Careers

C1MJA 200 (10) · 2 June 2014

“Rather than seeing mentoring as an academic pursuit . . .instead it’s being seen as an effective mental health intervention

’’

Finding the right adviceCareersM

JA

Editor: Cate Swannell • cswannell@mja.com.au • (02) 9562 6666

continued on page C2

AMSA President Jessica Dean

New attention is being paid to how formal mentoring programs can help the mental health and wellbeing of medical students and junior doctors

AMSA mentoring coordinator’s brief, says AMSA President Jessica Dean.

“It’s been around for a very long time in various forms, but I think that the reason that so much attention is being paid to formal mentoring processes is because we’re starting to realise the benefi t of it in terms of evidence”, Ms Dean tells the MJA.

“Rather than seeing mentoring as an academic pursuit — which is what the original objective was in the various medical societies — instead it’s being seen as an effective mental health intervention.”

Mentoring for allThe vast majority of on-campus mentoring programs are overseen by student medical societies and remain opt-in arrangements. However, the School of Medicine and Pharmacology at the University of Western Australia (UWA) is leading the way with an innovative initiative that sees all students (up to 240 each year) liaise with a clinical mentor during the transition to clinical training.

“We know that this is always a stressful time”, Associate Professor Dr Paul McGurgan, who coordinates the school’s personal and professional development program which incorporates both clinician–student and student–student mentoring, says.

The clinician–student UWA program encourages students to fi nd their own mentor but, if that’s not possible, will make the arrangements on their behalf.

By covering all students it ensures that those who need help but who may not otherwise volunteer for mentoring get

In 2005, MJA editor Martin Van Der Weyden observed sadly that increasingly busy schedules could

spell the end for the Australian medical profession’s long tradition of mentoring.1

“We have all been infl uenced by mentors who have inspired and supported us, and invested effort and time on our behalf”, he wrote. “Unfortunately, such precious mentoring is slowly disappearing from our time-poor, fragmented and dehumanised health systems, and perhaps even from our medical schools.”

Fast forward nearly a decade and mentoring is once again part of the conversation.

In the past fortnight the Australian Medical Students’ Association (AMSA) has appointed its fi rst national mentoring coordinator and in March, the New South Wales branch of the Australian Medical Association (AMA) launched the latest of a growing number of AMA-sponsored intern–doctor, student–doctor and junior doctor–senior doctor mentorship programs around the country (see Box).

At the same time, the Australasian College for Emergency Medicine (ACEM) and other colleges have begun a host of formal programs to recruit and train mentors. Many, such as the Royal Australasian College of Physicians, now also present annual mentoring awards.

Amid all this action, there remain many and varied defi nitions of what mentoring really means in the medical workplace, but the description most widely quoted in the profession was

put forward in 1998 by the United Kingdom’s Standing Committee on Postgraduate Medical and Dental Education (SCOPME):

“The process whereby an experienced, highly regarded, empathic person (the mentor) guides another individual (the mentee) in the development and re-examination of their own ideas, learning, and personal and professional development.”

Mental health benefi tsMentoring has long been considered benefi cial from an academic or career perspective, but there is increasing recognition that it may also benefi t the psychological outlook of students, interns and doctors-in-training in particular.

Published evidence remains scarce, but a recent evaluation of a UK paediatric mentoring program showed that mentoring relationships improved both the self-confi dence and professional outlook of junior doctors.2

More attention is being paid to this aspect of mentoring following last year’s fi ndings from beyondblue that Australian doctors and medical students suffer high rates of burnout, suicidal thoughts and psychological stress compared with the general population.

The survey showed that medical students were particularly at risk, with nearly half reporting minor psychiatric disorders such as depression or anxiety.

A literature review of the links between mentoring and mental health and wellbeing, and an evaluation of the current Australian medical student mentoring programs is part of the new

In this section

C1FEATURE

Finding the right advice

C4Champion of general practice

C4

New chief for Rural Health Workforce Australia

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Careers

C2 MJA 200 (10) · 2 June 2014

the benefi t of one-on-one guidance. This commences when they transition to clinical training and continues until they graduate.

The approach appears to be working well. Eighty-six per cent of the mentoring doctors rated the program highly in a 2012 evaluation and there was a similar response from the fi nal-year med students.

Beyond the nation’s campuses, mentoring for interns and junior doctors is also being offered in many hospitals around the country, with a similar focus on the mental health and wellbeing benefi ts it can bring.

In addition to his academic role at UWA, Professor McGurgan is a consultant obstetrician–gynaecologist at Perth’s King Edward Memorial Hospital and has set up a program bringing together the hospital’s junior doctors and their senior colleagues for mentoring relationships outside the regular realm of clinical skills appraisal.

