welcome to the March 2010 edition, in this issue:

New enewsletter Format

Welcome to the March edition of the North Coast Post and the first in our new electronic format. The enewsletter design will hopefully make it quicker and easier for you to find out what’s been happening at North Coast GP Training, what’s coming up and all things NCGPT related.

At the top of this enewsletter (above) is a list of articles included in this edition. You can go directly to any article by clicking on the heading or you can scroll up and down through the articles. If you prefer to print the newsletter  you still can (it will be around ten pages long).

This new format has many exciting features like being able to include video stories and the ability to monitor which articles are of most interest to our readers. We also hope it will save a few trees and solve the issues we were having with bulk mail outs with larger files.

I hope you enjoy this new format and would greatly appreciate your feedback. If you have any ideas about content I'd Iove to hear these as well. Send me an email at  seano@ncgpt.org.au 
 

Sean O’Meara, Communications Manager NCGPT

ME Update from Christine Ahern

Christine Ahern with new GPT1 registrar Helen Smetana
 

Yes we are up and running again – in fact I don’t think we ever stop!

Orientation, Basic Workshop and Emergency release days have been held across the region and a Medical Educator meeting, which included Queensland RTP’s for the first time, was held recently at Lennox Head. Preparations are underway for supervisor workshops and the dermatology release days coming up in the next few weeks. The recent sexual health release day at Ballina was a great success.

In our culturally diverse environment, it is extremely important that all doctors develop good communication skills. Sexual health issues, in particular, require sensitivity and can challenge us in ways that more mainstream issues may not.

In the limited time allowed for a consultation, we must strike the right balance between asking questions, listening to the answers and imparting information. And we must find the words that both we and the patient are comfortable with. Experienced doctors take these skills for granted. Often these are the skills that our younger and overseas trained colleagues want to learn. This, as well as the important clinical information imparted, is why a half day release is dedicated to this topic.

Orientation Days

New registrars Vicki Liu, Jessie Atkins and Jo Adendorff at the Ballina Orientation Day

Now an integral component of the NCGPT education program, orientation occurred in our  three nodes in the first or second day of term. This year we welcomed 25 new registrars to our region. The larger groups in Port Macquarie and Ballina were able to enjoy social interactions, (starting with a breakfast in Port Macquarie), while the lone “new kid on the block” in Coffs Harbour enjoyed unprecedented individual instruction and attention.

Thanks to everyone for choosing to train with NCGPT, whether for one term or your entire training we aim to make your experience positive and affirming.

Basic Workshop

The GPT1 group at the Basic Workshop in Angourie

The basic workshop seems to get busier and fuller every year, and still “more time” and “more topics” are requested in the evaluation! We will continue to do our best. It is always fantastic to see our Medical Educators teach familiar topics with a renewed approach and increased enthusiasm. And it is gratifying to see registrars and new graduates engage in teaching and bringing fresh ideas and passion.

We finally got the timing right for Nicola’s “introduction to dermatology” allowing her to finish comfortably – there was at least 30 seconds to spare! Chronic disease management in an afternoon? No problem at all for the NCGPT team! So a huge thank you to Hilton, Rob, Linda, Deb and Nicola as well as Rosie and our guest presenters.
 

Thank you also to Sue and John, and our dedicated RLOs for travelling to Yamba to meet the new crew, and to Neil and the admin team for exceptional organisational skills! We have already endeavored to answer questions and provide information and training as requested in the evaluations and we are looking at how to incorporate other ideas in the “Life Stages” workshop in June. But in the meantime, remember you have excellent supervisors to teach and mentor you throughout your training. Your day to day practice is where most of your learning will happen!

Christine Ahern - Director of Training

RLO Report from Katherine Dent

Welcome everyone to another term of GP training. As always at North Coast, we are off to a busy start to the year. George and I had the opportunity to meet most of the new registrars at the Basic Workshop in Yamba. There was as always plenty of questions during the RLO session about contract negotiation and minimum terms and condition, and we love the opportunity to get together with you all to discuss it.

Following straight on into the weekend was the exam preparation workshop for the upcoming RACGP exams. Candidates were run through both written and clinical scenarios. It was a busy and mentally draining weekend for the participants but it was also a wonderful opportunity for some of the subsequent registrars to catch up with each other.

This month we welcome Kirsten Patterson as our new RLO. She is a GPT1 registrar practicing in Murwillumbah. It is great to have her on board.

