<font face="Verdana, Arial, Helvetica" size="2">Originally posted by Stephen Ewen:
Another huge plus for Flinders from another angle is their Rural and Remote Medicine track. Within it, students are able to ficus on some of these areas during PBL basics, and then do much of their clinicals in northern Australia. The program operates on the reality that the sets of skills needed by truly rural practitioners are much beyond a gatekeeper or narrowly defined speciality. In my opinion, Australia leads the world in this type of thing.•
With a couple of notable exceptions the students who did their 3rd years in the Rural and Remote Track just BLEW us away on clinical skills. While they didn't have a chance to manage some of the "big city" type of stuff (ie, no neonates, no GSWs, no aesthetic surgery, etc.) with good basic medical care they were far and away more advanced because they basically had the patients, clinic and hospital to themselves (or at most 1 other student).
The program was highly dependent on physician-student interaction and teaching. Most of the students got excellent teaching and were made part of the team in these rural locations, accompanying the Royal Flying Doctors out on retrievals, doing all the small procedures, assisting in the OR, clinics and on hospital rounds.
I had the opportunity to do Rural Surgery in the Northern Territory and LOVED it. While I had a wonderful experience at Flinders in Adelaide and got to do lots (because I was around a lot and asked to do a lot), I was able to see things not typically seen in a first world country, manage patients without benefit of a CT scanner, community resources and of course, learn a lot about a wonderful group of people. I soon learned to focus on what had to be done and to do it quickly because it was not unusual for patients to slip away in the middle of the night. Sometimes they would return for follow-up, sometimes they wouldn't. I think the record was a fellow who spent 3 years with an external fixator on his right tibia before returning!
At any rate, the program was wonderful exposure for those planning on being GPs practicing in remote areas. Most of these guys are the true general practitioners we really don't see in the US much anymore - doing everything from delivering babies, to ortho and neuro procedures, treating IM problems and dealing with Psychiatric patients in areas without much resources. I recall one local bloke in a tiny town who performed a craniotomy with a workman's drill one of the townies had retrieved for him. The GP had only arrived in town the day before, hadn't even unpacked his suitcase or set up his practice (hence the lack of medical tools).
I'm not sure the program was the best choice for Americans who are considering coming back to the US, as some of the students found themselves somewhat at a loss during 4th year or after when trying to learn the ropes of working in a major hospital. It can be awfully isolating as well and seemed to work best for the students who had spouses to go with them.
But all in all, seems like the students in that track really got some excellent teaching, and it paid off.