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Rural Remote Area placement Program Position Profile:

Under agreement with the College of Rural and Remote Medicine (ACRRM) through the Rural and Remote Area Placement Program (RRAPP), Northern Territory General Practice Education (NTGPE) is committed to support the placement of Resident Medical Officers (RMO's) from Royal Darwin Hospital (usually during their relieving term) into remote communities to work with resident General Practitioners for a period of four to six weeks once or twice per year. The purpose of this program is to provide an opportunity for RMO's to gain an understanding of the issues pertaining to primary health care in a remote setting and to consider rural and remote health as a career option.

Whilst in a remote community clinic, the RMO will remain the employee of Territory Health Services but work under the supervision of the resident GP in a multi-disciplinary health team environment with GP Registrars, nursing staff, Aboriginal Health Workers and allied health workers.
In consultation with other health team members, the RMO will participate in the day-to-day activities of the health clinic to provide primary health care to the community residents and visitors.

The RMO will ensure that they communicate with their supervising GP and other members of the health team providing care to the patients, on a day to day and case by case basis.
The RMO shall participate in the coordination and facilitation of diagnosis and management, and where necessary, the evacuation of the patient for further treatment or diagnosis

Role:

1. The RMO is clinically responsible to the supervising GP who has legal responsibility for the care of patients.

2. The RMO shall work under the direction and supervision of the GP or where appropriate, the GP Registrar and/or nurse/manager within the Health clinic.

3. Within the remote clinic environment and under the conditions of that clinic, the RMO may be responsible for:

3.1 Communication of their assessment of the patient to the supervising GP and other relevant Health team members.

3.2 Instituting immediate treatment, when appropriate.

3.3 Setting in train the diagnosis and management of the patient’s condition, including requesting pathology tests, and prescribing appropriate medications when confident of quality care or following procedural manuals.

3.4 Arranging necessary radiology, procedural treatment or referral for consultation after consultation with the GP Supervisor.

3.5 Communication with the patient about their condition and management, or with immediate family members if the patient is unconscious or unable to comprehend

3.6 Accurately recording history and examination, management plan, investigations and action taken in the patient’s medical record, including regular progress notes and documentation of follow-up and referrals.

3.7 Assisting at operations and procedures where required, consistent with their clinical responsibilities and training requirements.

3.8 Communicating and coordinating effectively with other health team members in regard to health assessments, care plans, diagnostic requests and consultations.

3.9 Review of all pathology, radiology and other diagnostic reports and advising the supervising GP and Registrar, with other relevant health team members, of results.

3.10 Following up the patient to unsure the management is carried out, assessing its outcome, communicating any significant change in the patient’s condition to the supervising GP and/or taking appropriate action.

3.11 Providing ongoing support and information to the patient and family (where appropriate).

3.12 Ensuring, with other members of the team that all arrangements required for autopsy death and cremation certificates are made expeditiously and appropriate support to other health team members and family is given.

3.13 The initial assessment of patients presenting for treatment (in the event that an AHW is not first point of contact).

4. The RMO provides patients with routine and emergency after hours care with the agreement of the supervising GP. However the RMO should not provide routine management after hours to patients not in their care during normal working hours, other than where the medical staff levels in the remote clinic make this unavoidable.

5. The RMO will not undertake escort duties for patients being evacuated to regional hospitals without agreement of GP Supervisor or Clinic manager.

6. The RMO also has personal responsibility for:

6.1 Participation in postgraduate education, attending NTGPE teleconferences as part of their training program.

6.2 Education of other health team members as required, including medical students

6.3 Participating in review and audit and research projects as required

6.4 Developing a personal approach to continuing postgraduate education and undertaking skills acquisition

7. All professional staff respond to unusual and emergency situations by performing any duties that are in the interests of the patient. However during their remote placement (in consultation with other health team members), the RMO may be responsible for:

1. Staff health services

2. Retrieval of medical records (during or after hours)

3. Completion of clerical components of the medical record

4. Filing diagnostic test results

5. Writing letters for patients who were not under the RMO's care

6. Booking and arranging follow-up tests and appointments

7. Acting as couriers of patients, documents, pathology samples, blood products and x-rays, etc.

8. Venesection for routine pathology tests

Prior to placement in a remote community the RMO will receive appropriate medical and cultural orientation. A team of Medical Educators, Cultural Educators administrative and project support staff at NTGPE will support the RMO via weekly teleconferencing. Following the placement the RMO will participate in an evaluation de-briefing with staff

Supported by the Australian College of Rural and Remote Medicine and the Commonwealth Government Department of Health and Ageing