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Why Australia is the best place in the world to practice Emergency Medicine

I have long held the view that Emergency Medicine as it is practiced in Australia is about as good as it gets if you want an emergency career that is rewarding and for your specialist expertise to be held in high regard by your medical peers.

In Australia the Emergency Department is the hub of the hospital, both clinically and socially and the Australasian College for Emergency Medicine (ACEM) is highly respected both domestically and abroad as one of the best when it comes to teaching and representation of its members.

It then occurred to me that I had not actually worked in Emergency myself for nearly 18 years, so rather than confabulate I asked a range of doctors (some home grown – some imported) who currently do work in Emergency to respond to the question “Why Australia is the best place in the world to practice Emergency Medicine?”.

Here, in their own words, are some of their answers:

Career Opportunity

  • There is huge opportunity to travel and work thanks to workforce shortage outside of all major metropolitan centres
  • There are established joint accreditation pathways with Paediatrics and Intensive Care Medicine
  • I live in a city and my roster allows me to do locums once a month which I do to support my farming interests
  • Emergency Medicine in Australia is the fastest growing specialty and one that continuously brings new skills and treatments to the patients at the hospital's "front door"
  • Significant opportunity to engage in research
  • Lots of academic posts available

Lifestyle

  • Very flexible rosters allow for family or other interests to be accommodated
  • In rural centres there are great lifestyle choices such as owning land or bushwalking, rock climbing surfing, etc. I own 100 acres and grow beef plus I also have rainforest along my 1.5km river frontage
  • The Emergency Department is the largest department in our hospital and so is very social and lively – everyone wanders through at some point
  • Fabulous weather all year round as far as I can tell
  • Quality of life: Living in Australia full stop! Great for families, great education, etc

Medical Practice Opportunities

  • Emergency Department sees all acute admissions to the hospital in Australia and so is well funded, respected and busy
  • I am able to do intubations, sedations and complex procedures without other specialties (e.g. Anaesthetics and ICU) getting their noses out of joint
  • There is significant use of Ultrasound in Emergency here, which I really appreciate
  • Traditionally, the ED is the safest place (apart from ICU) for a patient to be - highly trained doctors and nurses are therefore required
  • Emergency Medicine in Australia is a mature specialty in which Emergency Physicians are able to practice the core skills of patient assessment, initiation of care and resuscitation
  • I have really enjoyed wilderness and remote area medicine since I came here - something I never saw back in the UK
  • I find indigenous medicine very interesting and rewarding
  • I have had the chance to practice some tropical & dive medicine
  • There are several sub-specializations, which allow transit from the hothouse with advancing years – I personally do hyperbaric medicine. Other sub-specialties include:
    • Ambulance
    • Retrieval
    • Toxicity
    • Hospital in the Home
    • Medical Administration
    • Pre-hospital
    • Aged Care
    • Addiction Medicine

Work Conditions

  • Guys from the US are usually stressed and “burnt out” until they come here
  • Those from the UK often complain about the 4-hour rule in the NHS and limited clinical involvement in admitted patients. Many prefer our system of Emergency care delivery
  • Australian Medicare provides for universal access, so no eligibility problems for patients, as in USA, some countries in Europe, and all Asia
  • Good pay and working conditions. 4 shifts a week and usually only one in four weekends
  • And for the American boys and girls...we have lower levels of risk for staff as we are essentially a gun-free society
  • Litigation levels in Emergency Medicine are very low, and most hospitals fully indemnify doctors for medico-legal insurance
  • Compared to the UK our health system is well resourced with active hospital infrastructure renewal programs
  • Ample rosters (all on 38 hours or less)
  • Most paid shift penalties, very few require a night shift on the floor for consultants
  • Although on-call is the rule calls are often fixed on the phone
  • Working hours: much more favourable than other countries
  • I’ve found most Emergency Specialists here to be very reasonable people and enjoyable to work with
  • Australia has one of the most advanced Emergency Medicine specialty practices in the world

Money

  • Salaries generally comparable with other non-procedural specialties within Australia
  • The pay structures are salaried mostly. The actual pay may be less than in the US, but the work is safer and more sustainable
  • Salaries probably are better than in UK
  • Easy to do private work or locums to supplement income
  • There is plenty of locum work available at good rates if you want it
  • There are great opportunities to work in the private sector to earn extra money by doing some shifts

Training, College and Recognition

  • Very good training program for juniors and registrars
  • Most accredited departments are multi-FACEM so tend to get good teaching
  • World leading education and training opportunities – huge investment in high tech simulation capacity
  • The college pathway for recognition transparent. Most well qualified Emergency Physicians from countries with a fellowship seem to qualify
  • Very well regarded standards in our College (ACEM) and collegial relationships are collaborative rather than competitive
  • We own the specialty of Emergency Medicine and don't let other specialties dictate to us what we should or should not do

For Career Medical Officers

  • Good pay with a possible structure to senior CMO. Much higher than their home country generally
  • Job security - pretty good if you function well as a CMO both clinically and with communication skills
  • Positions close to large metro available for overseas applicants
  • Safe - Family usually very happy especially if you live/work in an area that has a group of physicians of similar cultural background
  • Education - increasing education for CMOs now with HETI taking central responsibility
  • Good community and colleague respect if you are good

So there you have it. I couldn't (and didn't) say it better myself. It's reassuring to hear so many positive messages coming from the profession itself, particularly from those that have come from other countries. I certainly feel more confident now that the title of this blog is more than just a hollow claim.

Dr John Bethell, Director

Wavelength International

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Comments

  • kim 27/08/2013 10:52pm (4 years ago)

    Love this.... i'm so perplexed by the fact the ED physicians in the UK dont intubate or do much procedures... then what do they do if you are an EP and you dont intubate your own emergent airways????

  • Daniel 01/06/2015 6:20am (24 months ago)

    Interested in working in ED in Australia on a permanent basis. Wondering what salaries are like currently as staff specialist? Cheers, Daniel

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