He says that it helps to overcome the perception that every time a junior doctor interacts with a senior clinician it is related to assessment. This can be particularly valuable when mistakes are made or cases don’t go according to expectations.

“That is a cross that a lot of people used to bear silently, with a lot more morbidity arising because of that. They need a person to walk them through that.”

He adds that it can also help to provide some perspective on work–life balance when it appears unattainable.

“When you’re trying to address how you manage to have a family, look after your kids and loved ones, and also put in 60 hours of work, you have someone to ask ‘How do you best cope with that?’”

Teaching the mentorsBeing sensitive to when a mentoree needs extra support — such as when something has gone wrong — is part of the training many mentors now receive. The ability to properly educate mentors to be alert to such signs is one of the benefi ts of the shift from informal to formal mentoring.

Happily, in the 5 years that Professor McGurgan has overseen the UWA program, he has only received a handful of responses from mentors about struggling students and unprofessional behaviour.

Instead, he has sometimes been surprised by students coming forward to express concern about their mentors.

“I hadn’t expected to have that sort of issue. That’s a good demonstration that both parties get a lot from it when it comes to the emotional intelligence that you’re trying to develop in these sometimes quite young people fi rst going into medical practice.”

AMSA is also looking at mentor training as an opportunity to break some of the cycles — such as bullying — identifi ed by beyondblue as the cause of some of the mental health issues experienced by young doctors.

By educating mentors how to behave, lessons in preventing bullying can be passed by osmosis to a whole generation of younger doctors, says Ms Dean.

“In being able to educate mentors in the importance of addressing inappropriate behaviours such as workplace bullying, they can share the wonderful elements of the medical profession such as the work, support and collaboration, while limiting the inheritance of the less desirable aspects such as humiliation.”

Not all formal mentoring relationships are a raging success, with many ending shortly after the minimum required period. When they succeed, however, it can be an enormous benefi t for everyone.

“It’s one of those things, when you have a good mentor–mentoree

relationship, it really just adds huge value”, Professor McGurgan says.

And it can be a genuinely win-win-win situation, says Ms Dean, for the mentor, the mentee and the profession.

“It’s so mutually benefi cial. No one is not getting anything out of it; the mentors and mentorees receive wonderful skills, experiences and support services, and that helps everyone.”

Despite Professor Van Der Weyden’s misgivings, it appears that mentoring, albeit with some modifi cations, is here to stay.

1. Van Der Weyden M. Mentors and mentoring [editorial]. Med J Aust 2005; 182: 601.

2. Eisen S, Sukhani S, Brightwell A, et al. Peer mentoring: evaluation of a novel programme in paediatrics. Arch Dis Child 2014; 99: 142-146.

Annabel McGilvray

Personal support

Formal mentoring programs

In her fi rst year of medicine at the University of Queensland, Casey Linton was one of about 30 students in her year who signed up for the AMA Queensland Med-Connect program linking clinicians and students.

“I was interested in getting some personal support throughout my medical career because medicine is a very challenging career and it can be diffi cult to know how to negotiate all the diff erent aspects of it.

“I thought it would be good to get the perspective of someone who’s already been there and negotiated that path somewhat successfully and come out the other end as a doctor.”

Three years later, she and her Med-Connect mentor, Dr Lisa Byrom, continue to meet and talk regularly.

It has been a multifaceted relationship with Dr Byrom providing clinical tutoring as well as advice for work–life balance, something that Ms Linton says has helped her outlook while studying.

“She provides me with professional advice and also more personal support for my individual concerns”, Ms Linton says.

“And Lisa acknowledges that fi nding a balance within medicine can be a diffi cult thing to do and can see that I need advice in achieving that.”

Dr Byrom says that she also gets an incredible satisfaction out of mentoring and despite having only graduated three years ago, has already adopted a small group of mentoree students at the University of Queensland (UQ).

“The benefi ts are manifold. You get to keep up to date with what the med school is teaching them and how the medical schools are changing. Also I fi nd it incredibly rewarding watching the mentorees grow as students and clinicians.”

By coincidence, both Dr Byrom and Ms Linton are now doing full-time research at UQ with Dr Byrom completing a research Masters and Ms Linton immersed in the research segment of an intercalated MBBS/MPhil.

And in an unexpected twist, when Ms Linton and Dr Byrom recently took a break to have coff ee together, it was Ms Linton who gently suggested Dr Byrom look at work–life balance.

