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It took an unexpected, life-changing experience in India for NTGPE GP registrar Dr Tim Hewitt to find his true calling in general practice.
After completing his intern and resident years at a large hospital in Melbourne, Tim was very much gearing up to go down a hospital specialty pathway.
Life, however, had other ideas, with those plans put on the backburner when his wife’s work moved them to the capital of India's southern Karnataka state, Bangalore, with a population of around 11 million people.
“I certainly didn’t always think I’d be a GP,” he said. “We ended up living in Bangalore for a few years and I had a great experience away from clinical medicine.
“I completed a Master of International Public Health and found a job with an organisation delivering basic primary health education in hospitals to some of India’s most disadvantaged people.
“I came back to Australia with a much greater interest in preventative and primary health care and with a recognition that general practice actually ticked many more professional and lifestyle boxes for me than any other specialty – and I haven’t looked back.”
Tim’s journey to the Territory was initially one of convenience, which soon developed into an unbroken bond.
“I felt like I needed to get back into clinical work after being in India for a few years, but my wife needed to stay in Bangalore for a bit longer,” he said.
“Darwin was the closest Australian city to Bangalore, so I called up Royal Darwin Hospital ED and asked for a job and they gave it to me more or less on the spot.
“I thought it would just be a short-term thing, but it didn’t take long to realise that the NT had a lot more to offer than I thought, both professionally and from a lifestyle point of view.
“The work has been really interesting, and I love running and exploring the outdoors, so there has been plenty to keep me occupied outside of work.
“My wife has since moved to Darwin and we’ve subsequently bought an apartment, had a baby, made plenty of friends, become involved in some community organisations, and have no intention to leave the NT anytime soon!”
Tim’s training with NTGPE has seen him recently complete a year of mainstream general practice working part-time at Cavenagh Medical in Darwin CBD, with an imminent six-month placement at Danila Dilba in Palmerston.
In the second half of this year, Tim will also be working with Top End Health Service, flying out to health clinics in remote communities with the aim of completing most of his remote placement requirements at the back end of his GP training.
“It’s tempting to overlook mainstream GP placements in the NT in favour of ostensibly more interesting or exciting options, but I think it’s important to have mainstream experience,” he said.
“My training so far has been a great opportunity to better understand referral pathways, consolidate medical knowledge and procedural skills, and also, importantly, to learn how to bill appropriately.
“Doing a mainstream placement has given me an appreciation for the work that the majority of GPs in Australia do and, I think, has set me in good stead for future positions in both metropolitan and remote areas.”
Tim says he has used his time in the NT to change and adapt his approach to general practice, including exploring more about Aboriginal health care and the many challenges associated with it.
“I’d like to think that I’ve become more culturally aware and more holistic in considering and trying to address the socio-economic factors that may be contributing to the poor health of my patients,” he said.
“Working in Aboriginal health has also made me appreciate that, as a GP, you are one part of a much larger healthcare team, made up of professionals with a wide range of different skills.
“It’s important to function as a part of that team, and to refer appropriately, rather than trying to take everything on yourself.”
Tim believes training in the NT is a gratifying experience, helping to fill a much-needed gap with GP training remaining undersubscribed.
“It feels good to know that I’m not just here to make up numbers or provide an alternative to a pre-existing service – there is a huge demand for GPs and not enough of us, so I feel like I’m playing an important role in the healthcare system, and enjoying it at the same time,” he said.
“The opportunities up here are endless. I think that the GP plays a larger role in health care in the NT than in some other parts of Australia.
“The remoteness of the Territory coupled with a limited amount of resources means that the GP here manages a lot of things that might be outside the purview of a traditional city GP in other states.
“It’s exciting to be able to diversify my skill set and know that my work life can be as full of variety as I want it to be.”
Tim is also appreciative of the support and flexibility NTGPE has provided to date during his GP training, especially with a young family and the subsequent option to train part-time.
“NTGPE has been very supportive and accommodating in allowing me to take things a bit slower, and have made it clear what my requirements are and how I can best tick them off on my current schedule,” he said.
“If I’ve had any concerns, they’re easy to contact and respond promptly. The education sessions have been useful and the medical educators are dedicated and knowledgeable.
“Catching up regularly with my training advisor has helped me to ensure I’m on the right track with my assessments and placements.”
Tim regards it a privilege and rewarding to get to be a trusted part of patients’ lives, especially at times when they are making difficult health decisions, with this process also forcing him to take time to reflect on his own beliefs and biases.
“I recall an elderly lady who almost certainly had bowel cancer but refused any investigations despite how ardently I tried to persuade her,” he said.
“She had her own reasons not to want to take things any further and was content with her decision, which I had to admire.
“Situations like this can be very challenging and humbling, but these interactions are a unique and ultimately very rewarding part of this job.”
Tim is excited for the future, a future that very much has NT at the forefront of his aspirations.
“There’s a decent chance that we’ll still be somewhere in the NT because of the amount of opportunity that there is here,” he said.
“I see myself having a balance of clinical and non-clinical work – perhaps getting involved in some teaching and supervision.
“The beauty of doing GP training is that I can be quite confident that I can pick up work wherever our family ends up.”