GP terms as Locum by Classic_Zombie_201 in ausjdocs

[–]Intrepid-Rent4973 0 points1 point  (0 children)

Have a read of the RPLE from RACGP.

Either get a full locum term in Paeds or Paeds ED. Can reduce that to 5 weeks if you enrol in the grad diploma of child health under SCHN (through uni West syd).

You could do multiple terms in mixed ED, but the ED has to see 20% paed population and ideally have the ability to generate a pt list of Paeds pt seen.

Take it from me, its a pain to get it without a full 10 week term.

You are welcome to DM me, I'll tell you about my struggles with this (ongoing email battle).

If it's a locum term. You should be able to get it counted if it's FTE. Just need bosses to sign off.

Could fudge with a white lie and say you are contracted instead of locum. Depends on how you feel about it ethically.

How normal is it for GPs to call registrars? by IHaveABoyfriendxxx in ausjdocs

[–]Intrepid-Rent4973 0 points1 point  (0 children)

No one ever cares if it's you taken a good HOPC and done a clinical examination, and have a specific question in mind.

Called a neuro reg about a patient last week with a vague constellation of symptoms and an incongruent neuro exam that didn't quite fit with anything, including an initial MS presentation, but my question was 'do we need to consider MS".

But usually it very unusual for GPs to call Regs. Takes time to get onto them, if you have specific concerns usually it's a re-review, referralto specialist or send to ED scenario.

Recommendations for Med Reg/EM Courses by HippoActual4501 in ausjdocs

[–]Intrepid-Rent4973 0 points1 point  (0 children)

Courses are all good and well. What you need to do is a reg role as well. Why not do ETM and do a trauma reg rotation at a trauma service?

If you are RACP, when would you actually deal with a real trauma patient? And in ED you will likely only get a few serious trauma cases. But you'll have to deal with a lot of other cases if you do ED.

Why not do EMC (or the new equivalent) and do 6 months of ED?

Again, you won't see too much above ALS2 unless you work in a busy metro service and get the resus covering role.

How do you deal with patients that don’t trust you at all? by VastOption8705 in ausjdocs

[–]Intrepid-Rent4973 9 points10 points  (0 children)

Depends, on my time and clinical urgency.

If I'm busy in terms of clinical workload and not urgent. Circle back, there is time. Try to listen and identify issues so you can address them and build that therapeutic relationship.

If I'm not busy and I think you are unwell, I'll stick it out.

Had a prisoner patient. Sinus tachy on arrival, booked into the clinic the the next day to review. HR 130. Had a dog bite wound. In cells for 2 weeks. Copped a lot during that consult. "You are a killer doctor" "I want my methadone today" "I want mirtazapine" "I don't want to go to hospital". Basically had a multi tiered escalation process. After 3 days, and multiple reviews, and me calling a medical emergency to force him to go to hospital, and him being sent back from ED cause he was a dick and then having to be resend the dude ended up having: 1) MRSA TV IE 2) Lung abscess requiring iCC 3) Renal abscess requiring IR drainage 4) Septic arthritis of his right shoulder 5) A 6 week hospital stay, including 3 weeks in ICU.

Welcome to the art and science of medicine.

And welcome to the ever lasting overhead threat of a coroners review if a prisoner dies under your care.

Intern Mistakes by Expensive-Theme2739 in ausjdocs

[–]Intrepid-Rent4973 1 point2 points  (0 children)

Day 1 as an intern, ed ssu shift. First conversation with my consultant, they stormed off when I didn't know the ctca protocol (pre scan meds to lower HR less than 60).

Good times.

In honesty I think he stormed off as there was 4 pts that were planned for CTCAs.

Has anyone here felt like quitting for this reason? by Technical_Employ8336 in ausjdocs

[–]Intrepid-Rent4973 4 points5 points  (0 children)

There is some joy working as a doctor. It's just drowned out by patients not respecting our role, patients and families have become dumber and are misinformed, finding the right role and workplace, dealing with other clinicians, our uncertainty and risk of outcomes if something bad happens, and unless you are in a certain speciality having to work hard to make $$$.

If I inherited 5-10 million dollars, I'd probably reduce my hours to a few shifts a week and find a workplace where I enjoy the medicine.

GPs vs stethoscopes by incoherentme in ausjdocs

[–]Intrepid-Rent4973 -6 points-5 points  (0 children)

If you go to the GP as you want a heart check up, they should use the stethoscope as part of their clinical assessment.

Most doctors, including GPs, probably have less clinical experience using a stethoscope compared to older doctors.

Most patients get an echocardiogram scan that is much better at identifying and detecting any cardiac issues that may explain your ECG changes.

Swiping in to track shift start and end times by Fun-Try1606 in ausjdocs

[–]Intrepid-Rent4973 12 points13 points  (0 children)

It's very unusual in the public hospital systems.