Med-Connect, AMA (Queensland)– students to doctors (amaq.com.au)

AMA/ASMOF Alliance Mentoring Program, AMA (NSW)– interns to senior doctors (sim.mead@amansw.com.au)

John Flynn Placement Program (ACRRM)– students to rural and remote general practitioners (http://www.acrrm.org.au/jfpp/PM2013)

Mentoring Champions Program, ACEM– doctors to doctors (www.acem.org.au)

GP Obstetrics and Anaesthetics Mentoring, Rural Health West– doctors to doctors (www.ruralwest.com.au)

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Careers

C3MJA 200 (10) · 2 June 2014

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Careers

C4 MJA 200 (10) · 2 June 2014

When Dr Linda Mann set up her own general practice in Leichhardt in

Sydney’s inner west in 1987 she was one of very few.“It was 7 December 1987 and the number of women

who owned and managed their own practice could be counted on the fi ngers of one hand”, Dr Mann tells the MJA. “I knew only one other.”

Shortly after hanging out her shingle, Dr Mann teamed up with a colleague from the University of New South Wales’ class of 1976, Dr Dianne Chambers.

“We wanted to create more GPs in our own image”, Dr Mann says. “We wanted to be a bulk-billing, left-wing, feminist practice — and we became a teaching practice very early. Our fi rst registrar was 1989 or ‘90.”

That fi rst registrar was Dr Julie Blaze, now a GP practising in Bulli, New South Wales.

“Linda’s my hero”, Dr Blaze tells the MJA. “She’s a champion for general practice.

“GPs are often thought of by specialists as of lesser importance. Linda made me proud to be a GP and not feel like a specialist’s second cousin.”

Dr Mann suspects her feminist approach was something of a breath of fresh air.

“We had a cohort of female specialists we referred to. It was unbelievably necessary. In 1978, for example, the board of St Vincent’s had 42 people on it, only one of whom was a woman.”

Dr Mann didn’t start her medical career as a GP. Instead, an interest in genetics saw her complete her Bachelor of Science (Medicine) at UNSW in 1974 after her own GP told her she was “too intelligent” to be a general practitioner.

“That says something about people’s opinions of general practice, doesn’t it?” she says.

She completed her MB BS in 1976 and was on the specialist path, “living the hospital life” at St Vincent’s in Sydney when a revelation hit.

“I saw myself in the emergency department and I was getting furious with the overdose patients who hadn’t managed to kill themselves, and I was furious with those with minor conditions who were wasting our time”, she says.

“It was hard on the patients and nobody was hitting the sweet spot for me. If that’s not the defi nition of burnout, I don’t know what is.”

Dr Mann decided to head overseas and applied for a position in Scotland in obstetrics and gynaecology. But, being Linda Mann, she opted to take the overland route through Africa rather than hopping on a plane.

“I was worried I was going to be late and they would give the position to someone else so I kept contacting them and reassuring them that I was going to get

Champion of general practice

there. They formed a unique image of me as a blonde, surfi e bombshell – instead they got me”, she laughs.

The Scottish experience proved worthwhile and also restored Dr Mann’s love for genetics, leading to her appointment at the Institute of Medical Genetics in Glasgow, where she spent 18 months.

After attempting fellowship in Britain she realised that after all it was general practice that was calling her.

Dr Mann returned to Sydney in 1986 and spent time in an entrepreneur-run practice — “Dodgy Brothers” she called them — and in an inner west practice run by a GP with “interesting prescribing habits”, before making the decision to set up her own practice.

She and Dr Chambers did well enough to expand the practice, eventually to three sites across the inner west. The Leichhardt practice won the inaugural Australian General Practice of the Year. Now, several incarnations later, Your Doctors is a 19-GP, three-location operation.

“We wanted to spread the word of general practice far and wide”, Dr Mann says.

To that end she also got involved in the Royal Flying Doctors Service Women’s Project, supporting rural areas, particularly around Hillston and Hay in western New South Wales. More recently, Dr Mann spends a month a year in Borroloola, a town on the McArthur River in the Northern Territory, about 50 km upstream from the Gulf of Carpentaria.

“Borroloola’s one of those towns that would love to have their own doctor but they don’t”, she says. “I thought that if I could give them a month a year, even that amount of continuity of care was not a bad thing.”

Politics is something that fi res up Dr Mann, who was chair of the Central Sydney GP Division, and subsequently the fi rst chair of the Inner West Sydney Medicare Local.

The recent federal Budget has given her plenty to be fi red up about.

“The plans for copayments ‘which GPs can forgo’ leads us back to the 19th century, when the needy poor were beholden to the god-like doctor to give them free treatment”, she says.

