The End of the Locum Road

After nearly 2 years, 13 jobs in 11 different towns across 4 states, having taken 85 flights and slept in more different beds than I’d care to count, my time as a locum has finally come to an end.

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I originally left my cushy city life in order to fulfill my return of service obligations under the Medical Rural Bonded Scholarship scheme, which thankfully coincided with a time in my life when I was ready for a change.  It’s gratifying to look back on my original blog post and realise that I’ve actually achieved everything I’d set out to do. I wanted to try out “big towns and little towns, GP clinics, Aboriginal Medical Services, hospital and DMO jobs, north, south, east and west, hot and cold, coastal and outback” and yep, I’ve done it all. I’ve also managed to complete nearly half of my MRBS obligatory rural time along the way, and ultimately, I’ve succeeding in finding a place to settle down for a while.

But to look back on it as merely points on a map or a checklist that’s been ticked off, really doesn’t do justice to the richness of the experience. For one thing, it’s reminded me how incredible life is outside the boundaries of the big city. Out here, nature is humbling. Ancient landscapes remain unconquered by human hands and the sky feels bigger, the sunsets more spectacular, the stars more profound.  The people seem different, too. I’m still amazed by the way I, a complete stranger, was welcomed into people’s homes and invited to share their lives, and this was even more marked in the smallest and most remote places. Isolation has a wonderful way of breaking down cliques and bringing people together.

Being exposed to a more diverse range of humanity has been confronting at times, too. My heart has broken from witnessing the effects of profound social disadvantage: homelessness, hopelessness, alcohol abuse, unimaginable family violence, self-harm and suicide, third-world diseases in our own backyard, chronic illness and neglect. I felt helpless, and guiltily relieved about my own incredibly privileged life. Yet, as a GP, it’s immensely rewarding to build relationships with folk from all walks of life, and to hope that even the tiniest positive impact may one day make a significant difference to patients and communities. In the end isn’t that why we do what we do?

So here’s a hot tip: if you want to gain self-insight, step outside of your comfort zone, surround yourself with strangers in a completely new environment every few weeks and you’ll soon find out what you’re made of. I’ve realised that I need community and human connection more than anything else. I gain so much from conversation and company, and if I don’t get regular doses of physical affection I start to seriously consider advertising free hugs in the main street. This was a lesson hard learned, as the disruptive locum lifestyle left me constantly battling with loneliness, isolation and disconnectedness.  But the flip side of that dark coin was the chance to meet so many wonderful, life-enhancing people along the way, some of whom have become my closest friends.

If nothing else, the lack of geographical continuity has forced me to find innovative ways to connect with others and I’ve certainly embraced the potential of social media with enthusiasm. I don’t even think it would be too much of an exaggeration to say that Twitter has changed my life. What an amazingly friendly, supportive, inclusive bunch of like minded folk I’ve come to know. It was these online connections that first introduced me to blogging and the concept of FOAM. I’ve moved from an enthusiastic reader and consumer into a blogger, opinionated writer, FOAM contributer and novice podcaster, all activities which give me enormous satisfaction and no doubt make me a better clinician. If I can help to sprinkle a little bit of medical education into the lives of others along the way, then that is just a bonus.

So it’s been a roller-coaster ride of highs and low, triumphs and difficulties, great joys and dark moments. Ultimately it’s been an incredible learning experience and I can’t regret that for a second. Not only do I have a pocketful of new clinical and technical skills, I’ve also learnt some important life skills. I’ve become much more adaptable, flexible, resilient and socially brave as a result of my travels. I’ll make a dinner reservation for one, turn up to an event full of complete strangers and head off on adventures with people I’ve only just met. I’m less judgemental, less snobbish, more open-minded and have become extraordinarily good at learning peoples’ names.  I’m no longer quite as sensible as people have always accused me of being. I take more risks and jump at opportunities that I might once have passed up in favour of comfortable self-doubt. I think I’m a better version of myself than when I started.

