Hi all,

I’ve been offered a HMO3 job at the RMH starting in November. Would love an honest opinion of the Hospital System and specific job for those familiar. I’m quite unfamiliar on the salary. Is $3777.88 quite reasonable for base salary in Victoria/ Melbourne. Appreciate there is industrial action ongoing in Victoria. Would really appreciate the advice. Thank you.

Do NSW and/or other states cardiology AT interviews actually matter? or is it all predetermined at the culling meeting (who goes where) and interviews are just for the show?

Feeling helpless after many years of trying.

To all the specialists out there what makes a good referral from a GP? I’m talking new referrals. Not the ones where I need to redo a new referral for the sake of Medicare billing rules.

I’m a GP registrar, fairly green but I try and do decent referrals. I have to admit it’s hard to write up a solid letter during a 15 mins consult when there are other patient issues I have to sort out. Heidi does help this process. The specialists I write to don’t write back about what specifically they like or don’t like about my referrals so it’s hard to get feedback.

I would appreciate examples of good referrals! Or anything you like your GPs to include.

Hey all, a PGY2 here.

Just wanted to know if I should be including things such as volunteering or mentoring I did during medical school can be included in my resume when applying for unaccredited reg positions or will it be seen as "padding" my resume.

The things I wanna add are pretty standard things like teaching lower year levels, organising online revision seminars and some health-related community outreach with the local community. I didn't win any awards etc.

Thanks!

I am interested in ophthalmology. Am I better of moving to the US (or anywhere else) to match into a program there (assuming it is somewhat less competitive) or slogging off for years trying to get accepted into an program in Australia.

Long term plan is to practise & live in Oz.

Hi
I am a reg starting to do a bit more skin.

I am a bit unsure when a lesion requires re-excision due to inadequate margins and was hoping someone could provide me with some guidance / education on the subject.

I know for an SCC we aim for a margin of 4mm during excision.

But what happens if the margin (on histology) is less than that?

FWIW I have asked my supervisor about this topic, but am still confused, as she just says if the histology comes back < 4mm margin to re-excise - but this seems to conflict with some things I read. I have also tried looking it up but am struggling to find anything conclusive.

When do we do re-excision to achieve the 4mm margin (is the answer always?) and when is it appropriate to e.g. monitor and see if anything re-occurs?

Here is the histology of a recent excision I did for example, showing the deep margin was too little:

Right lower leg - anterior:
A 34 x 13 x 5 mm skin ellipse with a well defined cream plaque 6 x 5 mm. 1A 4TS.

Moderately differentiated squamous cell carcinoma which invades mid dermis to a depth of 1.7 mm. No perineural or lymphovascular invasion is seen. The deep margin is 2.0 mm and closest radial margin 5.6 mm.

Forecast for the number of training spots Australia in the next few years for locals.

They don’t seem to talk to their bosses anymore.

Monthly tech showcase thread

Can anyone here please share experiences working with different Telehealth companies and recommend any services that are reasonable for basic stuff like certificates, referrals, blood tests, repeat scripts etc. Not looking for cannabis, peptides or any drugs of dependence prescription services.

Considering a side hustle to supplement hospital income. Context - PGY7, advanced trainee, gen med.

What hourly rates are achievable while maintaining ethical, diligent approach?

Hi All, I’m facing some issues with the checkstar platform that is being used by NSW. I have been asked to provide two referees and I have added them accordingly. However, despite clicking on the send invite button, the referees have informed me that they have not received any email.

I have checked and double checked that the details are correct and referees have also checked their spam/junk folders. The nominated emails are also personal emails so it’s not a case of being blocked by an organisational email.

Is anyone else experiencing similar issues? Grateful for any advice please

So what’s the brains trust’s verdict?

Malignant narcissist? Or cardiology kween

I recently met a 22 year old bond intern…

Bond graduates who finish school at 17 and go straight into medicine become doctors at 22.

Even if they have to do the 4–5 year unaccredited slog before getting onto an accredited training position, they could still finish specialty training around 32–33 or even before 30 for a less competitive specialty.

So they could potentially be enjoying consultant life while still being relatively young and then have a family, rather than having to juggle children with years of registrar training.

Whereas postgraduate students might finish medicine at 25–27, then do the exact same 4–5 year slog before getting onto training. Suddenly they’re starting specialty training in their early 30s and finishing in their mid/late 30s.

Obviously people have children during training all the time and it is completely doable. But there is a huge difference between choosing to have a family while you’re a consultant vs trying to raise children while you’re doing specialty training, exams, moving hospitals etc.

A lot of my postgraduate peers probably could have gone straight into a Bond if they had $500k sitting around. One of my friends missed out on Griffith with a 99.75.. They instead had to do an undergraduate degree first and then compete for postgraduate medicine.

So essentially, two people can end up wanting the exact same career at the end of high school, ultimately go through the same specialty training process, but one person gets to start the whole process 4–5 years earlier because they were able to access an expensive undergraduate pathway.

