MJA 206 (7) • 17 April 2017 C1 Careers Dr Sam Brophy-Williams Dr Sam had expertise to bring to bear, got more I certainly think I’ve is to learn … the learning curve steeper now. “There’s little point in being resentful or being proud or run a thinking ‘oh come on I’ve whole maternity hospital, I don’t to do these silly forms’. My have much actively mindset is very this idea of, now’s the cultivating to go back again.” Coming back to the reality of life as a trainee, albeit an Australia in of one, after 6 months advanced great responsibility, is a challenge in and of itself. Dr Brophy- is now working Williams Darwin and training at Royal Hospital. “It is a change, going from being, not only the paediatrician, but in usually the most my case I was senior medical person in the whole the hospital. For a while I was medical director of the hospital. much “Coming back, I think it very depends on the mindset with Although which you approach it. I’m really happy with the work I Afghanistan and I felt I did in non-work part of life. But it’s walked certainly something I’ve from enriched and wanting away ” Seeing the health system as a whole gives as a whole so system Seeing the health much challenging and enjoyable. “It is challenging – not just the clinical part of it but also the non-clinical part of the work and there is very limited antenatal care, there is very not many ultrasounds, not many blood tests, they come as a bit of a surprise. investigations had far fewer “We treatments at our and far fewer Afghanistan], so you fingertips [in come to rely a lot more on your clinical acumen rather than lab tests, and you come to rely a lot more on coming up with some solutions.” creative Intimidating? Certainly, but it was for Dr Brophy-Williams birth weight … neonatal sepsis, birth weight jaundice. “ and the part that I play the part to meaning more in it play clinicians that all a subset of much “There was rarer conditions which usually in some antenatal have we Australia Afghanistan where hint at, but in As for the clinical experience he As for the clinical experience an picked up in Kabul, it was learning opportunity, invaluable he says. in part clinical, and “My job was in part training, teaching and supervising and managing the department. The babies that we admitted to our newborn unit came with much the same problems that babies admitted into neonatal units the biggest so have, Australia in prematurity, low problems were But I never felt that I personally, or felt But I never ever were MSF as an organisation, largely was targeted. So, the risk place at one of being in the wrong the wrong time. about our “I could tell you a lot tell little district, but I couldn’t the Friday you anything about the middle of night social scene in Kabul.” to go beforeto go he finishes his R SAM Brophy-Williams is Brophy-Williams R SAM andjust still 31 months has 18

. “There wasn’t anywhere else . “There wasn’t

incidents in Kabul – kidnappings there. and bombings – while I was home from work each afternoon,” quite a few he says. “There were colleagues. “They faced a lot more danger than I did, just trying to get weren’t always easy for his Afghani his for easy always weren’t Dr Brophy-Williams was always always was Dr Brophy-Williams that things however, aware, absolutely cherished.” and the hospital which was a and the hospital which was few hundred metres of freedom I was unique because we could unique because we was the house between actually walk bubble,” he says. “Physically, and were Where we socially as well. we lived in a strange sort of lived we dangerous place. because of that, though, was “Part the hospital, it didn’t feel like a colleagues, who lived together in colleagues, who lived a house about 400 metres from hot spots for a long time, but for and his MSF Dr Brophy-Williams Kabul has been one of the world’s could get caesarean sections and those sort of life-saving things.” maternity care, particularly high- quality maternity care where you of about a million people, for free MJA people could go, for a population “The area the hospital was in was was in “The area the hospital was under-serviced,” he tells the very on-staff paediatricians. Dr Brophy-Williams was the only was Dr Brophy-Williams non-Afghani in the group of eight hospital in Australia. deliveries a day, about three times deliveries as many as a tertiary maternity western outskirts of Kabul, the western around 50 hospital averages Frontie`res. Located in the poorer, Located Frontie`res. Kabul, the capital of Aghanistan, Aghanistan, Kabul, the capital of Sans courtesy of Me´dicins He is just back from a 6-month He is just back from hospital in posting to a maternity can only dream about. but he’s already gathered he’s but experiences other doctors his age advanced training in paediatrics, paediatrics, in training advanced

Dr Sam Brophy-Williams is an advanced paediatrics trainee and is just back in Australia after 6 months in after Australia in back and is just trainee paediatrics is an advanced … Brophy-Williams Dr Sam Frontie`res Sans Me´dicins with Afghanistan

