Ararat Medical Centre
Ararat Medical Centre is recognised for its contribution to health care services and medical education and has received various awards including the RACGP Practice of the Year in 2016, RWAV Victorian Rural Practice of the Year Award 2017, AAPM Victorian Practice Manager of the Year 2017 and RWAV Victorian Practice Manager Award, 2013.
With a long term commitment to medical education, this multi-disciplinary practice hosts training positions for AGPT registrars, international medical graduates, medical students, nursing and allied health trainees.
Registrars are allocated a primary supervisor and are supported by three accredited supervisors, plus all senior GPs are available as support when required. Training includes face to face allocated time, allocated personal study time, corridor teaching, clinical discussions, case presentations, exam preparation, radiology meetings, pharmacy presentations and access to education and training opportunities at the hospital and via the Primary Health Network. There are opportunities to pursue extended skills training positions in obstetrics, anaesthetics, and emergency.
Ararat Medical Centre recognises the value of a diverse practice experience. Registrars have opportunities to extend their skills in minor surgery, aged care and palliative care, assist visiting consultants in surgery and ophthalmology, and work with allied health and nursing staff in various programs.
Registrars are included in the out patients clinic and after hours Urgent Care Centre roster and are supported by a senior clinician at all times. Registrars have VMO status to admit and manage inpatients. The practice runs a weekend clinic for urgent care presentations, from the hospital. After hours on call requirements are usually one week night on call per fortnight and one weekend in four.
With Ararat Medical Centre providing medical cover for the hospital and urgent care centre, registrars have the opportunity to develop their skills in treating and managing more complex and critical cases. Practice Manager, Mr Garry Hurst explained the registrars are fully supported. New registrars are gradually introduced into the roster, are partnered with an experienced GP and have 24 hour back up at all times.
“The on call roster and the duty doctor clinic are an opportunity for the registrars to keep up their emergency skills. They provide variety in their clinical load and the opportunity to admit and manage patients”. said Mr Garry Hurst.
CREATING A SENSE OF COMMUNITY – MEDICAL RESIDENTIAL PRECINCT
As part of the East Grampians medical community, Ararat Medical Centre prioritises welcoming new GPs, registrars and medical students and ensuring they settle into the community.
Practice Manager, Garry Hurst explained Ararat Medical Centre have, in partnership with Deakin University developed a housing precinct for new GPs, registrars and medical students arriving in Ararat. He described it as a great asset for the Medical Centre and the township in attracting and retaining GPs.
“We continue to explore ways to provide pathways and support systems for training and social networks within the community…. to set up an instant community with the new doctors, registrars and medical students, helping them settle in.” said Mr Garry Hurst.
DR MICHAEL CONNELLAN
Practice principal and primary supervisor at Ararat Medical Centre, Dr Michael Connellan has extensive experience as a rural proceduralist GP. He is a Fellow with the RACGP and ACCRM and is a practicing GP Obstetrician and GP Anaesthetist. Dr Connellan joined the practice in 1994 and found life in Ararat “fitted the bill” for he and his family.
Dr Connellan has received various awards including the RACGP GP Supervisor of the year, from RWAV for services to Rural Victoria and Melbourne University for his services as an examiner and supervisor.
As the principal supervisor responsible for the registrar training program at the practice, Dr Connellan believes a large rural practice delivers comprehensive and diverse training opportunities for registrars. He reflected that the practice has always been involved in the training program and the longest serving practitioner, Dr Derek Pope, was himself a registrar at the practice.
Dr Connellan explained the practice has a “knock on our door” policy where registrars can approach any of senior practitioners who are available to share their various knowledge, skills and special interests.
“We have certainly taken the teaching and supervision of students – particularly registrars, very seriously… there is a lot of time spent doing supervision…. We have always said that that is our investment in the future.” said Dr Michael Connellan.
Working in a small rural community provides a wide scope of variety and interest for GPs. Ararat enables Dr Connellan to utilise his training and experience and provides him with a broad scope of practice. The practice recognises the value of flexibility and variety for its GPs. For Dr Connellan, the emergency work, anaesthetics and obstetric practice, together with teaching, provide diversity which “keeps you ticking along”.
“I have always liked procedural general practice work for the variety. I am not sitting at my desk all day staring at computer screens. One day I am doing clinical general practice, another I am doing anaesthetics, then teaching. I travel to a small farming community out of town and work at the bush nursing centre, do some on call, do some emergency work and inpatient care. That variety is what attracts me to general practice”. said Dr Michael Connellan.
Dr BENJAMIN GANESAN
Dr Benjamin Ganesan grew up in Melbourne, obtaining his MBBS from Monash University in 2013. Completing his intern and registrar rotations with Monash Health, he pursued obstetrics for a couple of years, but decided not to commit to the O&G pathway, preferring general practice, for its broad range and more flexible work life balance.
Dr Ganesan joined AGPT Program in 2017, completing an ARST post in Anaesthetics at Ballarat & Hamilton hospitals. He commenced with Ararat Medical Centre in 2018 as a GPT1.
