health
Students and Junior Doctors.
system. If not, you can download
them free at the AMA website –
www.ama.com.au. While you’re
there, why don’t you take a look
at the AMACDT’s recent policy
statements on issues important to
Doctors-in-Training?
6 INTERNSHIP 101 – WHAT YOU NEED TO KNOW
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INSIGHT INTO INTERN-AL WORKINGS
AT CHARLIES, RPH & FREO
I AM DOING WHAT I HAVE ALWAYS WANTED TO DO
DR GLEN B. LEGGE, INTERN, FREMANTLE HOSPITAL
During this period away I have So now at the time of writing this
been fortunate enough to meet article, my cohort year and I are
and learn from some of the best coming to the end of the second
and brightest minds in the field rotation in our intern year. Already
of structural biology. However, we are looking ahead, as the online
in September 2008 I travelled to applications for RMO positions
Kolkata, India to participate with next year are open and it is time
the US-Japan Cooperative Medical to apply. There are lots of changes
That’s it; I’m going to med Sciences Program. This trip approaching, but the one that
school”. And as New Years compelled me to reconsider how to I am seeking is an RMO position at
Eve 2008 rolled into 2009, effectively transition novel molecular Fiona Stanley Hospital.
treatments from bench to bedside.
that thought set into motion I went to the FSH RMO information
I became convinced that to make
events that would sweep night last month and there was a
a real difference I must make the
me and my family from the real buzz in the air. I liked what
transition back to clinical medicine
Bayou City of Houston, Texas I heard from the top down – from
and that fateful decision on New
to the streets of Fremantle for its CARE values and its vision to
Year’s Eve 2008 led me to apply to
an entrance interview at the achieve the best clinical outcomes
Notre Dame.
with the available resources. I also
University of Notre Dame.
I possess a boundless optimism liked the prioritisation of patient
This time I was certain that I would that I will find a way to combine the safety and community care, even
get into the program, so much so knowledge gained from molecular if this has meant the four-stage
that I sold my house and travelled structure and function during my transition schedule has taken longer
half a planet for it. It wasn’t always research years with my years in than initially envisaged.
this way, and twice I tried this route prevocational training and beyond.
Dr John Keenan, Medical
in 1992 and 1993, was interviewed It is not an easy task to step back
Accreditation Lead at FSH said,
and did not succeed. and retrain as a medic at this
“a major component of coming to
stage of my career, though now
I felt at the time that I had to readjust this hospital is to be part of the
with the first stage of the clinical
my career goals, and a career in innovation and change”.
training complete, I can look
science subsequently emerged
back with a degree of pride and Prof David Fletcher said of FSH, “It is
through the inspirational work of
accomplishment. the place to come, it is the future.
Professor Art Olson who lectured in
You’d be mad to go anywhere else.”
Perth at the time on the molecular I chose Fremantle Hospital for my
structure of proteins. Art’s work led internship. This was due to the Prof Greg Sweetman – a favourite
me to successfully apply for a Ph.D. famous Fremantle Hospital culture, for many us from our Notre Dame
in the laboratory of Professor Sir which has not disappointed, and years – who is leading medical
Alan Fersht, FRS at The University pragmatically, its proximity to home. education at FSH added, “Why
of Cambridge. As a result, my wife There have been times when I have would you go anywhere else?”
and I did not return to live in Perth walked to the car at night beaming
As for my interest in transitional
for 16 years until 2009 to commence from the ED shift. It’s all good, even
medicine and research, there’s the
the MBBS degree at Notre Dame. tonight where I stayed back
Harry Perkins Centre. Okay, I’m in –
to complete a discharge summary
we have a hospital to build together.
for a 100+ day surgical admission.
It’s going to be brilliant.
I am doing what I have always
wanted to do, and that is a joy.
INTERNSHIP 101 – WHAT YOU NEED TO KNOW 7
MEDICINE’S FASCINATING JOURNEY
DR ROBERT GROHS
INTERN, ROYAL PERTH HOSPITAL
This is because with the title of Sir David Paradine Frost, the late
‘consultant’ comes a new set British journalist, also shared this
of responsibilities including the view when he said, “Don’t aim for
I AM DOING WHAT I HAVE ALWAYS WANTED TO DO
coordination of patient care, success if you want it; just do what
often over multiple hospitals; the you love and believe in, and it will
DR GLEN B. LEGGE, INTERN, FREMANTLE HOSPITAL
education and mentoring of junior come naturally”.
staff; and in many cases, the
With this healthy outlook, I must
establishment of one’s own practice.
also acknowledge the thoughts from
There have already been many a Fellow who wanted to touch on life
The journey of medicine
times throughout medicine where away from medicine.
