Graphic: A day in the life
In terms of medical jobs, it likely doesn't get any more varied and multi-faceted than this! But what else would you expect in a service that covers an area more than three times that of the United Kingdom?
In fact, there are three distinct roles to our Medical Officer positions: There is the Retrieval work out of our Dubbo base, then there is Emergency Telehealth and Retrieval out of Broken Hill, and lastly, our doctors generally also work in either the Emergency Department or in Anaesthetics at Dubbo Hospital.
In addition, we also cooperate with the School of Rural Health of the University of Sydney, Dubbo Campus, so there are regular opportunities to get involved in teaching and simulation with medical students!
Retrieval out of Dubbo:
Dubbo is the main retrieval base for RFDS South Eastern Section, and our Retrieval Doctors typically live in town in 3-4 bedroom houses provided by us.
Our base has offices and administration facilities, but also clinical areas, drug and equipment storage and, of course, our simulation and training centre.
Then there is our aircraft hangar with maintenance facilities as well.
The 24/7 Operations Centre is also located here.
Our retrieval shifts are 12 hours, and all taskings come through via the NSW Ambulance Aeromedical Control Centre in Sydney. The majority of our work is what we refer to as "hospital primary jobs", where our flight nurses and doctors would be sent out to retrieve critically ill or injured patients from small remote healthcare facilities, often hundreds of kilometres away.
We would typically be the first doctors to be with the patient. Depending on the case, we will then treat and stabilise the patient to ensure a safe transfer to higher level, sometimes tertiary, care.
As nothing in Dubbo is more than 15-minute drive away, a significant proportion of the on-call time can be done from home. During the week, however, we run daily simulations and training session on base, and quite a few of our doctors have taken on additional projects such as research, audits, or study.
Retrieval out of Broken Hill:
Well, working out of Broken Hill is probably the closest you can still get to being a "Flying Doctor" like in the early days!
Our outback base services small healthcare sites and expansive private properties and stations in all of Far Western NSW, as well as work sites and communities in northern South Australia and well into southern Queensland. A huge area!
Calls for help would typically come through via our RFDS emergency phone line, and, when picking up the phone, we can never quite know what awaits.
A state-of-the-art telehealth and camera network, along with remote prescribing capabilities, allows us to support remote area nurses in small healthcare facilities around the region.
In addition to this, we are also the trusted line of help for countless remote properties, many of which have remote landing strips and also the famous RFDS medical chest, containing vital medicines.
Much of this work would be similar to what one would see in an ED Short Stay unit - with the added geographical and logistical challenges that come with huge distances and limited resources.
Identifying and managing a critical patient in need of urgent retrieval is a core skill of our doctors; add to this the complex task of juggling the logistics of these transfers across hundreds of kilometres, and you have the picture. In addition to this, we also support Broken Hill Hospital on the ground, as well as with transfers of unstable patients to tertiary centres in Adelaide.
All our Retrieval Doctors have a critical care background with extensive training in hospital settings.
As it's unpredictable when we'll need our skills in the retrieval parts of the job, and because simulation can only do so much, we strongly believe that regular clinical practice in the hospital is vital to ensuring we maintain our skills at the highest level.
We have long maintained a partnership with Dubbo Hospital, a busy (and very modern) regional referral centre, that services the town itself, but also large areas of Western and Far Western NSW.
Depending on background, most of our doctors’ work regularly in either the Emergency or Anaesthetic Departments.
A nice additional benefit is that this creates a sense of a wider local medical community where we know many doctors across all specialties personally.
Teaching at the School of Rural Health, University of Sydney, Dubbo Campus:
We have long had a successful cooperation with the School of Rural Health, University of Sydney, Dubbo Campus, mainly in the teaching of critical care skill through lectures and simulations.
All of our Retrieval Doctors have the opportunity to get involved, and the times are ideal.
The campus has recently started running a full four-year medical degree program and opened a very impressive brand-new medical simulation facility.