Former UWA medical student and RCSWA Northam 2021 alumnus Dr Jasper Brooksbank reflects on his formative rural training experiences in this Q&A...

Where do you hail from?

I was born in Subiaco and spent the first few years of my life living in Perth. Around kindergarten I moved down to Narrogin as Dad was pursuing a job there and that’s where my rural life started! I spent the first few years of primary school there and took note of the bustling community and social life that my parents found, and enjoyed the safety and freedom of a small town. In Year 3 I moved to Albany where I stayed until finishing my gap year. So, I would probably say I come from Albany but spent a bit of time in a couple of regional areas.

What/who made you consider becoming a doctor? 

I didn’t have any doctors in the family or even close family friends who were doctors so I’m not really sure where it started. I had actually wanted to be an engineer as I enjoyed maths, but in Year 11 I started thinking about something different. I had always enjoyed health sciences, but the thing that really made me think about medicine was the vastness of the field – knowing that I could spend my entire life learning while also sating my need for socialising, working in a team, and helping others was too good of an offer to miss. So, I applied to the UWA Doctor of Medicine (MD) program in Year 12 and never looked back.

Describe your training journey so far.

I started by completing a Bachelor Degree in Anatomy and Physiology at UWA, which took me a little longer than three years to complete due to some unfortunate errors in balancing my social life and study in my first year. On the bright side, this allowed me to spend a couple of months travelling before starting medicine.

Completing the four-year MD at UWA was a bit of a shock initially. The first year was very theory-heavy which I found overwhelming, but once I entered the clinical years, everything started to click. I’ve always been someone who learns better by doing.

I spent my third year of the MD in Northam with the Rural Clinical School and really loved the small hospital community. As a student, I felt that I could be much more hands on than I was ever able to in the city. Because of this, I attribute a lot of my current capability to the year I spent in Northam. I also managed to forge relationships with visiting specialists, who I still feel comfortable contacting when I have questions.

I completed my final year of the MD back in Perth and was then successful in securing a contract with the South Metropolitan Health Service as an intern at Fiona Stanley Hospital (FSH). One of the key reasons for my application to FSH was their connection with Northam – I was very keen to go back as a doctor! And I have gone back. I completed my fourth rotation of intern year in the Northam Emergency Department (ED), having completed 10 weeks on the Northam General Medicine Ward prior to this.

Did the rural clinical environment match your expectations? 

Working as an intern at the Northam Hospital was very different from my time there as a student. The hospital seemed much busier than when I was a student – I don’t know if it was actually busier or I experienced a different side of things. It was a great way for me to get plenty of experience in quite a short period of time.

I was very well supported by senior doctors and it was interesting working directly with SMOs / consultants with no Registrars on staff. The access to visiting specialists was actually quite high. It helps that almost everyone coming out to work in Northam is lovely.

What were the major differences you experienced in a rural setting vs metro?

I think it’s just a different work environment with different supports available. While critical patients from the Wheatbelt may be transferred to the city using critical care paramedics or RFDS, many patients will come through Northam Hospital for initial assessment. Seeing the same patients but without access to surgical teams, consulting specialties, or required different blood tests or imaging modalities makes for an interesting management plan. Having to explain a difficult/complex situation over the phone in sufficient detail for the specialist you’re consulting to give you a plan is an incredible way to understand your patients and their conditions in greater depth. 

Apart from that, the small workforce meant I regularly worked with the same nursing and allied health staff, which created a great sense of community. I had similar experiences in metropolitan teams, but something about either being in a rural centre, or just Northam, makes it different to my experiences in the city which I love.

Image: Dr Jasper Brooksbank.

One of the greatest gifts Northam gave me, which of course I may have found somewhere else anyway, is doubt. Northam has been interesting enough to work in and given me such a variety of cases/patients that for the first time, I had some doubt in what I wanted to do. While from a distance that doubt is quite scary, I find it very freeing as it tells me to take it slow and try a few things out.

Overall though, I am interested in something that allows me to see a large variety of patients, but still get involved in the minutia of their conditions. I find great satisfaction in learning more and more with every patient I see, and I hope to find myself in a position where that never has to stop.

What was a typical day on placement like for you?

The Northam ED is very different to the ward placements I’ve done before. A great example of the variety of experiences can be seen in one of my first days working in the ED. I arrived and first up had teaching where we brushed up on our limb plastering. After this, I went to the ED and started pulling patients from the waiting room. I started with assessing a hand wound, ordering imaging and then, after discussing with my supervisor, proceeded to anaesthetise the area and suture it back together. My next patient had a foreign body in their eye so required examination with a slit lamp for other damage, and then removal using a small needle. We had an emergency case come in after this, so I helped by taking an arterial blood gas and getting IV access. Finally, I had a patient with a greatly distended bladder requiring bladder catheterisation and then organising admission to the ward. I got so much hands-on experience which was fantastic.

What is the best part of doing what you do?

There are many “best parts” of the job, and it often depends on the day. Some days I spend a lot of time managing the care of complicated patients, which involves having extended discussions with seniors on the intricacies of their case and subsequent care planning. This is very well supported with both formal and informal teaching.

Other days I feel like the best part is all the patient interactions, and how much benefit they can get from seemingly simple things such as reassurance. I find it is helpful to sometimes take a step back and reassess what I believe is commonly known information compared to what actually may be well known information, and also remember that the people I am treating and their families are often scared of what is happening. Taking an extra moment to explain something to a patient can really go a long way to improving their experience and gives me instant feedback that I’ve helped them feel better.

Lastly, sometimes the best part is the great people I get to work with. The multidisciplinary clinicians that I interact with on a day-to-day basis are all there for the same reason as me, because they care about helping people. These colleagues can make your day or week much more enjoyable by keeping spirits on the ward high and providing an element of social outlet.

Do you have any professional mentors or people you look to for advice? 

I have a few mentors, ‘collected’ over the years of med school and as an intern sought different types of support from each of them. I have mentors that are far removed from my level and those that are a lot closer. I have mentors that are in the fields that I’m interested and mentors that have done completely other things. I couldn’t really place it on one or two different people as I think it depends on the questions I have or guidance I need, but I always seem to have someone I can lean back on and get a bit of help.

Have you learnt any big life lessons going rural?

Spending time working in regional WA has probably just helped me reflect on the vastness of medicine and reminded me that there are so many different paths I can take in my career, and they can all happen at different times. Rural life and work have helped me step back a little and get some perspective, which is always a good thing.

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