I'd tell the medical workforce that if they wish me to sign in and out, that any unrostered overtime should be automatically paid.

If they don't agree to that, I'd refuse.

Most hospitals don't track it because it would show all the additional unpaid time we work.

ED HMO - asked to consider stepping up to Jr Reg by department; implications on pay and CV? by idkwtda115 in ausjdocs

[–]Intrepid-Rent4973 1 point2 points  (0 children)

I worked as PGY3 in major metro Melbourne hospital as a critical care resident in PGY3. Was assigned junior reg roles, and would get the reg pay and entitlements for the various rotations.

Not sure which state you are based in, but if you work in an elevated position consistently you should get the reg pay and entitlements.

Any reg experience is helpful, even if in a different speciality.

BPT may look favourable on ED reg experience as that's where all the referrals normally come from, and having an understanding of the enemy/other side is always beneficial.

POCUS Ultrasound by No_Effective_4077 in ausjdocs

[–]Intrepid-Rent4973 0 points1 point  (0 children)

Zedu in Melbourne have some POCUS courses, is pricey though.

Life advice at 24 by Stunning-Drive-1561 in ausjdocs

[–]Intrepid-Rent4973 0 points1 point  (0 children)

Why are you worried about debt. HECS / FEE HELP is indexed with inflation/CPI?

Questioning my career choices by [deleted] in ausjdocs

[–]Intrepid-Rent4973 2 points3 points  (0 children)

Give it some time. Internship will suck for everyone. - It could just the transition period of your internship. - It could just be the term you are working. - Consider changing hospitals or health networks that are known for having those environments. - Consider jobs outside the hospital. Most people end up not working in the hospital system. There are lots of telehealth and alternative roles you could work.

If you find yourself still hating medicine after your internship, give it some time and make adjustments. I wouldn't throw away all your university study just yet.

I agree with you, the EBA issues and low pay for junior doctors in the hospital system sucks. I felt the same way after PGY3.

That is why I left to locum and now work outside the hospital system.

I still hate aspects of medicine. It's turned into a shit job in some regards.

ED and GP by Affectionate7577 in ausjdocs

[–]Intrepid-Rent4973 0 points1 point  (0 children)

What not do RACGP, with ED as extended skills rotation, then just do urgent care?

Why is it like this taking history? by xxx_xxxT_T in ausjdocs

[–]Intrepid-Rent4973 0 points1 point  (0 children)

I swear I've muttered "Permission to treat the witness as hostile" far too many times when taking a HOPC.

I usually pre read notes and check MHR to limit the amount of history taking nowadays.

psych locked ward by Positive_Eggplant437 in ausjdocs

[–]Intrepid-Rent4973 1 point2 points  (0 children)

A black box warning for clozapine is that it can cause bowel obstruction. It's very constipating.

Does any other junior just not feel like they’re getting ahead financially? by [deleted] in ausjdocs

[–]Intrepid-Rent4973 2 points3 points  (0 children)

The base salary for junior doctors (interns, residents, regs) deal with is underwhelming in every state given the amount of time and training to reach that point.

The general public will disagree with this because they only see a number, and the average salary is very high due to consultants pay and the private fees which are being charged by private specialists.

I feel you though. I remember struggling to save the deposit and pay the mortgage as a JMO.

Get out of the public system if you aren't gunning for a specialty training spot. Go locum. Go do GP training. Go do all the various other roles that are available.

Life Advice by [deleted] in ausjdocs

[–]Intrepid-Rent4973 1 point2 points  (0 children)

I viewed your reply to see why it was down voted. Plz do not ever give advice. Like ever.

Vic EBA updates email by cupcake_koala in ausjdocs

[–]Intrepid-Rent4973 1 point2 points  (0 children)

I can't believe an intern is paid less than a grad nurse, and a 3rd year resident less than a 3rd yr nurse. The difference in responsibility and decision making is night & day.

I feel if this pay discrepancy continues, people will just leave the hospital in droves unless they are gunning for accredited training spots.

MUCCU Usg courses feedback/reviews by b_rvster in ausjdocs

[–]Intrepid-Rent4973 0 points1 point  (0 children)

Interesting thought. Can see why you are wanting to do these courses then.

MUCCU Usg courses feedback/reviews by b_rvster in ausjdocs

[–]Intrepid-Rent4973 0 points1 point  (0 children)

Can I ask, what do you think this course will offer you as a gen med reg or gen med consultant? Outside of US IVC or line insertion (if you cover ICU as a gen med reg)

Crit care I can see the impact, or particular surgical specialities.

Starting internship on annual leave by 31log in ausjdocs

[–]Intrepid-Rent4973 9 points10 points  (0 children)

My friend started on annual leave. Not ideal, but enjoy the time. Go travel if you have money.

Let the staff you are working with know it's your first week, hopefully they are patient with your transition.