The city to country contrast - Dr. James McCracken

17 Jul 2015

After graduating from the ANU Medical School in 2011, and a brief sojourn in Canberra, Laura (my wife), Ollie (our dog) and I, packed up after four years in the Nation’s Capital and headed back down the Hume to Melbourne, where we all (well, not Ollie) moved to Canberra from in 2008. 

We moved back to Melbourne as I’d been offered an intern position with Melbourne Health at the Royal Melbourne Hospital, and Laura was heavily pregnant with our first child. However, we left Canberra with a heavy heart, having had a most enjoyable four years, having embraced Canberra, its quirks and having made some fantastic friends.

So the first year of being a doctor has been a fabulous year. Many long days, long nights, times when you felt you knew something and were doing some good, and times that you felt you weren’t. Was I prepared for the year? I think there’s only so much you can learn about swimming by standing on the shore. 

As I write this, I’m currently on my final rotation for the year, on secondment to the Western General Hospital, in Footscray, knee-deep in general medicine, which is Victoria’s answer to geriatrics. It’s a great chance to reflect on what’s been an incredible year (grand final results aside). 

I kicked off at RMH in January doing the deathly rotation of nights. On nights as an intern you cover three surgical wards and two general medical wards. I turned up on my first night, not even knowing where these wards were. Having been assured that nights weren’t going to be “that difficult”, my first page was for a MET call that didn’t end so well. Nights, as you can appreciate, were a baptism of fire of what it meant to be a junior doctor. 

In February, we welcomed Hamish into the world. I was told by a certain Professor that coming home to bath his children was the highlight of his day. Certainly coming home to Ham, and seeing him grow (and now crawl!) are indeed highlights that put everyday into perspective. 

My other rotations have included palliative care, certainly a contrast of coming back from leave having had a child. It was perhaps the rotation I was least looking forward to this year, but indeed one I’ve taken the most away from and was perhaps one of the most rewarding. 

From there, I dragged Laura and Hamish to Horsham, about 4 hours west of Melbourne in the heart of the wheat growing Wimm­era, for 10 weeks of general surg­ery. Being a country hospital, the Wimmera Base Hospital was true General Surgery. The surgeons would take out an appendix, repair a fracture, take out some tonsils and perform a hemicolectomy. It was a contrast to working at the tertiary centres of Canberra or Melbourne, but the sense of community was something you’d only find in the country – the little old ladies who come in to take the patients washing for them, that is returned the next day, laundered and ironed, free of charge. 

From here I returned to Melbourne for a ten-week stint in RMHs busiest, and most unglamorous surgical unit – colorectal. From there, I headed to the ground floor with the cowboys in ED. Another rotation that I wasn’t looking forward to, but is perhaps the most formative and educational. Being at RMH, there were also the nasty things that would come in through the door. RMH and The Alfred take care of 90% of Victoria’s road trauma, trauma not just on the road, but trauma for the parents, loved ones and for those who spend many months in rehabilitation.

On top of this, I’ve also been studying a Masters of Public Health by correspondence through the University of Sydney. I’d always wanted to do an MPH, which has given me a new-found perspective on public health, the aetiology and causes of disease, and the importance of good health policy. 

I’ve not been involved with the AMA this year, aside from being a member, due to other priorities. However, I’m aware of the issues that JMOs face. These include the day-to-day issues, such as unpaid overtime, poor working conditions, and due to the tsunami, difficulty finding HMO 2 & 3 positions, as well as increasing competition for training program positions. I plan to join the AMA CDT next year, and roll up my sleeves, as should all JMOs.

Where to from here? Next year I’ve signed up for a surgical year at the Royal Melbourne, with view of going into surgical training. I’ve been very proud to be an ANU Medical School graduate. I don’t think I could’ve been better prepared for the year (though my knowledge of STIs thanks to Prof Bowden was handy, but raised a few eyebrows in ED!).