Don’t forget to check www.ncgpt.org.au/events for upcoming events and of course, good luck for all sitting their exam in March

RLOs Katherine and George

Staff Changes at NCGPT

Liz Degotardi with Sharyn Corben             Katherine Tucker

Our very efficient receptionist and Admin Officer Denise Sheehan has left NCGPT after deciding to head back to Brisbane to be closer to home and continue her Law studies. Communications Assistant Renee Sherlock has also decided to return to study and has enrolled at Sydney University to pursue a career in teaching. They will be greatly missed and we wish them both well with their studies. Katherine Tucker has replaced Denise at the front desk and you may have already heard her happy voice when calling NCGPT.

Liz Degotardi, our OTD Fellowship Support Program Manager has also recently left us on maternity leave but will be returning in 2011. Sharyn Corben has been employed to fill the OTD Fellowship Support Program Managers position while Liz is away. Sharyn and Katherine introduce yourself……….

Sharyn Corben

A long time ago I began my first career as a primary school teacher and progressed to the position of School Principal. My husband and I worked in the NSW Education Department in a variety of schools in the Sydney, Newcastle, Lismore and Albury Regions.

Ten years ago I decided on early retirement which lasted for 4 months before I accepted a position with Upper Murray Family Care in Wodonga, Victoria. It was a very interesting 8 years there as a Director supporting over 13 diverse programs including Community Legal Service, Family Relationship Centre, Foster Care and Family Support Services.

I finally retired in August 2009 and we relocated to Byron Bay and blue, salty water as opposed to the brown Murray River. This move pleased both of our daughters as they now have a great location for their holidays! The relieving position at NCGPT was very appealing and again I was attracted out of retirement.

The challenges of the positions are new and exciting and I believe that my past work experience should provide me with a sound basis. My goal is to be able to maintain the high standards that Liz has achieved and still be able to fit in some “play” activities that I have enjoyed during the last 6 months.

Katherine Tucker
I was born in Maitland and my parents moved to Bangalow when I was 6 years old. I joined Bangalow Pony Club at the age of ten and continued until I was seventeen. I went to Southern Cross High and completed my school certificate while also doing an Equine Studies course through Evans River High.

I thought I would pursue a career with horses but then I started a Certificate II in Office Administration at Ballina Tafe and took a liking to it so I applied to be a receptionist. I started a certificate III in Property Real Estate at a Lennox Head Real estate agency and continued for another two years. This position gave me some excellent experience and skills which I now use at NCGPT.

 

Kevin Rudd at GPRA event - Video

Kevin Rudd made an unscheduled visit during morning tea at the recent GPRA event in Canberra - Breathing New Life into General Practice. He met and greeted delegates and gave an impromptu address about his recent GP training announcement  and his vision of healthcare reform in Australia. Hear what he had to say at;

http://www.youtube.com/watch?v=93npoOxvqTY 

Supervisor Workshops

Carrots or Sticks: Motivation for Great Teaching

All supervisors have been sent a date saver for the upcoming supervisor workshops. Regular attendance is a requirement of reaccreditation with the RACGP, but more importantly attending gives supervisors a chance to network with peers and possibly learn new skills, although we realise you are all very skilled already which is why we work really, really hard to come up with new concepts and share what we have learned as educators during the preceding year! But perhaps most important of all, this is your chance to let us know what is going well for you and what you would like to see changed. So looking forward to seeing even greater numbers than ever before!

Thank you to those who took the time to personally respond to my January article. In particular thanks to Emily who drew my attention to an excellent resource: “First do no harm, Being a resilient doctor in the 21st century” by Michael Kidd and Leanne Rowe. The important message of this book is that by looking after ourselves we are better able to look after others.

Christine Ahern

Academic Posts - Semester 2

Applications for Semester 2, 2010 Academic Posts and the 2010 Registrar Research Workshop are now open and close Friday, 19th March 2010. Currently, there are 15 academic placements available to commence July, 2010. These placements are an excellent opportunity for general practice registrars to develop skills in research, teaching, project work and critical evaluation of research. The GPET website has further information, including a report from a recently completed Academic Registrar on her experiences of the post.

http://www.agpt.com.au/TrainingPosts/AcademicPosts/

Applications for the 2010 Registrar Research Workshop are also open. This workshop will be held in Darwin on Monday, 28th June through to Tuesday, 29th June 2010 in conjunction with the Primary Health Care Research and Information Service (PHC RIS) annual conference ‘2010 PHC Research Conference – Primary health care research and health reform: Improving care’. The Registrar Research Workshop is aimed at introducing registrars to the field of research within the primary health care setting. There is also funding to allow a limited number of registrars the opportunity to attend the PHC Research conference.

