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Dr Gemma Johnston

Born in Darwin, Gemma belongs to the Jawoyn people of the Northern Territory and has always wanted to be a doctor. She is currently undertaking her GP training and is based in Broome.

Listen to Gemma’s story below.

What triggered this career path for you?

When I was a medical student, I got to do six weeks, which I ended up extending out to about eight weeks over my uni holidays, in my GP rural term, which was up in Wyndham, which is the very top of WA in the East Kimberley. And I loved it, I loved everything about it, I love the fact that you know, you were the GP, you were, you know, you were delivering babies, you were in the emergency centre, you visit people in their homes, you were flying out to nearby communities. And I love the lifestyle of it, you know, that you one minute in the office, the next minute, I was in the supervisor’s troopy going down the road to go fishing. So it was just beautiful and it really like opened my eyes up to a different kind of working lifestyle.

And then as I mentioned, I got to, in one of my years while I was working in Broome hospital, got to head up to Beagle Bay, and do some community work and that gave me a bit of a taste of something different not actually being based in the community, but being able to fly out and still being sort of quite regional, but then getting to go out to remote areas, which was really good.

What do you enjoy most about rural medicine and working in Aboriginal and Torres Strait Islander health?

I like the fact that you're part of the community, like, you know, and so some people don't like this part, because they get a bit turned off of it. But I like that you go down to the shops, and you get to see, you know, the community members and you get to see patients, you know, and get to see their journeys outside of medicine. I think that’s a big part.

It's good, it can be challenging, and I guess that's not something that I should probably sugar-coat. It is rewarding and there's like, really great times, but it can, it can be challenging, you know, you are that it is true, you are in a small community, so your reputation is sort of on the line. You know, you have to make sure that you don't do things outside of the clinic that will reflect badly on yourself in the community. And then some really tough medicine sometimes you're getting really complex cases and we know that our Aboriginal population have really complex health needs and you're in an area where there's limited access to specialists, you know, limited access to some of the services so you are thinking on your feet and trying to treat people.

But in the whole, it's mostly rewarding, you know, I really love my job.

What were your expectations versus the reality of working in rural and Aboriginal and Torres Strait Islander health?

Most of my expectations were spot on in terms of the reality of Aboriginal Torres Strait Islander health, you know, being exposed to it as personally and professionally as I went through training. And my mum's been a huge, well was, recently passed away, a huge advocate for Aboriginal and Torres Strait Islander health. So growing up around that that's, you know, always sort of shaped my learning. I think in terms of the rural work that kind of took a little while there were some challenges there. You know, I talk about this tight-knit community, but it does take time to get trust from families and communities, especially because they had so many people who come in and out of the communities that it's, you know, it's hard for them to sort of rely that you're going to be there for them when you could just hop on a plane and leave the community.

And even though I am an Aboriginal Torres Strait Islander doctor, it's not my Country, so that it still does take time for people to warm up. You know, so people have this perception about you know, you're an Aboriginal doctor, you should be fine. No, it's not necessarily my community that I’m going into.

Can you describe the diversity of services provided?

It's a one-stop shop. It's amazing in terms of an AMS, there Aboriginal health workers and they're so great in being that link between the community especially when you're like oh, so and so hasn't turned up for my appointment. They are like, ‘Oh nup, they’re at a funeral’ or ‘No, she's looking after her five grandchildren today’ kind of thing. So it's really good to know like to have that connection. And also that sometimes when you're struggling to talk to patients about health topics that they offer that support, whether it be you know, providing a bit of a language service or making what you're trying to say a bit more understanding for patients. We get a lot of visiting services, like the dentist, we've got a child health nurse and midwife and GP obstetrician, and we get the physicians visiting.

When I was flying out to the remote communities, it's literally you and when we have a doctor jumped on the plane with you that day. The Aboriginal health workers, so they're so key in those communities, because they're the ones who, them and the RANs [remote area nurses], the remote area nurses, are the ones who are on the ground literally 24/7, live in those communities, they know exactly who's around what's happening, who's sick, who needs to come and see you.

What do you enjoy most about rural medicine and working in Aboriginal and Torres Strait Islander health?

Everything! That's really hard, you can’t say that there’s one thing. I love going to work. I don’t really have days where I don’t want to go to work.

How do you maintain your work/life balance? What do you do in your spare time?

I love where I am living. After work, it's a half an hour, on a weekend, it's half an hour drive, and you're in the middle of nowhere, and you can be camping under the stars. And you know, you get to see some pretty amazing sights. And that's really great for like, as a doctor's mental health. It can get tough in the clinic, or you've had had a tough day, it's really nice to be able to go for a walk along Cable Beach in the evening and watch the sunset.

I don't know, if it's still a slogan, I think it was a few years ago that like, you know, you can choose your career pathway in GP and I didn't really understand what that meant. But now the more I've progressed through my training and come out the other end, and I'm like, you can you pick, you can work three days a week, or you can work four days a week. And then if you want to, especially rurally if you want to you can fly out to communities you can or if you want to work in the hospital, you can so you can really pick what you do in terms of inside the work, which definitely helps with your mental health load and your burnout. Because if you know, you're not working five days a week seeing the same sort of stuff, you get to mix it up, that kind of helps.

What is the most unusual presentation/complaint you have seen?

I think for me the one that stuck out the most when I read this question was and now it's become very every day for me, which it shouldn't, it's an unfortunate thing, is something that we call Coke-coloured urine. Children who get post streptococcal glomerulonephritis produce this urine, which is Coke coloured, so literally like Coke in a cup, so it doesn't look like wee anymore. And the first time that a young kid, I had suspected he might have had that, but I'd never seen it in metropolitan, like when I when I was ever working in a city, always just in textbooks and in theory, and history wasn't very clear. But then he came out of the toilet and handed me this urine glass and I was very much like, oh, okay, now I fully understand what my lecturers were talking about. This is Coke coloured, you could have sworn he’s poured Coke into a cup.

What advice would you provide to others considering a career in rural medicine?

I think if it's in the back of your mind, and you're that kind of person who's willing to kind of be exposed to new challenges, new environments, you know, that work/life balance of being clinical, but also getting to do all the other things, I would just suggest just do it, like, give it a go. And I think that's we all get stuck in this mindset of ‘Oh, well, I can't really change things once I've decided’, but if you give it a go, and it really sucked, which it won't I, I assure you most people will be like, ‘Oh, well, why didn't I do this sooner?’, then you can always change your mind later. But I think people need more exposure to rural medicine.

And in terms of GP, well, it's like I said, it's the job where you choose the job, like you choose your career pathway, you pick and choose exactly what you want to do, how much you want to work, how much you do work. And, and it's just so rewarding. Like, I don't think I can, like emphasise that enough, you get to see real change in patients. Whereas in the in the hospital setting you kind of see this rotating door of people come in and out. And you don't get to see them beyond that you don't get to see how they've changed over time.

You’re a GP in life, which is like it's a bit corny, but it is true that we get to see kids kind of grow up and I'm looking forward to that in my career that there is already families that you know, I've seen newborn babies at their six-week check and then I've seen the met the one-year-old immunisations and that's kind of really cool to be able to follow someone through their life and hopefully I'll still be there when they're 17. And you know, going through their first pregnancy in their 20s kind of thing.

So give it a go. I think that's the biggest piece of advice, give it a go. I'd be shocked if you didn't enjoy GP [general practice] but also rural medicine.

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