A cog in the machine in the A cog D C2 MJA 206 (7) • 17 April 2017 whole lifetrajectoryisaltered you intervene early,someone’s “I findthat very encouraging –if very normallives. all aboutyouandgoonhave leave hospital,andprobablyforget “A lotofthepatientsgetbetterand development. of childhoodandpsychological is very muchaboutthecourse developmental paediatricswhich of thespectrumatcommunity intensive caretotheotherend could takemefromneonatal paediatrics myadvanced training the stageI’matnowingeneral at choosing,likeIam.Even at people whoaren’tvery good “Paediatrics isagreatcareerfor he says. went soIkeptgoingonthatpath,” found thatIlikeditthefurther do that.Iheadedthatway andI paediatrics gives youalicenceto around andhave fun,and immature andIliketomuck “Partly becauseI’malittlebit Dr Brophy-Williams. Paediatrics always appealedto [returning fromanMSFmission].” frustration thatsomepeoplefeel “That takesaway someofthe going toendupbeing. improve thekindofdoctoryou’re opportunities andseeitastimeto tread andso…trylookforthe path we’re allgoingtohave to is thereinfrontofme,andit’sa towards medicalspecialisation and realisingthatthelongpath “It’s aboutputtingegoaside to get better.” I canlearn,toseekthatfeedback, time Icanreallymaximisewhat Careers “Some ofmyadultcolleaguesare energises me. for thebetter.Thatinspiresand clinical skills.Second,there’s “For alotofreasons.Firstly,the doctor. “absolutely” madehimabetter experience his Afghanistan future MSFmissionsandsays Dr Brophy-Williams planson the wholething.” feeling likeareplaceablepartin should bedelivered ratherthan in howyouthinkclinicalmedicine that aren’tworking,tohave avoice It empowers youtochangethings the partthatallcliniciansplayinit. meaning tothepartthatIplayand a wholegives somuchmore “Seeing thehealthsystemas that wholemachineworks. really appreciatingorseeinghow part inalargerwhole,andnot anonymity, ofbeingareplaceable medical colleagues,isthatsenseof dissatisfaction thatIseeamongmy “One ofthebiggestsources valuable forclinicians,”hesays. public healthpointofviewisso appreciation ofmedicinefromthe the widermedicalmachine. An how thecogthatismefitsinto “I’ve always beeninterestedin Masters inPublicHealth. School inBoston,earninghis spent ayear atHarvard Medical Monash Scholarshipin2012and Dr Brophy-Williams wonaJohn such along-lastingeffect.” the changesyoumakedon’thave of thatlife-coursetrajectoryand dealing withlives towards theend that bringstobearskillsare the managingsideofit. And necessitate theexistenceofMSF “Unfortunately, thethingsthat to beinahurry”. students recently,“youdon’thave As hetoldagroupofmedical communication.” job aboutinteractingand fundamentally, medicineisa with allsortsofpeopleand better youareatinteracting have tothatsortofthing,the “The broaderexposureyoucan from. circumstances peoplearecoming that peoplelive andthedifferent world andwiththedifferent ways connection withtherestof you abetterdoctorthroughthat metaphysical stuffaboutmaking “And thirdlythere’sthemore front ofyou. relevant beyondjustthepatientin doi: 10.5694/mja17.1704C1 Cate Swannell multimedia/podcasts. is available at www.mja.com.au/ A podcast withDrSam Brophy-Williams criteria.” than justmeetingtheminimum something tocontributerather where youfeelthatyou’ve got getting yourselfintoaposition into thissortofthing–it’sabout no rush.People whowant toget “It soundsmorbid,butthere’s earthquake. to beanotherfamineor next fewyears, there’sstillgoing that nomatterwhatyoudointhe “That’s heartbreakingtothink overnight. organisations, arenotgoingaway and allsortofhumanitarian MJA 206 (7) • 17 April 2017 C3 ) Careers was awarded awarded was Telethon Kids Telethon Westmead Institute Institute Westmead system. A/Professor A/Professor system. research Byrne’s the will examine of therapies for MS in for of therapies Associate time. real Byrne Scott Professor $18 000 awarded was sunlight find out how to the immune suppresses will work on “Chronic “Chronic on will work Torres diseases: young healthy Strait Dr Dagmar women”. Cook (James Meyer will work University) and on “Vector-borne infectious