Applications close COB Friday, 30th April 2010 with further information available on the GPET website.

http://www.agpt.com.au/TrainingPosts/RegistrarResearchWorkshop/

NCGPT encourages all registrars to consider an academic post as part of their training. Three NCGPT registrars have already taken up this opportunity with two having completed and one starting this term. These posts provide registrars with a chance to pursue an area of interest with an academic or research focus. The process has been both rewarding and enlightening according to the previous registrars. NCGPT will assist registrars who express an interest with their application and the establishment of their placement if successful. Contact Christine Ahern at NCGPT for further information or assistance.

Dr Nyoli Valentine, Registrar Research and Development Officer from GPET can be contacted on 1300-658-515 or at RRADO@gpet.com.au  

Koori Korner

By Dr Sarah McEwan, NCGPT Indigenous Support Officer

Welcome to the first edition of the North Coast GP Training Koori Korner - the name of this NCGPT addition will become clearer after this first edition.NCGPT encompasses GP registrars and GPs that provide health care to the following nations of Aboriginal people; Bundjalung, Gumbaynggir and Birpai Nations. The majority of Aboriginal people of this area will refer to themselves as Koori people, hence why we named this section of the North Coast Post – Koori Korner.

Koori Korner is an exciting new fixture to the North Coast Post and will in future editions feature;

- Facts and figures in relation to Aboriginal Health

- Interviews with GP registrars and GPs in the local area working in Aboriginal health

- Interviews with prominent local Aboriginal community members

- Local initiatives to “close the gap” on the health discrepancies in Aboriginal Health.

- Resources for where to find more information

- Links to journal articles used in our half day releases

- Exam questions and tips; cases for role plays

- Feedback from readers

- Outline and explanation of medicare specific item numbers for Indigenous people etc.

This edition marks the 2-year anniversary since Prime Minster Kevin Rudd’s apology to Aboriginal people of Australia. What better way to celebrate such an event than to proclaim NCGPT’s stance on our own closing the gap initiative. NCGPT aims to increase the level of Aboriginal health focused education of GP registrars and GP’s. NCGPT aims to celebrate the differences in this population group and enhance learning so that we can all serve our local Aboriginal communities better to improve health outcomes. The following is a link to the creative spirit website and demonstrates some of the Indigenous and non-Indigenous reactions to the apology speech.

http://www.creativespirits.info/aboriginalculture/politics/stolen-generations-sorry-apology.html

Koori Korner’s vision;

- Educate readers about Aboriginal people, culture and health issues faced

- Bring awareness to day-to-day issues Aboriginal people face

- Focus on positive outcomes that are happening in relation to Aboriginal health

Koori Korner’s aim;

- To be a think tank for our readers

- Provide inspiration about how individually or collectively you can help to make a difference with the Aboriginal patients that you see in your practice.

- To be interactive; if you have a good news story in relation to a patient outcome or interaction please contact us and we can feature this as part of our write up.

- If you have ideas about community/practice interventions that you may want to initiate, again feel free to contact us so we can assist you to make your ideas happen.

In Australia’s multicultural society it is essential for doctors to be responsive to the ethnic and cultural diversity of the communities they serve. NCGPTs mission and vision emphasises the benefits of having a workforce that promotes an understanding of the specific needs and expectations of people from different backgrounds – both within its own workforce and in the wider community.

Valuing equity and diversity is recognised in NCGPT as a good business practice. It also contributes to a cohesive working environment.

Importantly, it is also conducive to identifying new opportunities to improve the range of services NCGPT provides to the community.

This is highlighted by NCGPT's approach to fulfilling the cultural and social needs of North Coast Australian tradition and urban Indigenous Australian communities - including preparing general practitioners to address the unique issues affecting them.

Past experiences have resulted in Indigenous people having the worst outcomes in relation to numerous health indicators. This cannot be understood solely in medical terms. The illnesses and rates of occurrence require an understanding of the history of dispossession, colonisation, failed attempts as assimilation, racism and the denial of citizenship rights.

