Venturing into Australia

by Dr Charity Low Cheng Hong, Family Physician

The “Land Down Under” is amazing for a number of reasons. The country endowed with natural wonders and beaches, filled with wineries and agriculture, koalas and kangaroos; the nation with the highest skin cancer rates, … and the highest job satisfaction rate for doctors in the world! I am privileged to have a glimpse of these as I venture forth!

In Feb 2021, I brought my family over to Australia to be with my elder son who had enrolled into UWA. In this time of COVID, travel is restricted. Hurdle after hurdle had to be cleared – application for ECMFG, AMC, work visa, exemption letter, negative swab, G2G application. We had to ensure two weeks of hotel quarantine and two negative swabs before being set free with a hearty letter of Welcome to Australia!

International Medical Graduates (IMG) such as me are assigned to Priority District Areas (PDA) for work. The PDA maps is re-drawn yearly. I have obtained a job in Mundaring area. What followed was application for Provider number, Prescriber number, PRODA account…I recollected that when I was taking the MMed (Family Medicine) examination of the College of Singapore Family Physician, our local laboured to secure the presence of Australia Professors as external examiners to assess the standard of our candidates. This was done for consecutive years before FRACGP extended the right hand of fellowship to mutually recognise and accept our Fellowship cross-country through the Specialist Pathway.

Dr Charity Low as part of a vibrant, sporting frontline team in Australia

I am much grateful for the prestige of our post-graduate degree. I am a beneficiary of the hard work of our predecessors!

The clinic I am working at is a private GP medical centre but it is a bulk billing clinic, as it claims from the government for services rendered to citizens and Permanent Residents. These have Medicare which entitled them to free consultations, blood tests, X-rays, CT scans as long as the investigations could be justified by relevant history and physical examinations.

Patients purchase medications from pharmacy next door at subsidised rates. Radiological centres are in region nearby. In this clinic, there are 3 to 5 doctors on duty with 2 nurses and 2 receptionists for different sessions, with a phlebotomist who assists in blood taking. Ranked among the better equipped clinics, there is a full range of primary care surgical equipment including liquid nitrogen, hemorrhoid ligator, surgical loopes and operating microscope for aural suction. In this pandemic, patients with flu symptoms are generally advised to stay at home and go for COVID swab test in designated drive-through regional centres.

Tele and video-consultations are available. Thanks to the strict border restriction in WA, there are mainly sporadic positive cases which have led to different restrictions of masks wearing at specific periods; the plan is for cautious step-wise opening. In general, with safe-distancing precautions, functions and activities are almost as per normal at the beaches.

I have to juggle to learn the different healthcare system in Australia: the PBS and MBS system, the Wagpet portal, clinical guidelines. Patient profiles are different too.

Mundaring hills is filled with scenic beauty of trekking tracks, forests; multi-coloured flowers, wild parrots and other singing birds are part of its flora and fauna. A number of retired, elderly stay here, either in their own homes or in retirement villages. Most of them have multiple, complex co-morbidities, are still independent and able to walk around the house, attending to light house chores and garden works. Some of them have regular help from support workers. They are mostly well-taken care of by the state, enjoying their old age with retirement benefits.

In collaboration with the specialists, I see a number of unfamiliar specialists’ medications. Mental health is greatly emphasised here. A number of patients have anxiety and depressive symptoms right from their teenage days. SSRIs are commonly prescribed. Chronic fatigue syndrome, chronic pain syndrome, and fibromyalgia are not uncommon. Skin cancers are managed at primary care setting with frequent biopsies and wide-margin excision. I have to learn the use of dermatoscope for the diagnosis of skin cancer. With most patients well-read and knowledgeable, communication skills are of paramount importance.

This is a free country. Free for all. I can see workers from all nationalities in shopping complexes, retail shops, restaurants, and banks. Respect for persons is highly upheld here; you will see passer-bys greeting and wishing one another, “How are you?” “Have a wonderful day!”

Though I am an international graduate and new to the practice, I am surprised to see patients respectful and grateful. Innumerable times daily, I could hear so pleasantly, “Thank you for your time, doctor,” “Thank you very much.” You can be sure that patients are also vocal in expressing their displeasure and views concerning aspects of treatment.

They write freely and extensively in feedback. Anti-vax movement is prominent. There are those who would rather lose their jobs than be vaccinated. Daily I will see groups of mountain bikers swishing through the streets with full gear at dawn. When summer starts, windsurfing, kite surfing, stand-boarding, canoeing, kayaking, sailing, picnics and all sorts of sports fill the beaches and gym.

Yes, I do enjoy it all — but not without hard work and a steep learning curve! My work day starts at 5.30am from home and ends at 5.30pm in the evening, with about 3 hours of travelling to-and-fro. Please be reminded that there are 18 hours of daylight in midsummer!

Dr Charity Low Cheng Hong