emerging mosquito can diseases: have been awarded awarded been have James Cook University James Cook Brain and Mind Centre Brain ) will work on “Skin health: do “Skin health: on ) will work relationship between UV light exposure, UV light exposure, between relationship is There and MS. the immune system a number of that evidence increasing in the important are factors environmental which is of MS, and course development countries in Scandinavian prevalent more PhD student UoS UV exposure. with low $6000 awarded was Panopoulos Angelica the enter immune cells how investigate to University of Sydney University Australia MS Research $250 000 by funding to of $1.5 million in new part as and prevent ways new support promising Parnell Dr Grant sclerosis. multiple treat and the of the UoS 3 years $158 000 over awarded was D protects vitamin how investigate to D is of vitamin level A low MS. against MS developing for risk factor a known D in the of vitamin the benefit however is largely of MS and prevention treatment of the UoS Barton Dr Joshua unknown. and the new investigate to 2 years 000 over $67 changes sub-clinical of detecting ways current The of MS sufferers. in the brains monitor clinicians to by used methods on patients of the disease the impact long over and measured insensitive are use aims to Dr Barton periods of time. monitor to systems visual the brain’s and the effectiveness progression disease excreta be used to enhance detection detection enhance to be used excreta diseases?” vector-borne of Australian ( Barnett Dr Timothy Institute causing isolates A streptococcus group encode WA remote in skin infections with disease correlate that genes or adverse antibiotic resistance, severity, outcomes?” immunological with the affiliated Four researchers communities and developing countries”. countries”. and developing communities ( Canuto Dr Karla , in Darwin in Darwin Centenary Institute Centenary Associate Professor Professor Associate Heidi Smith-Vaughan of School (Menzies will Research) Health on “Respiratory work genomic health: in public health Indigenous Australian Professor Jeffrey Jeffrey Professor the Sydney from Holst and School Medical the 174 $449 awarded was research complete to manipulating into using into cells cancer pathways biological five themes – skin health, respiratory respiratory – skin health, themes five antimicrobial diseases, chronic health, and mosquito-transmitted resistance, Grigg (Menzies Dr Matthew diseases. on will work Research) of Health School resistance: “Antimicrobial called a project of malaria and treatment epidemiology patterns longitudinal Malaysia: in Sabah, risk factors, acquisition of disease, and resistance, drug antimalarial injury”. kidney acute for therapy adjunctive treatment for colorectal cancers have have cancers colorectal for treatment and fewer responses treatment better radiation. during side effects http://sydney.edu.au/news-opinion/ news/2017/03/02/university-of-sydney- researchers-win--1-5m-to-defeat-cancer. html Research Menzies School of Health fellowships career five awarded has program of their collaborative part as in the Outcomes Health Improving 3-year The NORTH). North (HOT Tropical across given been have fellowships that will trigger their own death. death. own their will trigger that stress-response develop cells Cancer their survival promote to techniques these will hijack researchers and so cells the cancer and force responses their to will lead that a path choose to also Ackland, Stephen Professor death. Centre, Trials Clinical the NHMRC from a complete to 490 $449 awarded was can statins whether 2 trial testing phase cancer rectal of the side effects reduce shown have studies Previous treatments. before drugs statin taking people that rates. Previous research has shown that that shown has research Previous rates. who cancer and rectal colon with patients appear being diagnosed after aspirin take The do not. who than those longer live to taking whether determine trial will aim to without rates survival will improve aspirin Associate side effects. significant adding

