Intensive care

Hi, I'm Ben White. I'm a registrar with intensive care in Rockhampton.

Hello, my name is Daniel. I'm a senior registrar working at Rockhampton Hospital.

Hi, my name's Ricky. I'm a second-year junior doctor working at the Rockhampton Hospital.

I've just got onto the ICU training pathway in Queensland, and next year I'll be working as an ICU registrar.

For me, deciding to train in intensive care was a little bit by accident. I think it's a specialty that involves all the good things I liked about other specialties. So it had a broad range of presentations, it was quite diverse. I didn't want to be a one-system specialist, and there were a lot of good acute presentations as well, which is really great. It relies massively on communication skills, which is something I was trying to work on as well, especially in emergency situations where there was a bit of chaos when I was a junior doctor. It was nice to see the intensive care team come and make order from the chaos. So, personally for me, that inspired me to head down that line.

I think working in Rocky, especially, has been fantastic, and I've enjoyed every minute that I've worked in the ICU here. For me, probably the thing that I love the most about it is, as a junior doctor, you get a lot of support, but you also get a lot of trust from your senior colleagues, from your registrars, from your consultants. I think if you put your hand up, you show that you're interested, and you're keen to learn and you want to work hard, they will look after you. But also, they give you a lot of leeway to go and try to learn and do your best, and I think that's probably been one of the aspects I've loved the most about it.

I think that when you're working with limited resources, you rely more on your clinical judgement. In regional areas, you gain that independence, and I think it does make you a better clinician.

What I found is working in a rural centre in Rockhampton has been beneficial because you get to do a lot more hands-on stuff as a junior doctor. You're more towards the front line, you do a lot more procedural work, and I think the experiences you gain are beyond what you can gain at this level in a tertiary centre. I think the bosses treat you, you get to know them really well, so you get to work with the consultants directly. You get to know all the intensive care consultants, all the anaesthetists, all the ED specialists that you work with regularly, and I think that's probably one of the biggest benefits as well is that you get to know the people you work with, and you get to build that trust and that relationship with them. I think that puts you a step forward in your career from whenever you start.

So, for me, the benefits of working in regional Queensland have been an opportunity to be able to be involved in a great team that's been able to provide quite individual and personalised medical care. And I've also liked the opportunity of being able to do a lot of things outside the hospital. I have enjoyed going to the gym, picking up new sports, doing things like swimming, snorkelling, and going scuba diving over the weekend. It has been excellent, so I think I've had all that opportunity because I've been in a smaller regional area.

Working regionally is also good from the sense of lifestyle and balancing work and life. I think not having to commute long distances, I think that the culture amongst the hospital and the culture among the doctors and the nurses that work here is also a lot more pleasant. I think people are a lot more relaxed, and I think that also contributes to a greater environment to work in as well.

I'm lucky enough to have friends up here who have a boat, so we spend a lot of time fishing out of the Keppels, doing a decent bit of camping as well.

I think the biggest advice that I would have is, if you know you want to train in intensive care, go and make an effort to get to know the people in the unit that you work near or in the hospital that you work in. Go and speak to the senior doctors and get advice from people who have done it before you. It was a competitive process, and you had to go through an application and particularly for the Queensland pathway, you also had to do an interview process. So, it does require a lot of preparation, but it's easily done. When I was an intern, I tried to make sure I went to as many med calls as I could to get that sort of experience. I tried to see as many sick patients in the ED that I could to get to know how ICU works or how the critical aspect of ED works, and showing your face in those situations means that as you do go throughout the year, they're the team in the intensive care unit and the team in the critical side of ED will get to know you, and they'll trust you more. I think that sort of thing counts a lot on your references when you do go to apply to become an intensivist.

You'll need to apply for fellowship with the College of Intensive Care Medicine of Australia and New Zealand. Fellowship is a minimum six-year full-time training pathway consisting of six months of foundation training, 24 months of core training, 12 months of clinical medicine training, 12 months of clinical aesthesia training, six months of elective training, and 12 months of transitional training.