to me is special – although
I too have thought I had made it,
individual, it can be shared. He said, “Your career will always
only to realise that what I believed
be there but your relationships
As we know, the journey to be the finish line was in fact
and friendships may not.” What
from medical school to a necessary building block for
he meant was make the time to
specialisation is long, the next step forward. These
stay in contact with people, share
with each step bringing experiences included entering into
in their birthdays, weddings and
new challenges and medicine, those days in medical
funerals. For it is these people
fostering new opportunities school and starting to work in the
who will be there in your greatest
health system.
for growth. triumphs as well as during your
Although I have spoken about biggest challenges; when you need
The reason I have chosen to write
the ongoing journey of medicine objective advice or a buffer, they will
about the journey is because I think
in terms of goals, I have not yet be there.
sometimes it can be underestimated
spoken about it in terms of fun. This
– the focus at times being more on Finally, I want to share one piece of
is important as a number of doctors
the destination. advice my dad gave me. He said,
deliberately stressed each step of
“Whatever you do in life, do it well”.
Norton Juster, author of the famed the way, when there were times they
children’s book, The Phantom could have enjoyed the journey. This is similar to the advice an
Tollbooth, echoes this sentiment Ophthalmologist offered for this
A common refrain heard when
well by offering: “The most article. He explained that each step
speaking with the aforementioned
important reason for going from one of the journey should be undertaken
senior doctors was that you do
place to another is to see what’s as an opportunity to learn, as the
not want to become someone who
in between”. skills you learn now are likely to
reaches their destination only to turn
serve you well in the future. He used
Before choosing to write about this around having missed the journey.
the example of being competent
topic I sought the opinion of many A senior registrar from the highly
in the slit lamp examination, as
senior doctors, some in the twilight competitive field of Ophthalmology
this skill is very transferable to
of their journey. highlighted this further by advising
Emergency Medicine and rural
that your resume should be built
I asked each of them: “What is one General Practice.
around what you enjoy doing, as
piece of advice you could pass on to
you are more likely to end up in It is for the above reasons, that life is
the next generation of doctors?”
a field you enjoy – no matter how a journey to be enjoyed, and not just
Similar themes were echoed and the competitive the pathway. a destination to be achieved.
resounding view was that “...the goal
I found this outlook to be particularly
posts always move”.
true when I was heavily involved in
Just when we think we have made hockey before medicine.
it to the finish line – in the eyes of
many a ‘consultant’– the goal posts
move again.
8 INTERNSHIP 101 – WHAT YOU NEED TO KNOW
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INSIGHT INTO INTERN-AL WORKINGS
AT CHARLIES, RPH & FREO
INTERN AT WORK AND ALL THAT JAZZ
DR KEN LEE
INTERN, SIR CHARLES GAIRDNER HOSPITAL
As a freshly-minted intern, At times, it seems a little bumpy and
it is an incredible honour to intended goals can feel like a bit of
be initiated into the field of struggle, akin to wading through
medicine through such an moist molasses, but the results are
never too far away. There is a feeling
amazing system of modern
of great satisfaction as tasks are
healthcare that we have
completed and teams come together
in Australia.
towards health outcomes for the
The care within our hospital systems patient. It is only due to the large
is delivered by an ever-increasingly contingent of diligent and committed
diverse set of multidisciplinary doctors and allied health, working in
and distributed healthcare teams. various fields amongst the context
This ensures that as an intern, my of constraints and demanding
development is guided and well pressures that ensure this constant
supported and I am thankful for delivery of service to the patient.
a healthcare system with such
As a naïve intern you hope for
staffing to ensure checks are in
a model system, based upon
There is a feeling of place to minimise error. I find the
precision, order and control like an
common thread amongst this
great satisfaction as orchestra pit with a conductor at the
diversity of areas is how they all rely
helm. I often find that it is more an
tasks are completed and interconnect through effective
example of successful freeform jazz
teamwork and communication
and teams come musicians who seem to operate at
to ensure effective and safe
the edge of chaos. You have to be a
together towards patient care.
brilliant player to be able to do this
health outcomes for My role as an intern at SCGH and everyday I am struck with awe
is predominantly to be a and respect at the calibre of medical
the patient. communicator, often at the professionals in our system – you
nexus point of multidisciplinary take a step back, pinch yourself
connections. There is a dizzying and realise that you are jamming
number of tools and tasks towards with the best. It is also quite a large
this one endeavor – from paper jam session.
to electronic and pager through
Dr John Zorbas, Co-Chair of the
to meetings. At times, the work
Doctors in Training Committee,
processes involved mean that it is
made the insightful comments in the
not always a very straightforward
last Medicus edition that, “a system
path towards patient care.
this large needs a well coordinated
team. Faults come about because of
inaction, not action”.