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A newsletter produced by AMA Queensland especially for Resident's and Registrars
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theroundsResidents & RegistRaRs
MOCA Q&a
A MA Queensland CoRR is currently traveling across Queensland meeting with
junior doctors to understand what you want from your enterprise bargaining agreement. We want to know what is important to you: More money? Fewer hours? Better access to leave? Improved secondment
arrangements? MOCA is the contract with Queensland Health that sets the wages, working hours, leave allowances and more for all doctors employed by Queensland Health.We are compiling our list of improvements to the current agreement based on these discussions. You can contribute in person or on Facebook. We need to know from you how MOCA is impacting on your work and life in order to advocate on your behalf.
Some of the issues already flagged are: Professional development leave (PDL) and allowances.
- Currently college trainees are eligible for $1500pa
- PGY2 and above accrue one week PDL per year to a maximum of two weeks
Phone consultations while on call -Duetosignificantimpactson
workload and fatigue, appropriate remuneration is imperative
Fatigue management and appropriate rostering
- A maximum 13 hour shift will allow a two-doctor departmental roster
- A minimum 10 hour break between shifts allows for adequate rest time
The new agreement may be signed as early as the end of this year so now is the time to have your say.Remember – MOCA is about your future.
What is MOCA? MedicalOfficersCertifiedAgreement.
Who does it apply to? All salaried medical staff at Queensland Health Hospitals.
Why am I interested? Because it determines your pay ($$$) and work conditions.
When do I get a say? MOCA lasts three years, and will expire in May. Negotiations for the next agreement start soon.
And then what? AMA Queensland CoRR will collate a list of requested improvements to the current agreement. Representatives will negotiate with Queensland Health on your behalf to get the best possible deal for you.
O C T O B E R 2 0 1 1 • V O L U M E 3
What impact does MOCa have on you?
Wednesday 17 November, 6:30pm at the PA Hospital Auditorium
Hosted with the PA JHS, this event will provide useful and practical skills to all junior doctors.
RSVP to [email protected]
Resume Writing and Interview Skills
Need a break?‘Like’ AMA Queensland on Facebook before 31 October for your chance to WIN a $500 travel voucher
Search for AMA Queensland on Facebook and ‘Like’ us
theroundsReflection on life as a registrar in the torres strait
F e at U R e s t O R Y:
By Dr ALex KippeN
Multi-Drug Resistant TBs, Melioidosis’, Acute Rheumatic Fevers and PSGN patients that are perhaps less common in mainstream Australian rural hospitals.
Other weeks I cover the Emergency Department which also sees the usual array of chest pain, trauma and sepsis. This is made all the more fascinating with the occasional PNG case of severe snake envenomations, rare tropical disease and the multitude of weird and wonderful ways in which Tuberculosis can present. Late presentation due to the week or more that a family may have travelled to present to an outer island clinic, complicates what would otherwise be more routine cases of machete traumas, simple pneumonias or bacterial meningitis.
I take part in the anaesthetic roster which mainly involves anaesthetising for obstetric cases (C-sections, ectopic pregnancies, retained placentas and products of conception), GA dental lists for kids, GP surgical lists (appendicectomies, skin excisions and grafts etc) and then cases for the visiting Orthopedic and General Surgical teams who arrive from Cairns Base Hospital every two to three months to do a week of consulting and operating.
On average, I work one to two days per week as a GP in the Queensland Health-run Primary Health Care Clinic on Thursday Island, the rest of the time at the hospital and then helicopter to two outer islands for overnight GP clinic visits every three weeks.
i n January 2010, my wife Felicity, son Noah and I decided to move up to Thursday Island to experience
something different by living in and contributing to a remote indigenous community and hoping to have a bit of an adventure as a family in the process in a unique part of the world.
What prompted the move was that I had been fortunate enough to experience a rotation out of Cairns Base Hospital as a resident three years earlier and had not been able to shake the idea of returning for a more permanent stint. I had been attracted to the completely different way of life, complex chronic disease, high frequency of exotic tropical pathology, critical illness and complex medical conditions, often dealt with by staff in the face of challenging physical conditions and resources.
We have not been disappointed.
The Torres Strait is an archipelago of islands scattered across 48,000 square km between the Cape or tip of Australian mainland and Papua New Guinea. It includes 21 populated islandsandfiveNorthernPeninsulacommunitieswithanofficialpopulationof8,510 but a more realistic one approaching 13,000. It is the most northern part of Australia and has an amazingly vibrant cultureincludinginfluencesfromAboriginal,Melanesian, Papua New Guinean, Japanese, Chinese and Portuguese heritage. Saibai and Boigu Islands to the North-West are aboutfivekmfromPNGmainlandandPapua
New Guineans and Australian Torres Strait Islanders travel freely across the border under the Torres Strait Treaty.
The western province of PNG is very remote, even by PNG standards and the health facilitiesintheregionaresignificantlyunderstaffed and under-resourced (Osteomyelitis gets oral Amoxycillin and Aspirin if there has been a recent resupply and there is no snake anti-venom available). This means that in addition to the remote setting and high burden of disease within indigenous health, there are also very sick Papua New Guineans who have managed to survive the travel to one of the Australian outer island clinics.