Dr Ganesan explained how his placement at Ararat Medical Centre enables him to continue developing his anaesthetic skills while completing his AGPT training. In addition to his general practice sessions, he works as GP anaesthetist, supporting visiting surgeons, generally for elective surgery, with responsibility for pre and post anaesthetic care and follow up.
“This is a long standing practice. One of the few practices that looks after the local hospital providing its anaesthetic and obstetric services. So for a GP trainee interested in emergency medicine, obstetrics or anaesthetics, this is a place that can provide that. We are close enough to Ballarat and Melbourne if you need emergency support” Dr Benjamin Ganesan.
Dr Ganesan described the practice and hospital as very supportive. He appreciates the access to a variety of supervisors who were always happy to take questions, “medical or otherwise”.
“Three supervisors are available from the practice. Each of them has their own approach to teaching. It is good to get different opinions on how they would manage or approach a situation. You then develop your own approach, because eventually you will be independent without their support”. said Dr Benjamin Ganesan.
“One of the things that attracted me to general practice is that you get to see a diverse range of people and a variety of health issues. You get to put a lot of different thinking caps on. I enjoy the preventative health perspective, the continuity of care, you have the opportunity to educate about health issues that the patient might not even be aware of yet”. said Dr Benjamin Ganesan.
Dr Claire grew up in rural Victoria. She was inspired by stories of medical practice from her GP Surgeon Grandfather and knew a medical career was for her.
Dr Claire explained how she sees a variety of medical presentations, from neo-nates to 90s+ in Ararat. She has had procedural opportunities within the practice and with visiting specialists, sitting in on consultations or assisting in surgical procedures. Additionally the clinic duty doctor role provides interest and diversity.
“The duty doctor role here and being on call at the urgent care centre is really an opportunity for developing extensive skills. Lots of different presentations … from basic little things to resuscitations that need to be stabilised and sent off to a tertiary centre”. said Dr Claire.
Dr Claire described the practice as having a strong philosophy of teaching and being eager to pass on their knowledge. She appreciates being able to approach her supervisors at any stage and has found the opportunity for case discussions and analysis of clinical reasoning to be particularly valuable.
“We have lots of clinical reasoning discussion…. why did you do this, what made you do that. It helps your thought processes develop in relation to why, clinically you made some decisions and why you did not think about other things. It makes you think about your clinical decisions and helps you identify your knowledge gaps”. said Dr Claire.
Dr Claire acknowledged the extensive orientation process and support for registrars makes the transition from hospital to general practice a smooth one. From a social point of view, Dr Claire believes the cohort of medical personnel in Ararat adds to the sense of community. Registrars have easy access to the social network attached to the practice and to the hospital.
As a medical trainee interested in rural practice, Dr Claire’s objective is to be equipped to meet the challenges of being remote. She explained that she is keen to continue developing her skills in procedural medicine and is considering completing anaesthetics training in the future.
“I like to think I will eventually to be able to handle whatever comes in the door – at least until the cavalry arrives, that’s what the (ACRRM) training is meant to do”. said Dr Claire.
The major referral centres are Ballarat, Bendigo and Melbourne. Emergency evacuations are by road ambulance to Ballarat or air ambulance to Melbourne.
GRAMPIANS MEDICAL TRAINING PROGRAM
Ararat Medical Centre works closely with the Health Service to provide ongoing support relating to medical staff recruitment and training, with senior GPs from the practice managing the intern program.
In an endeavour to provide training opportunities, a supported career pathway for medical trainees from undergraduate through to general practitioner or specialist registrar qualification has been developed. This community based intern program has been created by a partnership between East Grampians Health Service, St John of God Hospital Ballarat and Maryborough District Health Service.
In sequence, the program offers PGY1, based in Ararat with rotations through Ararat, Ballarat and Maryborough hospitals, PGY2 rotations at Ballarat Hospital, PGY 3 – Advanced Rural Skills Training in O&G at Ballarat Hospital followed by general practice placement at Ararat Medical Centre whilst completing the AGPT Program.
Ararat population 8,297 servicing a region of 11,800. 200km NW Melbourne, 90km NW Ballarat, 160 SW Bendigo.
Ararat Medical Centre http://www.araratmedicalcentre.com.au/
East Grampians Health Service http://eghs.net.au/employment/grampians-medical-training
Grampians Community Intern Program http://eghs.net.au/wp-content/uploads/2017/06/GMT-Pre-Reading-Brochure-2018.pdf
RACGP Practice of the Year 2016 https://www.racgp.org.au/yourracgp/news/media-releases/ararat-medical-centre-named-racgp-general-practice-of-the-year/
RWAV Victorian Rural Practice of the Year Award 2017 https://www.rwav.com.au/victorian-rural-health-award-winners-2017/
RWAV Victorian Practice Manager of the Year 2017 http://www.aapmconference.com.au/2017-conference/2017-pmoy