Career Overview a Career As a Gastroenterologist Offers a Blend of Procedural and Physician Skills. ''Clinically It's Fasc

Careers A In this section C1 GUT INSTINCTS MJ Why specialise in Careers gastroenterology? Experts give their Career Overview views. C2 REGISTRAR Q+A Australia (GESA), says this diversity Dr Payal Saxena, is one of the main reasons he would fi nal year trainee in recommend the specialty to junior gastroenterology doctors. C5 MEDICAL MENTOR “Clinically it’s fascinating because of Professor its breadth, whether it’s liver disease, Graeme Young peptic ulcers, swallowing disorders or on his career as a gut diseases. It’s very broad.” gastroenterologist The specialty allows doctors to sub- C8 ROAD LESS specialise in areas such as hepatology, TRAVELLED infl ammatory bowel disease or From refugee mum to endoscopy”. But, on the other hand, medical student if you’re interested in a wide range C9 of eclectic stuff, you can retain those MONEY AND PRACTICE generalist interests”, says Professor Making your Medicare Grimm. claims compliant Professor Macrae says that Dr Payal Saxena Gut instincts and colleagues. gastroenterology also offers an appealing mix of “intellectual physician skills and technical skills”. A career as a gastroenterologist off ers a blend of The role of endoscopy in managing procedural and physician skills. gastrointestinal diseases continues to increase, with new interventions and astroenterologist Professor Gastroenterology registrar Dr Payal technologies under development. Finlay Macrae says the location Saxena says there is also considerable Gof the digestive system in the teamwork between gastroenterologists. body was a key reason for his decision to She says she has particularly enjoyed her ‘‘ specialise in gastroenterology when he training because her colleagues have all Clinically it’s fascinating because of its breadth, was a junior doctor in the 1970s. been fun and sociable. “We have a lot of whether it’s liver disease, peptic ulcers, “One part of the attraction was the meetings but it’s never taxing because central location of the organ in the body everyone’s so pleasant”, she says. (For swallowing disorders or gut diseases. and the professional relationships with more of Dr Saxena’s story, see page C2.) ” a number of other disciplines which that The variety of gastroenterology is Gastroenterology trainees are allowed”, says Professor Macrae, who is commonly cited as a key attraction encouraged to undertake a supervised head of colorectal medicine and genetics of the specialty. Gastroenterologists research project, and a signifi cant at The Royal Melbourne Hospital. manage disorders affecting all the number of gastroenterologists combine Gastroenterologists work with a range organs of the alimentary canal, as well clinical and research careers. of medical and other health workers as the liver, pancreas and gallbladder. The majority of gastroenterologists including cardiologists, respiratory Gastroenterology also includes a variety work in full-time clinical practice, mainly physicians, neurologists, gynaecologists, of pathology, ranging from genetic in metropolitan areas, although there is dietitians, psychologists and surgeons. disorders to malignancies to auto- a need for more gastroenterologists in “They all have interactions with what immune diseases. rural and regional areas. we do, which adds to the interest of the Professor Michael Grimm, president Securing a position in a public specialty”, he says. of the Gastroenterological Society of hospital can be challenging; continued on page C2 Editor: Sophie McNamara • [email protected] • (02) 9562 6666 MJA 195 (5) · 5 September 2011 C1 Careers Career Overview Registrar Q+A ‘‘ Dr Payal Saxena, fi nal The role of endoscopy in managing year advanced trainee in gastrointestinal diseases gastroenterology, based at continues to increase Bankstown Hospital, Sydney. ” Why gastroenterology? During basic physician training I ended up with heaps of gastro terms. I hadn’t asked for any, it just happened. During a gastro term in Wagga, some friends suggested I see what scopes were all about. And I initially thought “no way, gross”, but when I continued from page C1 saw it in theatre I got really interested. You’ve got however, there is substantial scope Professor Macrae suggests that a camera, pictures on the big screen and you don’t for gastroenterologists to work in gastroenterology trainees look beyond have to scrub up. I really enjoyed it. I did more gastro community-based private practices. the core components of the advanced terms, and it just got more and more interesting. Gastroenterologists can also make an training curriculum to areas of increasing impact on population health or policy, importance in the specialty, such as Have you enjoyed the advanced training? through organisations such as GESA, capsule endoscopies and genetics. I’ve loved it, I love my job. Gastroenterology has a involvement in government advisory “We have a revolution in genetics great deal of variety. There’s never a boring day. committees or through the impact of which will rival the industrial revolution As you progress through your training there are so many things that you can learn about in great detail. their research, says Professor Macrae. in terms of its impact on society, but we There’s general outpatient gastroenterology, there’s The specialty remains male have little interest from trainees because a lot of acute inpatient medicine, hepatology and, dominated; however, there are a number it is not something they have to tick off with the procedural side of things, there’s general of prominent female gastroenterologists, to complete their training. My advice is endoscopy as well as advanced procedures. including a past president of GESA, to keep your eyes open and look where Professor Barbara Leggett, from Royal medicine is going.” Are you planning any overseas work? Sophie McNamara Brisbane Hospital. As well as endoscopy and gastroenterology, I’m Training also very interested in innovation and design of endoscopic technology and equipment. Next year Junior doctors considering a career and hepatology, in some cases as I’m off to Johns Hopkins University in Baltimore, US, as a gastroenterologist fi rst need to a prelude to commencing a higher to work with some of the gastroenterologists who complete basic physician training research degree. have pioneered some newer endoscopic techniques. through the Royal Australasian Professor Michael Grimm, I’ll be doing a 2-year fellowship that will involve College of Physicians (RACP). president of the Gastroenterological both research and training, some of it in procedures This is a 36-month (or full-time Society of Australia (GESA), says that are not yet well established in practice. I’ll be equivalent) program that includes that it can be competitive to secure a looking at new equipment and technologies that will terms in various physician specialties, position in gastroenterology training. improve our job and the care we can provide to our followed by a rigorous clinical and “Generally people who get into their patients. written exam. fi rst year of training have not just Registrars can then commence done well enough in the physician Do you plan to subspecialise? their advanced training in gastro- exams but also have another string I’m planning to subspecialise in advanced enterology. The 24-month core to their bow that sets them apart”, interventional endoscopic procedures. This year curriculum provides registrars with he says. I’m doing the interventional endoscopy job at broad experience in managing a wide Part-time training has historically Bankstown, which I’m really enjoying. We do variety of gastrointestinal disorders, been diffi cult, but Professor Grimm some procedures that aren’t provided everywhere as well as in using endoscopic says GESA recognises the increasing else, such as radiofrequency ablation, which is a procedures and gastrointestinal demand for this fl exibility and relatively new procedure, for Barrett’s oesophagus. and hepatic imaging. Registrars is considering ways of accom- We also do a lot of diagnostic and therapeutic are also required to complete modating it. endoscopic ultrasound and stenting. Some of these another 12 months to fi nalise their More information is available interventional procedures would have traditionally specialist training. During this period on the RACP website (http://www. been done under radiology guidance or by surgeons. they are encouraged to pursue a racp.edu.au/page/specialty/ But now patients don’t have to have an operation, specialised area of gastroenterology gastroenterology). and it opens up a new side to our job. C2 MJA 195 (5) · 5 September 2011 Careers Medical recruitment is our specialty As part of the HCA group of companies, LML (Last Minute Locums) Medical Recruitment and On Call Locums help doctors and nurses of all grades and specialties find locum and permanent jobs throughout Australia and New Zealand. 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