With an unwavering dedication to equitable healthcare and education, RCSWA final year medical student George Kavalam is making a difference in the rural and remote communities he serves.
The Australian College of Rural and Remote Medicine’s 2023 President’s Prize winner is on the cusp of moving to Darwin for his internship.
He reflects on his training journey and life so far…
Where do you hail from?
I originally emigrated to Australia in 2004 from the Middle East and grew up on Whadjuk Noongar Boodja (Perth).
Who/what made you want to become a doctor?
The real passion I had for healthcare was sparked while I was on multiple volunteer tutoring programs with the non-profit Teach Learn Grow (TLG) organisation. I am currently an Executive Manager there and our goal is to bridge the gap in education disparity between rural and metro Australia. Through TLG, I have attended eight programs across rural WA, which has given me a special insight into the factors that influence a child’s ability to attend school.
While rural, I witnessed the inequitable burden on children in these areas when it comes to their health. Especially for First Nations kids who were afflicted by preventable disease that negatively impacted their ability to partake in school. In a metro setting, we take for granted the resources available to us to treat basic skin infections and ear infections. For kids in rural areas not afforded the same privilege, they are much more likely to be seriously affected. We see long term negative impacts on hearing and psychosocial development which widens the lifestyle gap for First Nations peoples. This reality is what drove me to pursue medicine.
Describe your training journey so far…
I have just completed my final year of medicine. I was based in Perth for the first four years of my studies and have spent my final two years of pure placement in rural areas.
In my penultimate year, I was part of the Northam RCSWA crew. There I learnt my craft through many hours spent in the emergency department and in local GP practices. That year rural helped consolidate my theoretical study, but also acknowledge the person behind the pathology. This helped me to understand how we can support people to return to a sense of dignified independent function, rather than paternalistic treatments.
In my final year, I had the privilege of working across two rural sites, namely Bunbury and Kalgoorlie. I received excellent teaching and exposure in my home base in Bunbury. Kalgoorlie though, is where I found my heart lay. While there, I was part of the paediatric team at the hospital and did a placement at the Bega Garnbirringu Health Service. I was given amazing opportunities to immerse myself in First Nations health and understand the nuances of culturally safe care. It was an important experience in my growth.
Does the rural clinical environment match your expectations?
My time in rural areas has far exceeded my expectations. The support, the care, and the guidance for me to be my best was second-to-none. I felt like I was a real part of the team while on rural placements, whereas I was overwhelmed in the metro setting at times with the large number of team members.
What were the major differences you experienced in a rural setting versus metro?
The most striking difference was the importance of community. This really added another dimension to the care we provided, in that first line management involved helping people return to their role in the small community we were a part of. Secondly, given the proximity of how the multidisciplinary team worked with the doctors, I gained an incredible appreciation of the healthcare team, and developed better communication skills to get the best outcomes for our patients.
Image: George Kavalam in Karlkurla Bushland Park Kalgoorlie
Do you have a speciality interest and what sparked your interest in it?
Paediatrics!! I love working with kids whether it is in a hospital or primary care setting. This is why I would be super keen on doing a paediatric specialty with an ACRRM fellowship or chasing paediatric training as a goal.
What does a typical day look like for you now?
Rural placement had the most fun, jam-packed days. It really depended on whether I was based in the hospital or in a primary care setting.
While on paediatrics in Kalgoorlie, I had an awesome time. My mornings would start with a run and a good breakfast. I would then walk across the road to the hospital (yes, it is that close), meet the team, and then do the morning ward round for the kids. I would then go to clinic, be allocated a room, and see some patients myself. I would then present the cases to our paediatrician, and she would sort out the prescriptions that were needed and provide advice. I would then head back to the ward and follow the on-call doctor for any paediatric admissions.
While on my Rural GP Placement at the Bega Garnbirringu Health Service, I was able to set myself up in one of the empty doctor’s rooms and see patients myself. I really loved the fact that it was a walk-in service with no time limit on consultations. I was able to spend the time to have a clinical yarn with my patients and understand the things that were important to them that influenced their reasons to get help for their health. I then presented the cases to the GP, and they would sort out the necessary referrals/prescriptions and provide me with feedback. I also had the chance to do a few remote clinics on the Bega Bus which operated as a mobile GP clinic. That was super fun!
Right now, I am on my transition to internship period through a placement at Sir Charles Gairdner Hospital. I can say that it is a great learning experience from a tertiary point of view, but I miss the rural life!
Image: George (centre) with parents Mathew and Sony Kavalam at the ACRRM 2023 President's Prize presentation in Hobart, Tasmania.
What is the best part of doing what you do?
It is absolutely the people I get to meet and form connections with, most importantly with my patients. I love having a conversation, getting to know them, and what is important for them. By taking the time to listen, I develop trust which is such a rewarding experience for me.
It is also the incredible rural healthcare community I am a part of. The likeminded students, the healthcare heroes and all the mentors that have supported me on my rural healthcare journey - they have been central to me enjoying every day in medicine.
Do you have any professional mentors or people you look to for advice?
Absolutely. I would not have gotten so far without them. Through my first years of medicine, I was grateful to find mentorship with Professor Asha Bowen, a paediatric infectious diseases specialist at Perth Children’s Hospital. She helped me find reason and passion within my dedication to bridge the gap, and helped get me involved in research, which has recently been released. Check out the latest Healthy Skin Guidelines (version 2)!
Throughout my rural years, I must thank Dr Anna Varone, Professor Helen Wright, Dr Christine Jeffries-Stokes and Dr Clare Trythall for their guidance. I had the pleasure of working with every one of these amazing healthcare heroes, and they have been incredible inspirations and sources of information.
Have you learnt any big life lessons going rural?
One of the biggest lessons I have learned is how to have unwavering passion for what I do. This has been consolidated just through the healthcare workers I have been inspired by who continue day after day to bring equity to vulnerable populations across remote and regional Australia. They see a problem, don’t muck around, and get on with the job. That is something I am so grateful to have learned.
Where to next for you?
I am starting my internship in Darwin through the rural generalist pathway! Super excited for the big move and to expose myself to more First Nations health opportunities, work in remote communities, and work with more likeminded people. I hope to find my passion and decide whether ACRRM or paediatric training is right for me. Cannot wait to get stuck in!
Our Regional Training Hubs team members live in all corners of WA and connect junior doctors and medical students with experienced mentors and professional development opportunities. Find out more at uwa.edu.au/rcswa/regional-training-hubs or email [email protected]