As always, the end of one journey marks the beginning of the next. My new challenge is to find my own little place in the vibrant ecosystem of the Broome community, and to re-learn how to be a hospital doctor. These transition periods always come with a mix of emotions: sadness at finally moving away from friends and family in Perth but excitement about getting to know a new mob of people, trepidation about my new work responsibilities but enthusiasm for the professional learning opportunities ahead, relief to have a bit more stability in my life but still much uncertainty as to how the future is going to pan out… My feet won’t have a chance to get too itchy, though, with upcoming trips planned to Chicago for SMACC, Darwin for NRHC and hopefully lots of exploring in and around the Kimberley.

And as for the blog? Well, it’s obviously not going to quite live up to its name any more. I still plan to use it as an outlet for my reflections on life as a country doctor, teaching / learning and my occasional long-winded rants. My educational content can now be found at the Bits and Bumps podcast (with fabulous co-host Marlene Pearce) and I hope to continue to contribute to other sites such as GPs Down UnderFOAM4GPBroome Docs and whoever else will have me!

If anyone out there is contemplating stepping out of their own comfort zone or taking on a new adventure (geographical, professional or otherwise), I say: what are you waiting for? Get out there and see what awaits over the next horizon. Then tweet, blog, photograph and write about what you discover. Or send me a postcard c/o Broome Hospital – I can’t wait to hear all about it!

May you all embrace the nomad within.

Penny

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7 thoughts on “The End of the Locum Road

  1. Hi Penny, I love your blog, I’m an MRBS scholar too, just starting 2nd year med and excited about future opportunities and experiences. Cheers, Judy 🙂

  2. Congratulations Penny, on not only surviving but thriving – and emerging a stronger, wiser and more self-aware person. It has been a pleasure sharing your ups and downs through your blog. I hope you continue to share your life journey as you enter a new exciting phase. Thank you… and keep writing! (sending e-hugs your way)

  3. I think you have well and truly earned your nomadic GP title and look forward to reading how an inspiring nomad settles into a more permanent role! I wondered if I might say a more grounded role but decided against it as your experience sounds entirely “grounding”. Every best wish Penny.

  4. I (kind of) remember Broome Hospital …

    It was the year after Malcolm Fraser’s “Fistful of Dollars” election campaign, so it must have been 1978, and was in the Dry Season.

    I rode to Broome on my motor-cycle from Port Hedland (it was dirt all the way back then, except for maybe 30km’s leading into Broome).

    I pitched my tent at a camp-site, and woke up in the early hours of the morning vomiting, shaking, thinking I was about to meet my maker.

    I rode my bike to Broome Hospital, no helmet, vomiting to one side as i went (my full-face helmet would have hindered this activity).

    First they figured it was a drug overdose (long haired young guy on a motorbike), then, some hours later, (not sure how they decided) said it was a spider bite.

    I slept there for a couple days, on the second day I noticed the nurses were all beautiful, and then I was discharged, and made my way to Cable Beach (back then just a beach and a caravan park).

    Good Times!

  5. Hi Penny,

    Great blog, what advice would you have for training GP registrars with MRBS background? I really love the idea of doing rural locum for a while as you did, how much Ed experience did you have prior to starting locuming? Or anaesthetics experience for airway management? What courses would you recommend?

    • Hi Chris – if you look back through to the early posts in the blog you can see that my ED experience wasn’t extensive, and that was one of the challenges. There are some basic courses you can do to get a baseline level of knowledge, eg CEMP (RACGP), REST (ACRRM), REACT. There’s also APLS (paeds), ALSO (obs).

      Probably some of the highest yield stuff is ETM (trauma –> highly recommend) and ultrasound training (various courses exist).

      I also have no anaesthetics experience but have done loads of courses and intubated lots of mannikins. I’m also lucky to always be working with anaesthetic trained doctors so always have back up if needed.

      All the best!

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