NT training lead revels in ‘sense of ownership and collegiality’

The RACGP’s Northern Territory GP training leader first experienced the undeniable rewards of holistic care as a young general practice registrar working in remote Northern Territory (NT).
 
Providing some palliative care to a family member was ‘one of those moments’ he knew he’d never forget, he told newsGP.
 
‘It was really a privileged position to be able to provide that kind of care among family members who took me into their intimate circles to provide those last moments,’ Dr Mangohig said.
 
‘That’s how I came to fall in love with general practice and keep at it.’
 
‘It’s that continuity of relationships that you can achieve … and seeing how people really grapple with illness or health from a child to an ageing person who’s in their last hours and being part of that.’
 
Having worked in Central Australia for most of his medical career, Dr Mangohig began his placements around Darwin and Adelaide, completing his Doctorate of Medicine at Flinders University.
 
During his third year of medical school, he spent time at the Royal Darwin Hospital, before moving to Tenant Creek Hospital’s emergency department, where he was guided by ‘some really good supervisors’, ahead of a stint at Alice Springs Hospital and a local Aboriginal Medical Service in 2013.
 
Now permanently based in Alice Springs, Dr Mangohig said these early experiences exposed him to a ‘different side of medicine.’
 
‘Moving away from larger regional centres and going more rural and remote then experiencing general practice on the community level, I saw this as the real art of medicine and its focus on person-centred care and continuity that you can achieve with building those relationships over time,’ he said.
 
‘We have a large First Nations population in Alice Springs … and it’s a very rewarding experience to be able to make a big difference [to their health].
 
‘Even as a medical student, as a registrar and now in a leadership role, those can make a big difference in helping the community that needs GPs and needs good primary care.’
 
That leadership role is the Acting Regional Director of Training for the NT, which Dr Mangohig has held since the RACGP and ACRRM officially reassumed responsibility of general practice training in February last year.
 
So far, he says, there’s been a ‘real sense of collegiality’ across the region.
 
‘With the transition I’ve been exposed to more inter-regional collaboration and it feels like we’re all in this organisation a bit like a family, that we’re a part of the college together,’ he said.
 
‘We’re all trying to achieve similar goals of ensuring good quality training and meeting the community needs for the 21st century, and that’s been a highlight and certainly an observation that’s been repeated in my time with the college.’
 
Dr Mangohig also acknowledges a sense of ownership from the educators, supervisors and registrars that ‘it’s their college’ running the training, and they are helping to shape it as it evolves.
 
With that evolution comes challenges, and the significant change of merging Australia’s RTOs into the college-led AGPT Program may carry a process of grieving or adjusting to the new landscape, according to Dr Mangohig.
 
‘We are still in a process of building, as a lot of medical educators from the previous organisation decided to move on and engage with other work, which is great, but it means that we’re training up a new generation of medical educators,’ he said.
 
‘We’ll keep upskilling our medical educators who are new in the game, helping them feel like they can reach their goals even if they feel like they’re starting from scratch, but utilising the skills they have as a GP, in medical education to achieve the goals that hopefully align with what the college needs to achieve for the year.’
 
Another challenge Dr Mangohig cites is adjusting to a new culture of engagement within a large organisation such as the RACGP.
 
‘That tension between national consistency and how do we preserve some of the contextual difference that is important to happen day-to-day when a supervisor engages with a registrar and the medical educator,’ he said.
 
‘These are things we want to stay within the national framework, but we also need to conceptualise the challenges they’re facing, whether that’s funding or a particular demographic of patients that have dramatically different geographical challenges.’
 
Harnessing these challenges to achieve goals for the coming year is made easier by having his own supportive supervisor, Dr Mangohig believes, who says Dr Karin Jodlowski-Tan has been providing him close mentorship and support since he began acting in the role.
 
‘A big goal for me is supervising registrar relationships, which is the bedrock of training,’ he said.
 
‘Improving that alliance between the supervisor and registrar and how does the training program with this medical educator help in that relationship? How do we get supervisors on board with new structures of profession-led and training some of the new systems?
 
‘Getting them involved and engaging with, firstly, locally within their own supervisor networks geographically, but also engaging with a national program and its educational framework.
 
‘It’s really about … improving those relationships across the different domains.’
 
Influencing more medical students early in their journey is also an important endeavour for the NT’s Acting Director of Training.
 
‘How do we reach GP trainees who are still spending time in hospital?’ he said.
 
‘How do we get them to start thinking like GPs, even if they’re practising in the hospital? How do we reach out and get them to feel connected to their colleagues who are already in general practices in community and feel connected to the college itself?’
 
To coincide with the one-year anniversary of the return to college-led general practice training, newsGP will continue to profile medical educators working across the training regions over the next month.
 
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AGPT Program college-led training GPs in training Northern Territory rural general practice