was Sydney Sydney -affiliated scholars scholars -affiliated Westmead Institute Westmead Hovey an Honorary Honorary an Hovey the at Associate, Trials Clinical NHMRC at Centre, School Medical $186 540 awarded an alternative test to a type for treatment Elizabeth Dr Elizabeth occurring. Greg Neely was was Neely Greg 000 $450 awarded research progress to of on the treatment cancer. pancreatic Neely’s Professor hopes team research cancer-fighting cells. cells. cancer-fighting Professor Associate Segelova, a medical a medical Segelova, St at oncologist was Hospital, Vincent’s to $213 460 awarded a multinational conduct trial on colorectal temozolomide to treat treat to temozolomide Dr Eva this cancer.

University of Sydney University

cancer to determine whether aspirin can can aspirin whether determine to cancer and death relapse reduce to be used be less toxic and more effective than effective and more toxic be less will work Dr Hovey’s therapy. current could treatment PCV whether investigate drug toxic the less by be substituted of glioma brain cancer, which could which could cancer, of glioma brain resistance or prevent resistance from from resistance or prevent resistance and future treatments more effective. The effective. more treatments and future combinations test to used be will research drug cancer overcome either to of drugs to detect molecular “signatures” that that “signatures” molecular detect to allow and thereby resistance drug define current to make ways find to researchers trials and develop the technology so so the technology and develop trials of established choice a have researchers create to be used can that tools PiggyBac system has the ability to make make to the ability has system PiggyBac be adapted to but is yet changes these team Dr Micklethwaite’s use. clinical for in clinical use for PiggyBac will optimise technology for making cancer-fighting making cancer-fighting for technology the introduce to is unable immune cells The cancer. defeat to needed genes Micklethwaite’s research centres on centres research Dr Micklethwaite’s technology “PiggyBac” of a new the use simpler therapy and gene cell make to the Currently, available. broadly and more of the UoSydney and of the UoSydney the test to 000 $450 awarded was immune modified of genetically impacts leukaemia. of cases fight to cells announced by Cancer Council NSW to to NSW Council Cancer by announced advancements ground-breaking make Micklethwaite Dr Ken research. in cancer Six Six grants new $6m in $2m from won have Around the universities and research institutes and research universities the Around C4 MJA 206 (7) • 17 April 2017 Careers Bio 21 inastaged process over thenext Unit’s research teams willrelocate to Health Sciences. While several ofthe the Faculty ofMedicine, Dentistry and Biochemistry andMolecular Biology in as aProfessor intheDepartment of at theUniversity ofMelbournewillbe Biology Unit. Hisacademic appointment remaining theHead ofSVI’s Structural take uptheBio21Director role while also joint appointmentwillsee Prof Parker Institute ofMedical Research between theUniversity and role as part of ajointappointment biologists, Prof Parker willtake upthe of Australia’s leading protein structural Science andBiotechnology Institute University ofMelbourne appointed as thenew Director ofthe Professor Michael Parker has been researchers-win-grants-to-fight-ms.html news/2017/03/07/university-of-sydney- http://sydney.edu.au/news-opinion/ early stages ofMS. barrier andtherefore contribute to the microparticles can breach theblood brain of whether tiny cell fragments called will helpdevelop abetter understanding in MSsufferers. The hopeisher research via theblood brain barrier, whichisfaulty cells are blocked from entering thebrain brain andspinalcord. Typically, immune ’s ’s Bio 21Molecular (SVI). The St Vincent’s . One haematology-receives-academic-promotion news/latest/articles/director-of-monash- http://www.monash.edu/medicine/ Lymphoma Flagship. Melbourne Genomics Health Alliance and Related Diseases Registry; andChair, Chair, Steering Committee, Lymphoma Society ofAustralia andNew Zealand; Opat isPresident oftheHaematology application of targeted therapy. Professor lymphoma biology to facilitate therational Opat’s isimproving theunderstanding of Another research interest ofProfessor and chronic lymphocytic leukaemia. investigator inover 40studies inlymphoma Professor Opat has also been principal Haematology Clinical Research Unit, of strategies. As Director oftheMonash these endshehas employed anumber lymphocytic leukaemia, andto achieve for patients withlymphoma andchronic Opat’s research aimsto improve outcomes Monash Health, at theSchool ofClinical Sciences at achievements withanacademic promotion has been acknowledged for hissignificant Monash Health Professor Stephen Opat Director ofClinical Haematology at director-bio-21-announced http://newsroom.melbourne.edu/news/new- based at SVI. few months, others willcontinue to be Monash University . Professor completed PhD. the focus ofProfessor Sehgal’s recently monitoring.” This research also formed early intervention and/or increased cardiovascular compromise, andallow infants at highriskfor long term changes would detect those premature identification ofarterial andventricular function,” said Professor Sehgal. “Early mal-adaptive coupling withcardiac vascular ageing inthiscohort alongside modalities, we have noted early restriction. “Using advanced ultrasound and vascular impact offetal growth recent research focuses onthecardiac at Monash Children’s Hospital. His of Paediatrics, isaNeonatal Consultant doi: Cate Swannell sciences-at-monash-health academic-promotion-at-school-of-clinical- latest/articles/neonatologist-receives- http://www.monash.edu/medicine/news/ 10.5694/mja17.1704C3

Sehgal, Department Adjunct Professor at academic promotion research withan recognised for his Sehgal has been Neonatalogist Arvind Monash University .