The lifestyle is quite unique and very remote but wonderful. Torres Strait culture has a wonderful emphasis on family, which has made for some truly lovely moments shared by all three of us.
The medicine has been everything I had hoped for. In preparation of coming to the Torres Strait, I completed a year of ICU and a year of anaesthetics. As a result, I took a positionasaSeniorMedicalOfficer(pre-vocational) and my job now involves great diversity. Some weeks I will be rostered to look after the general inpatient ward which may include the usual exacerbation COPDs, cellulitis’, Community Acquired Pneumonias, unstable Diabetics, Acute on Chronic Renal and Cardiac failures and the dehydrated kids with Ds and Vs that most rural hospitals would deal with. In addition to this is the
therounds
We’re with you all the way.
One of the more interesting and challenges jobs is manning the on-call phone where you are required to assess patients over the phone following their presentation to one of the Nurse run outer island clinics. Most patients can be managed over the phone using the set resources in these island clinics, others need to be brought intoTIHospitalviacommercialflighttobeassessed in person and yet others need to be retrieved by helicopter. I usually accompany the helicopter retrieval crew for the more critical patients and have had some great challenging retrieval experiences over my time here. It is quite confronting arriving on a small island, pushing through a crowd of PNG warriors who speak little English and then proceeding to intubate an unconscious child to try and get control of a clinical situation all the while trying to explain in hand signals (and my terrible Pidgin) what is happening so that the crowd stays comfortable and relaxed.
One of the factors that really makes our job interesting (and satisfying) is that we often have relatively long retrieval times for the Royal Flying Doctor Service to pick up a patient being transferred to Cairns Base Hospital due to the distances involved, as well as the higher capacity that TI Hospital has to stabilise and care for acutely unwell patients. The minimum retrieval time would be approximately four hours from phone-call to getting the Cairns plane in the air (if it happens to be instantly available),
with the retrieval plane on the Horn Island airstrip at three in the morning
60-year-old with necrotising fasciitis and multi-organ failure requiring inotropic support and intubation and ventilation
Five-year-old with meningococcus sepsis
Other memories of TI: Malariaandinfluenzaoutbreaks
An outer island clinic trip: patients in the morningandspearfishingintheafternoon
Taking Felicity and Noah on one of my helicopterislandclinics,flyingoverreefs and white sandy islands, dolphins, dugongs and turtles
CatchingandfilletingmyfirstGTandspearingmyfirstcrayfish
Being invited to a tombstone opening ceremony
Exploring new islands and reefs in clear blue water with not another boat in sight
Seriously consider a career as a rural generalist but also the many amazing and challenging experiences and adventures one can have on their journey through their junior doctor years - it can only stand you in good stead in both your clinical and personal life!
touching down at Horn Island, transferring patient to the helicopter to transfer from Thursday Island to Horn Island and then transferring into the RFDS plane. However, theRFDSplanehastoflyoveralotofCapecommunities on their way to Thursday Island, communities that don’t have the procedural capabilities, medical staff, onsite lab and XR and Ultrasound services that we have on TI, so retrieval planes frequently get re-tasked to retrieve critical patients who are in facilities with much lower capacity than TI. This means we often have to more robustly stabilise patients on TI, commencing invasive ventilation, inserting central lines and running inotropes etc.
For those interested, there is also a great Primary Care focus and the opportunity to take on a PHO position.
Cases I saw in one seven-day period on TI: •Flatfive-year-oldseverelydehydrated
Shigella dysentery
Four-month-old with bilateral pneumonia and pH of 7.01 but only requiring bubble C-PAP
Three-year-old infected VP shunt and septic
PNG neonate with bacterial meningitis and seizures
Head injury on one of the outer communities requiring a night-time chopper retrieval, intubation and stabilisation on site before rendezvousing
theroundsdrinks & dits
FRIDAY 30 SEPTEMBER 2011
Your CoRR
Andrew Turner Manager, Workplace Relations AMA Queensland
EMAIL: [email protected]
Jen Williams Chair Council of Residents and Registrars
EMAIL: [email protected]
Who else is on CoRR and hoW you Can ContaCt them:
Matthew Palmer Education [email protected]
Vanessa Palmer Communication [email protected]
Saul Felber Industrial [email protected]
Alex Kippin Rural and regional [email protected]
HOW tO COntaCt Us:
FACEBOOKAMA Queensland is now on Facebook! Search for us and ‘like’ our page, drop us a line on our wall and check out latest photos.
SKYPEOur CoRR meetings are going to be conducted using Skype. If you wish to participate please email Andrew Turner at the address below.
TWITTERFollow AMA Queensland President Dr Richard Kidd on Twitter.
QUEENS ARMS HOTEL
Drs Tiffany Litvine and Ainslee SenzDrs Matt Palmer, Vanessa Palmer and Tanya Trinh
Drs Ross Fowler, Rob Zeller and James Gardiner
Drs Josh Lawson, Chris Arnott, Natasha Behrendorff
Drs Alex Markwell and Peter Piliouras. Drs Saul Felber and Malaika Perchard.
Drs Melinda Stanton and Peter Stickler Drs Mark Jones and Dr Jennifer Williams
Contact us
Dr Jen WilliamsChair, CoRREMAIL: [email protected]
Dr Saul FelberIndustrial Deputy Chair, CoRR
EMAIL: [email protected]
