I think fear of uncertainty is almost universal amongst registrars who are assigned to go on rural placements, especially those who are assigned to NEATS. Don’t worry – you are not alone!

I thought that I’ll share my experience in Moree with you, so that you can find out more about what to expect and to base your decision on facts rather than preconceived ideas.

I was not keen at all in going to NEATS when I was told that I was assigned to them. I had applied to North Coast and GPLogic as my number 1 and 2 choices, and I was not impressed when I was told that I had received my final preference.

After that, time came for negotiations with NEATS about which town and which practice I will be going to. I had a good friend who was also assigned to NEATS so we tried to go to a town where we can both go together so that we are not all alone and isolated.

Another thing that scared me was the fear of the hospitals. In the past I have done a few ED terms and paediatric terms as RMO but I always had support from the registrar and / or the consultants. I felt that I was not ready to attend emergencies on my own. I didn’t sign up to GP training to become a ED / hospital VMO!

Therefore we were keen on going to Tamworth where there was a big base hospital with all the specialists and ED specialists, and most importantly, where we did not have to do any hospital work.

As it turned out, our bid failed and my friend and I reluctantly headed up to Moree. The drive up there was fairly depressing. I had just left my wife behind in Sydney who couldn’t come up because of her work, so I was already starting to miss her. I wasn’t sure how I was going to take the next six months away from home, going to a completely new environment. Certainly stories of Moree that I had heard from other people did not help. Most people’s reactions when I told them where I was going was, “Oh no, I feel sorry for you.”.

Six months have passed and now I’ve finished the term and now I am back in Sydney, working with UNSW and with IGPE, also mixing in clinical general practice as well.

I’ll tell you what happened in Moree:

1. We did a lot of travelling around the area. We explored neighbouring towns such as Narrabri, Tamworth, Inverell, Glen Innes, Armidale, Goondiwindi. We drove one weekend to Coffs Harbour, and on the other weekend to Noosa in Queensland. We “climbed” Mt Kaputar, which is a mountain where you can see 10% of NSW, saw a really really big dam near Inverell, and drove through very scenic areas on the way to Coffs.
2. Played tennis (for free) once or twice a week on most weeks.
3. Got to know the GPs and nurses in Moree. They all seem to have different reasons on how they ended up in Moree and different plans for the future.
4. Got to know people around Moree – patients, their relatives; also people from Church that I attended while I was there.
5. Saw, diagnosed, investigated and managed many hard-core things both in surgery and in the hospital. Hard to control diabetes, end stage COPD, APOs, Rapid AFs (many), STEMI, Prostate cancer, Depression, D+A problem (and the patient became a different man, and came back to thank me!), Post-strep GN, Pneumonias, etc etc.
6. Worked on a small audit project / study with my supervisor that we wrote up and submitted to a journal. Not approved yet.
7. Did and in parts actually enjoyed hospital work. Was on-call twice or so a month, which was actually less than what most GPs in town were doing. Rarely got called after 11pm.
8. Discovered how much support you get as a registrar in Moree. When you are on call, you have a GP surgeon on call and also GP anaesthetist and a GP obstetrician on call with you. If a trauma comes rolling in, then other guys get called in automatically and you don’t have to worry about things. If anything labour related comes in, let the obs deal with that. When I was unsure of things, I could always – either look up protocols / resources in ED; or call my supervisor on the phone; or call the GP surgeon or anaethetist; or call a specialist on call in Tamworth or in Sydney. The specialists are very very nice, different to ones that you call when you are a RMO or registrar in a big tertiary hospital. Most realize that you are isolated, in a small town, and they help you with specific advice, and if you are still not comfortable, you can always transfer them via air ambulance. The service is really good, although you do get little bit of a headache when ambulance is late or none is available etc.
9. Returned to Sydney 10 times or so – every 2-3 weeks. I know that they encourage people not to return too often, but I had a wife in Sydney so I just had to. Flights cost up to 400 return if you book late but book early enough and you can get away with 180 return. Flight time is around 1.5 hours and the airport is only 5 minutes drive down the road. I left on Thursday night after work and returned on Monday morning before work.
10. Gained an appreciation into rural health and the social problem that exists in Moree. Many are of Aboriginal origin and there is a big problem with substance abuse, and problems with unemployment, teenage pregnancies and so forth. Its quite different to the sort of problems that I am seeing now, working in Strathfield right in the middle of a busy shopping strip.
11. Financially I saved quite a bit of money. Hospital work and the practice work rurally is financially rewarding. Especially if you get into the habit of doing Care Plans and health assessments. Not only is this good for the patient, its good for your bottom line as well. In hospitals, every patient you see you bill for, and every procedure you do, including ABGs, ECG interpretations, suturing etc you get paid for… and as RMOs we were putting in a gazillion cannulas and charting up fluids for nothing!
12. Surprisingly the shopping is OK in Moree. They have Coles and Woollies which are big and new; Harvey Norman and Target, and quite a few shops. Of course its not Sydney so you don’t get David Jones or Myer etc – but since I was coming down every few weeks, I didn’t miss shopping at all! Nowadays you tend to shop online also so it’s not a major issue. They have few good restaurants in Moree. We tried to cook at home mostly and even came back home for lunch but when we went out there were excellent Thai restaurants, few taverns that actually serve decent meals, a Chinese restaurant (don’t tell them that I said this, but its not that good), and few cafes and so forth.
13. They provide you with free accommodation, with a lock up garage. The place is fully furnished, so its quite good. You just have to pay the electricity and telephone bills.

Of course there were downsides. Firstly I missed my wife and family: even though I was coming back every 2-3 weeks for a long weekend, at times it was difficult. But if doing a six month rural term is a requirement, and if you are going to be away from Sydney anyway, Moree is not a bad option.

Why am I pushing Moree? I am not getting paid to this, that’s for sure.
I am pushing Moree because there is a need for us out there. They really need more good registrars. They’ve had some issues with the NEATS registrars over there, and they really appreciated us coming up from Sydney. Moree deserves bright and young doctors like yourself even if it’s only for six months. Its not only the patients, but also the doctors there too. The GPs there all have character – some of them are not always placid teddy bears, but they all have a good heart and in the end they really mean well. They are good at what they do, but as with everyone they have areas where they can improve on. One thing about them though is that they are open to new ideas and if you have a new perspective on how to do things, they are accommodating.

Same goes for other towns like Inverell. Inverell is a smilar town as Moree, and I hear that you don’t even have to cover the hospital over the weekend anymore as they hire a GP locum to cover the hospital over the weekend. My brother went there for six months rural rotation, and he loved it.

Moree can take on up to 4 registrars at any one time. I am sure that they can even accommodate more if there is enough interest. I think if more go at the same time the better it is – you can share out the hospital work more evenly, and also there is an opportunity for social interaction amongst the registrars.

To conclude, I’d like to encourage those who are contemplating on applying to NEATS to not to worry - look at us, we survived. Secondly I’d like to encourage you to consider going to towns like Moree or Inverell. I am sure that at the end of your six months there, you would agree with what I just wrote.

If you want to discuss with me more in depth, especially details on what surgery to apply for etc, then please feel free to email me.