Medical Student Series: A snapshot of the reality of Obstetrics and Gynaecology, Emergency Medicine, Anaesthetics and Rural General Practice
Written by Dr Ashe Coxon
This series of articles titled ‘Medical Student Series’ will delve into some of the medical specialties that a doctor can pursue. The information is based on the experiences and research of the author.
As medical students rotate through their clinical years, they are traditionally exposed to Anaesthetics, Obstetrics and Gynaecology, Emergency Medicine, Medicine, Surgery, Psychiatry and General Practice. Some clinical placements are very informative, practical and allowing the student a realistic appreciation of what that career may look like and give the student the ability to make a truly informed decision. However other placements may have limitations on what experience and involvement the student may have, therefore limiting their capacity to make a truly informed decision on a career pathway.
Additionally, many medical students would have only experienced clinical placements in an urban GP setting, and not a rural. Rural general practice work can be extremely different to urban GP work and therefore having a rotation in urban GP does not expose you to what a life of a rural GP looks like.
The best way to decide if you would be interested in a career in a certain specialty is to get practical experience in the area – a hospital rotation, work experience or shadowing, but this is not always achievable. The intention of this article is to provide some further insights into four popular and common rotations that may be of interest to you but you have been unable to secure a rotation or felt you didn’t get a true experience when you did complete the rotation.
Emergency Medicine
Emergency medicine is traditionally viewed as fast paced, acute care and emergencies, but this is not always the case. There is also a large proportion of non –acute care patients to care for, social admissions and a wide range of all disciplines of medicine (Psychiatry, orthopedics, cardiac, paedaitrics etc). Emergency physicians need to have a wide range of knowledge and skills, quick thinking, leadership skills with good communication skills to communicate with family, lead a team and liaise with specialties they are referring to.
Emergency Medicine is very procedural, with involvement in resuscitations, airways management, suturing, fracture relocations, plastering and procedures like lumbar punctures and chest drain insertions. At the end of a shift, the doctor hand over patients with ongoing care being transferred to another doctor. For some they enjoy this aspect, but for others they do report missing the continuity of care and following the patients medical journey.
Emergency Medicine suits people who enjoy organized chaos, those who enjoy acute care, teamwork, and don’t have the desire to follow a plan and structure (Eg 30 minute appointment) and those who don’t mind not having continuity of care of the patient.
Obstetrics and Gynaecology
Obstetrics and Gynaecology is a mixture of procedural work, acute and emergency care, clinic work and continuity of care of the patient. Obstetricians and Gynaecologists are highly skilled and trained in specific procedures and also require good communication skills and team work are required. It is a surgical discipline so doctors will end up in theatre a lot, and often in an acute setting (Emergency caesarean sections, ectopic pregnancies etc) so for those who don’t enjoy theatre work, this is a big consideration.
People working in this field report enjoying the continuity of care throughout the pregnancy but it is highly unlikely to follow the patient up postpartum. Those that move into gynaecology have longer continuity of care of patients and often see patients regularly over many years.
If you are considering this as a career bear in mind the long hours, on calls and shift work that inevitably comes with this field.
Anaesthetics
Anaesthetics is a mixture of procedural work, clinic work (seeing patients in prebooking clinics), consulting patients on wards, calculations of medications, very specific knowledge on medications, interactions and pathophysiology and is a protocol based area. Anaesthetics suits people who enjoy following a structured plan, sequence of events, and calculations, but it also require knowledge and skills to deal with emergencies.
Anaesthetics is a very procedural area (Cannulation, intubation, sedation, nerve blocks, epidurals etc) Communication skills required and anaethetist is often the calming influence for a patient undergoing sedation.
Anaesthetics is a very team based environment in theatre (with nurses, ward staff and the surgeons) and is often is the nominated team leader especially in the event of an emergency.
Rural General Practice
Rural general practice is a very diverse career in which the doctor performs a mixture of procedural work, communication skills, continuity of care, ability to do a combination of all 3 above specialties. As a rural GP they have the ability to gain advanced skills in the above areas to allow them to provide emergency, obstetrics and anaesthetics services rurally. Rural GPs provide a vital service to small rural towns who don’t have access to metropolitan hospitals.
A rural GP can also work in a GP office and see patients regularly as outpatients and therefore get continuity of care as well. A wide range of skills required to work as a rural GP and many years of training, and ongoing upskilling is pertinent to obtain the skills required.
Rural general practice suit people who enjoy all aspects of medicine, enjoy procedural medicine, and who enjoys building relationships with patients and ‘cradle to grave’ medicine where they look after multiple family members.
This is only a small insight into each of these 4 specialty areas and if you are wanting to explore and discuss more medical options available to you then please reach out to us at [email protected]
