Medical educator Dr Cathy Milligan hopes registrars at her rural practice can develop an extensive range of skills.
For Western Australia’s Dr Cathy Milligan, quality medical education can provide almost as much for the supervisor as it does for the general practice registrar. As the recipient of the RACGP’s 2015 General Practice Supervisor of the Year Award, Dr Milligan certainly understands the two-way nature of the learning process.
Registrars are good with the protocols and practices and they keep you on your toes,’ she told Good Practice. ‘They will often ask about things you haven’t thought about for a while, so we can add to that knowledge together or we can go away and do our own research.
‘That is a really positive aspect of the relationship – bouncing off each other, both sides bringing different skill sets.’
A GP and director at Margaret River Surgery, Dr Milligan has been based in the south-west of WA for the last 19 years. After obtaining her medical degree from the University of Western Australia, she undertook several different rotations as a junior doctor in major hospitals in and around Perth, followed by a year of anaesthetics training in the UK, before starting a career in Australian general practice.
‘I work as a procedural GP, involving family practice, plus obstetrics, anaesthetics and emergency medicine, as well as women’s health,’ she said.
Medical education has been part of Dr Milligan’s career ever since she started in Margaret River Surgery, with the practice taking medical students and general practice registrars as long as she has worked there. The ability to train and work with eager young doctors helps Dr Milligan stay energised and up-to-date in her work as a rural GP.
It’s nice to be in touch with the next generation of doctors coming through because they bring a freshness and a quality, and you get to understand how they work and think,’ she said. ‘Plus, they are always fresh from the major hospitals so they’re pretty sharp with their protocols.
‘We [GPs] can share our experience and it’s really nice to watch the registrars use their existing skills that blossom in the environment down here in Margaret River, which is different from the tertiary hospitals.’
According to Dr Milligan, that different environment provided by a rural healthcare setting, in which patients often prefer to have their needs met locally rather than having to travel to see a specialist, provides the general practice registrars at Margaret River Surgery the opportunity to develop a broad variety of skills.
‘Because Margaret River is more in a rural and remote setting, we have limited specialist support. We are it in a town with a population of about 8000–9000 people,’ she said. ‘Of course, our specialist colleagues are on the phone down the road and we can always contact them for help and advice, but we largely work on our own and I think that develops a special skill set of crisper Leading the way PAUL HAYES Medical educator Dr Cathy Milligan hopes registrars at her rural practice can develop an extensive range of skills. judgement, deciding whether you can help this person or whether you need to transport them elsewhere.’
’ While Dr Milligan does acknowledge those decisions, coupled with patients’ desires to avoid travel, can place some pressure on young doctors, she believes the independence helps to build their confi dence and is ultimately very benefi cial for their training.
‘They have to be fairly confi dent and be able to work autonomously,’ she said. ‘Although they are supervised, the supervisor is not always on site with them. That said, they are always supported.’
’ With a total of 12 GPs offering services including obstetrics, anaesthetics, minor treatment room procedures, women’s and men’s health, mental health, palliative care, geriatric care, immunisations, diabetes education, and more, general practice registrars who come to Margaret River Surgery have access to a wealth of experience.
‘As a group practice we can help the registrars with all of our different expertise, so I think it’s a great experience for them,’ Dr Milligan said.
Special interests of obstetrics, anaesthetics, women’s health and emergency medicine have proven extremely valuable in Dr Milligan’s rural healthcare setting. Another of her special interests, however, tends to stand out from the rest.
Dr Milligan is a keen pilot and her love of aviation was one of the key motivators behind her obtaining her qualifi cation as an aviation medical examiner.
‘That involves a study course which heightens your awareness of the special medical issues in the cockpit and in aviation generally. CASA [Civil Aviation Safety Authority] licences you to examine commercial and general aviation pilots,’ she said.
‘It’s not my core business, but I’d probably do a couple each month. Of course, the consultations are extremely long, mainly because we exchange stories regarding our incredible fl ying feats – some of which may even have an element of truth.’
As a long-time general practice supervisor, Dr Milligan understands the fact that some GPs may be somewhat hesitant to take on the responsibilities that come with the role. But her advice to anyone considering becoming a supervisor is simple.
‘Don’t hesitate – it’s a great job,’ she said. ‘People might feel overwhelmed by the thought of the commitment, but once you’ve settled into it that time commitment is nothing huge.
‘The registrars will be an asset to your practice. The patients like the young ones and they’re very understanding of the fact that they are training registrars.
‘And like any good relationship, you will get more out of it than you put in.’
Dr Milligan described being named the RACGP’s 2015 Supervisor of the Year as a ‘surprise’, but she is extremely happy to have had her work acknowledged in such a way.
‘I haven’t really come to terms with it yet,’ she said. ‘It’s an honour to be recognised for the work I’m doing. There are lots of other doctors out there who are equally deserving, but I am grateful that this was my year to be voted. I’m very proud.’
First published in Good Practice October 2015 12 – 13