Experts estimate that Aboriginal people live 17 years less than non-Indigenous people. Infant mortality is 2-3 times higher. For Australia to move forward as a healthy society for all, we need to collectively “close the gap” between these shocking health statistics which will mean working on both health and social causes of ill health.

As GPs, we are the health professionals that see the majority of primary health presentations. It is imperative that we have a basis of cultural safety and an awareness of issues facing our Indigenous population groups.

Koori Korner’s First Edition will focus on Identification

First and foremost to be able to service our Indigenous communities we need to have awareness of who they are. If we are unable to identify whom in our waiting room is Aboriginal we are unable to identify who may be at higher risk of certain conditions, who may require extra services, who may qualify for a health assessment item number or a PBS listed medication.

Sometimes the identification step may not be as obvious as you initially thought and Indigenous patients may have a missed diagnosis, as you had not considered a possibility based on ethnicity or the patient may miss out on support services that they are eligible to use. It is worth training reception staff to ask as routine if the patient identifies himself or herself as Aboriginal or Torres Strait Islander. Not a bad practice to include this question as part of your general work up, you might be quite surprised to realise just how many people you are treating identify as being Aboriginal or Torres Strait Islander.

Which leads into the question “Who is Aboriginal?” The following website outlines this succinctly with some interactive sessions to test your skills on identifying and Aboriginal person, I challenge you to give it a go.

http://www.creativespirits.info/aboriginalculture/people/aboriginal-identity.html

I refer to a website http://www.shareourpride.org.au. This website talks about the different Aboriginal nations and language groups and terms of reference when dealing with Aboriginal people and how Aboriginal people identify themselves
 

• Torres Strait Islanders - People from the Torres Strait use the name of their island community to describe themselves, for example, Murray, Yam and Badu.
• Murri - An Indigenous person living in Queensland and northern New South Wales
• Koori - An Aboriginal person from Victoria and southern New South Wales.
• Palawah - An Aboriginal person from Tasmania.
• Nunga - An Aboriginal person from the southern part of South Australia.
• Koorie - An Aboriginal person from the south eastern area of Australia.
• Anangu - An Aboriginal person from the northern west part of South Australia and nearby areas of Western Australia and the Northern Territory.
• Wongatha - An Aboriginal person from the Western Australian Goldfields region (though some see this as one of many skin groups in the area)
• Nyoongar - An Aboriginal person from the south west of Western Australia.
• Yamatji - An Aboriginal person from the Gascoyne region in Western Australia

The following website also talks about identification and outlines some basic cultural protocols to be used to assist you to be able to communicate with Aboriginal or Torres Strait Islander people in a more effective manner.
 

http://www.abc.net.au/indigenous/education/cultural_protocol/faq.html

To close this edition of Koori Korner you may wish to follow the link to a song by Local Knowledge called “Blackfellas” which is a straight talking song by 3 young Aboriginal men from Newcastle area. The chorus has lyrics outlining the different names of the Aboriginal groups in our country (beware this straight talking song highlights some interesting cross cultural issues and incorporates some strong language - let this be your warning.. take a listen).
 

http://www.youtube.com/watch?v=KGlFnFsmBWM

Next month we will feature an interview with Dr Susan Yeung who has been working in an Aboriginal Medical Service in Ballina. She will outline her reasons for choosing Aboriginal Health, her top tips for what is needed prior to starting in an Aboriginal Health placement, some of the challenges and also some of the successes of this work. Plus lots more local information about the North Coast region and its Aboriginal population.

Any feedback, questions or articles you think that NCGPT should include in the Koori Korner please email through to drsjmcewan@gmail.com

Dr Sarah McEwan, NCGPT Indigenous Support Officer

DVA Medical Practitioners Package

The Department of Veterans’ Affairs (DVA) is constantly examining methods to improve communication with General Practitioners, specifically, how to raise awareness of the various DVA-funded health services available to their veteran patients.

To assist in addressing this, DVA has developed an Information for Medical Practitioners package, particularly aimed at newly graduating GPs, those practising in rural and regional areas, and GPs who are International Medical Graduates (IMGs). Moreover, it can be utilised as a ‘refresher’ for any GP who treats members of the veteran community.