Entry requirements and prerequisites include a general medical registration with the Medical Board of Australia, completion of PGY2, and being eligible to register with CICM after completion of six months in an accredited intensive care unit. In Queensland, the Queensland Intensive Care Training Pathway provides a centralised selection and allocation process for intensive care medicine trainees to accredited adult and paediatric intensive care units.

Applicants must apply through the RMO campaign to secure an employment contract for a position within an accredited intensive care unit. Trainees will also need to register with CICM after completion of foundation training.

I'm a British-trained doctor who initially came to Rockhampton for one year, and I've stayed here for three years, and I've absolutely loved it. I've loved my time here, and I think you will too. I think I've been incredibly lucky to work in Rockhampton and work in the intensive care unit here. Even through internship, doing some terms as a resident and then as a registrar as well, the support that we get is incredible. The consultants that work here support you to get onto a training program. They support you in your teaching and everything like that has been fantastic. It's something that I would recommend to anyone who's interested in intensive care. It's just trying to work rurally, and especially in Rockhampton as well, and I think it'll put you one step ahead in trying to get onto the training program that you want to.

Mackay Base Hospital is a Regional Hospital in North Queensland. We've got a population that we service about 150,000 people and we've got a very diverse case mix that comes through the hospital. Well Mackay Base Hospital really is a Regional Hospital that punches above its weight. Most of the patients in ICU are quite complex and those are nice challenge for any trainee. It's a modern hospital, it's got good services, it's a good team and it's a really good place to grow as a junior doctor. Mackay Base Hospital offered a lot to me.

I chose it because it gave me a supported environment where I could step up to a registrar role. I chose Mackay Base Hospital for a number of reasons. One, I wanted to work in a regional centre and understand the particular challenges that are faced by regional centres. 2 It allowed me to have some extra study time when I wasn't at work.

I think one of the best things about being in Mackay Base Hospital is that it's a really friendly team. I just think that it's a really nice cohesive unit. There's only 5 registrars. That's been something I haven't had before, is the kind of collegiality. The cold treatment climate hospital is fantastic. There's a great working relationship between the anaesthetic department and the intensive care department. We have time to teach and we enjoy teaching, and it's a really good place to get that independence, to start thinking about the decisions, to build the confidence that you need to get through the exam. Teaching is both formal and informal and it is a strong teaching environment, teaching culture.

We run a simulation here in the units being supported with our simulation centre, Simcos. The teaching, particularly the anaesthetic department around the anaesthetic primary exam is fantastic. It's a weekly session. We've got a very high success rate for their primary exam. The beauty of being in Mackay is that you get a lot of one on one time with your bosses. There is no senior registrar, so you'll be working one on one with the consultant. So you get a lot of exposure to procedures as well as six months of your anaesthetics which is our STP position is supporting that anaesthetic training. The benefits of a regional centre

compared to a tertiary centre was being included in all of the anaesthetic lists and the access to the consultants at Mackay Base Hospital Intensive Care unit, who are very keen to teach and very keen to go through hot case practises have proved A valuable part of my learning whilst I was in at Mackay Base Hospital.

Lifestyle is fantastic. There's nowhere else in the country you wanna do winter. I definitely am not a cold fish so I love being in the tropics. Also, you know, getting out to the Whitsundays, no complaints about that reef time. Each time it's been really good. The life sounds fantastic. There's plenty of outdoor activities. I quite like Bush walking and hiking. There's lots of those areas. I love Mackay because it's such a beautiful area and it's a nice sized city because you can get anywhere in no time and it's relaxed but it has everything we need. The beauty of the shift working is that you do have the time to donder off on several days adventure and come back again without claiming any leave. So I've tried to make the most of that after the primary exam.

I think it's a fantastic place for a trainee. I think at the end of this two year rotation in Mackay, most of our trainees are more independent than than their colleagues who come out of big units. We want them to see this as a good place to work. We want them to understand that regional intensive care practise is a challenge, but it's a good place to work from an ICU point of view. I certainly would get rid of any misconceptions that being in a regional centre before your exam would not be a benefit. If you're a senior ICU trainee, I couldn't think of a better place to do a year of anaesthetics and ICU then Mackay Base Hospital. I'd say I will be, you know, sorely missing this place when I leave into after my two years time. Loved it, made so many friends you know will be looking to come back and visit or even work one day.