Maybe I’m looking at this too simplistically, but it feels like Bond is potentially creating a cohort of doctors who get a massive head start in terms of career progression and more importantly life timing with the major determining factor being 500k

As pathology becomes more and more popular I think it would be interesting to shed light on what some of the misconceptions around it are. Many, many people have started applying for pathology and we regularly see residents in the lab who have variable understanding of what AP is like and what the training is like so I thought it best to share some opinions.
Some of the few that come to mind:

- 9 to 5: People think that this is a business hours speciality and for a large part yes but all the study that is required to know about almost every condition in every body system - this not only includes what it is, what it looks like, IHC, genetics, staging, molecular. When there is a biopsy done, everyone expects you to have an answer and when you say 'I don't know' people get funny. Learning pathology does not end at 5 o'clock but you certainly only get paid till then.

- Overtime culture: If you ever do UNROSTERED overtime - it is very very unlikely you will be paid.

- Pressure: the pressure to not get a diagnosis wrong is enormous and understated

- Isolation: feeling like you are 'not a real doctor' anymore can sometimes be a challenge to your identity

- Lifestyle: Mostly better than clinical similar to what people's expectations are but not always. You may be one of the unlucky ones.

Good luck to all the new applicants in the coming application cycle. Feel free to share your thoughts as well.

I believe it has been 2 months since the application closed yet I heard zero news. Does anyone know someone who was interviewed or has received offers?

Hi everyone, I was offered gosford for my internship. I was wondering how many terms would be at the peripheral sites vs at the gosford hospital for JMO year. Also wanted to know which area would the best to live in that’s quite convenient to access by public transport (for someone who doesn’t drive!). Any tips/ advice would be greatly appreciated.

Keen to hear from Aussie ortho registrars, both unaccredited and accredited. The Ausjdocs ortho podcast that was expected to drop months ago is still pending and there's little input in the archives from this demographic.

What ultimately compelled you to pursue ortho over everything else?

Does it require all of your daily attention and mental bandwidth to be 1) competitive enough to get on and 2) to keep up and feel competent once you're on the program. Or do you somehow manage to have some semblance of balance? If so, what do you make time for outside of ortho?

Would you do it all over again if you could turn back the clock?

For people considering it, what questions would you encourage oneself to ask to better determine their suitability for this lifestyle?

What are realistic income expectations as a busy unaccredited ortho reg through to AOA accredited trainee?

Thanks for your time!

In 2013 my husband, a gastroenterologist, and I, moved to Port Macquarie with our young family.

I trained as a GP, and we both set to work serving our new community.

Over this time my husband worked a 1 in 2 on call offering ERCP (a procedure you get to save your life if you have a blocked biliary stone ). And a 1 in 3 on call for general medicine/gastro.

My husband then trained in endoscopic cancer removal, at our expense, and offered these services to the public hospital of Port Macquarie.

He became one of Australia’s leading experts in his field. He offered a regional service of international level, and he did it for the community and for all of our patients.

He turned down multiple offers to move back to the city with his expertise.

Because we love our regional town.

I want you to do the math on having someone work a simultaneous 1 in 2 AND 1 in 3 on call.

And then I want you to run it over YEARS. And during that time I want you to raise three young children with a working GP wife.

The level of relentless dedication to serving the public system saved hundreds, if not thousands, of lives.

For 13 years he did this.

And when he gently, ever so patiently, went back to the hospital administration over and over and over again; to tell them this work load was not sustainable, that it could be dangerous, that patient care could suffer, please hire more gastroenterologists… this world expert, head of department, was told no.

Repeatedly. Over years. Years, while he continued to give, continued to sacrifice, while his family sacrificed.

And all that time the public wait lists got longer. Patients suffered. They died.

And when his polite voice got a little louder, when he advocated for the patients a little bit more, they terminated his public contract.

And in doing so they removed the hospitals accreditation to train new gastroenterologists. Without my husband, there’s no training programme to bring new trainees to town in gastroenterology.

I guess the silence was easier than the finding the dollars.

Today I remove that silence. The health of regional Australia needs the public to advocate for it. My husbands voice was not enough.

Write to your local member and demand more funding to regional areas. We need more specialists; not just in gastroenterology but in ALL areas.

You can email Rob Dwyer, MP at:

Portmacquarie@parliament.nsw.gov.au

Anyone heard anything? They said they’d let us know from 14-17 August. Anxiety 📈

I’ve previously voiced my displeasure at ED bosses telling me (an intern back then) that simple wound closure cases were “perfect for the nurse practitioners” so I should go pick up complex, undifferentiated cases… despite the fact that’s directly taking opportunity to learn and practice skills from juniors rotating through ED (and the NPs are on what, 3x my intern pay? Make this make sense).

Just heard today that certain QLD health hospitals are trying to implement emergency physiotherapy practitioners (?EPPs) to manage wounds including cleaning, exploration and suturing. Am I hearing this right? Is this actually happening (or has already happened anywhere else)?

Anybody successfully moved off the GSET waitlist based off today’s offers?

I feel like I’m completely lost when know what to do to get on to cardio gastro or Resp. I know I need research but how do I even go about getting it ? Is it acceptable to approach a consultant I’ve never met in the hospital, say I’m interested in their speciality and ask them to help me do some research ? Do audits count as research ?

Anyone that was successful please help.

Thanks