The package consists of:

- an Introduction;

- three information modules;

- a list of web links to information referred to in the modules;

- two useful DVA reference documents - the DVA Funded Health Services and DVA Treatment Entitlement Cards and Charts

- a feedback form

The modules, which can be used either individually or sequentially, consist of:
Module 1: Introduction to DVA
Module 2: DVA’s Health Programs – Hospital, Medical and Allied Health Services
Module 3: DVA’s Health Programs – Health and Related Services
 

The package is designed to be downloaded from the DVA website and the modules used either in PowerPoint presentation form as training tools by GP educators/organisations or in hard copy form, along with the other components of the package, as a reference document for individuals/practices.
 

The package will provide GPs (in any location) with a broad overview - a ‘snapshot’ - of DVA and its health services, together with relevant links and contact details to gain further detailed information.

The Information for Medical Practitioners package is available at:
http://www.dva.gov.au/service_providers/doctors/Pages/info.aspx  

Get Inside the Examiners Head - Report

NCGPT Medical Educator Sharon Sykes in action at the Workshop

The OTD and GPT3 Exam Preparation Workshop - Get Inside the Examiner’s Head!

Following feedback from our last exam prep workshop asking for “more of the same”, our new Medical Educator Peter Silberberg questioned “is our format of giving the exam questions and mock OSCEs to candidates really the best approach? Sure we could do more of the same, but… Give a man a fish and you feed him for a day; teach a man to fish and you feed him for a lifetime.”

And so began our new workshop format – teach our delegates to think like the examiners and exam writers, by teaching them to write exam questions. Brilliant we all said – this will be less work for us, the delegates can write the examples! And yes, our delegates did write KFP (Key Feature Problem) questions and an OSCE (Objective Structured Clinical Examination) which they submitted before the event.

What we hadn’t factored in was the amount of work that goes into reviewing 40 KFPs from 20 people and editing them along with 20 OSCEs…we have plenty of ideas for improvement. The upside has been the tremendous feedback from our delegates. Although completing the pre workshop task was time consuming, we had general agreement that it did help them to understand the format of the examination and to better understand what it is that the examiners are looking for. Hopefully we have guided our delegates to an approach to studying for the exam which is self-directed and rewarding.

Our aim has been to provide a realistic experience to help improve examination technique while optimising examination performance. Day one comprised of instruction and practice to show how the written paper and questions are constructed and marked. We used some examples provided by participants as example questions and delegates also completed AKT and KFP mock exams, after which answers were considered. Day two focused on the clinical exam. Participants become more familiar with the exam format, timing and marking scheme by participating in a full mock clinical exam.

Continuing with our efforts towards Vertical Integration, this workshop was open to all GP Registrars planning to sit the written examinations in March 2010 as well as all Overseas Trained Doctor (OTD) GPs we are working with in our region. The popularity of the workshops has grown and we had close to a 50/50 mix with 14 GP Registrars and 12 OTDs attending. In keeping with our initiative to assist with networking and integration within our GP community, partners and kids were again invited to attend. We had a lovely dinner on the Saturday night with a gorgeous pack of children playing together in the room.

We were also fortunate to have our new OTD Program Manager Sharyn Corben available to help with her induction to NCGPT and to experience how we run our workshops. Sharyn will be in charge of arranging the next Exam prep workshop 2010.2 to be held on 5-6th June at Coffs Harbour.

Will we continue with our new format? Well, “Teach a person to fish and you feed him for a lifetime. Unless you’re not sure how to make sushi — then you’d better teach yourself how to cook first.”

I hear Sharyn is a great cook.

Liz Degotardi- OTD Support Towards Fellowship Project Manager.

UpToDate Update

UpToDate is an electronic clinical resource which provides the most up to date evidence based clinical information to 360,000 clinicians worldwide. Late last year NCGPT decided to purchase individual subscriptions to UpToDate for our own registrars and medical educators. In addition 25 supervisors took up the offer of a subsidised subscription. By now those who signed up will have their CD version and also a username and password to access the online version.

If you haven’t dipped in for a look we strongly suggest you do so as soon as possible. Whether we continue this arrangement beyond this year will depend on funding and also a user evaluation of the product. During the year we will be contacting users to evaluate how useful you have found it as a clinical resource, source of information for patients and as a teaching/learning tool.

Any queries about UpToDate please contact Bruce Barling at bruceb@ncgpt.org.au

What do you think ?

So now you've seen the new North Coast Post fomat what do you think?

We would appreciate any and all feedback, so email your thoughts to seano@ncgpt.org.au