“Or the American experience where free clinics must pop up to treat low socioeconomic status folk.

“This is so far from the Australia I love. General practice is not the place to get the cash for distant medical research.”

Cate Swannell

Dr Linda Mann is a general practitioner with a passion for education, women’s health, genetics and supporting rural communities. She’s a hero to a generation of female GPs.

New chief for Rural Health Workforce Australia

Greg Mundy has been appointed as the new chief executive offi cer of Rural Health Workforce Australia (RHWA), the peak body for the national network of state and territory Rural Workforce Agencies.

Mr Mundy joins RHWA after three years as CEO of the Council of Ambulance Authorities, the peak body representing providers of public ambulance services in Australia and New Zealand. Before that he was CEO of Aged and Community Services Australia.

The chair of RHWA, Ian Taylor, welcomed Mr Mundy’s appointment.

“Greg is widely respected for his commitment to health and social care,” Mr Taylor said. “He will be a strong advocate for our agenda to make primary health care more accessible for rural Australians.”

Mr Mundy said it was an exciting time to be joining RHWA and the RWA network.

“Rural Workforce Agencies have been successfully delivering health workforce initiatives in rural, regional and remote communities for the last 25 years,” he said. “Each year they recruit hundreds of health professionals and provide services to them such as professional development and family support. It’s great to be part of such a positive movement.”

In addition to his current responsibilities, Mr Mundy is a board director of the National Rural Health Alliance and a council member of the Australian Healthcare and Hospitals Association. He started work at RHWA on 5 May and is based in Melbourne.

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Careers

C6 MJA 200 (10) · 2 June 2014

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Careers

C7 MJA 200 (10) · 2 June 2014

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Careers

C8 MJA 200 (10) · 2 June 2014

Associate Professor / Senior LecturerAcademic Manager Years 3 and 4 School of MedicineReference: 499550 • Element: Griffi th Health • Work type: Continuing, Full time

School of Medicine

The Griffi th University School of Medicine is known for its innovation and excellence in medical research and education. Through its local and international partnerships, the School of Medicine seeks to improve the health of urban, rural and remote communities through leadership and collaboration.

The School seeks an Associate Professor / Senior Lecturer to lead the curriculum development and support for Years 3 and 4 of the medical program, working closely with clinical staff at the Gold Coast, Logan, Tweed and private hospitals. It is also expected that the appointee would actively conduct research in a relevant discipline area and contribute to teaching and assessment in that area. The appointee will be a pivotal member of the medical education unit, led by the Director of Medical Studies.

The successful candidate will demonstrated leadership in teaching and curriculum development for the education and training of medical practitioners and the ability to contribute to the development of assessment, and provision of effective and timely feedback to students. Signifi cant postgraduate experience in medical practice in a range of discipline areas is essential.

This is a full-time, continuing position based at the Gold Coast campus.

Salary range: An attractive remuneration package will be negotiated with the successful applicant.

Further information: Obtain the Information Package and application requirements by visiting:http://jobs.griffi th.edu.au/cw/en/#/job/499550/associate-professor-senior-lecturer-academic-manager-years-3-and-4

Confi dential enquiries should be made to Professor Simon Broadley, Dean & Head, School of Medicine: simon.broadley@griffi th.edu.au

Closing date: All applications must be submitted online by 4.30pm Friday 13 June 2014.

Associate Professor / Senior LecturerClinical Skills and AssessmentReference: 499555 • Element: Griffi th Health • Work type: Continuing, Full time

School of Medicine

The Griffi th University School of Medicine is known for its innovation and excellence in medical research and education. Through its local and international partnerships, the School of Medicine seeks to improve the health of urban, rural and remote communities through leadership and collaboration.

The School seeks an Associate Professor / Senior Lecturer to play a vital role in the clinical skills team in the School of Medicine. The position will be deeply involved in the development and delivery of clinical skills learning in the medical program and will take primary responsibility for the assessment of clinical skills across the four years of the program, with guidance and support from the Deputy Head of School and Academic Lead in Clinical Skills. The position will also provide clinical input into the development of written assessment materials across the four themes of the program.

This is a full-time, continuing position based at the Griffi th Health Centre at the Gold Coast campus which supports the clinical skills learning and assessment of medical students both in the Centre and at clinical sites in south east Queensland and northern New South Wales. This position would suit a practicing medical doctor in any discipline who seeks to develop an interest in medical education and academic medicine.

Salary range: An attractive remuneration package will be negotiated with the successful applicant.

Further information: Obtain the Information Package and application requirements by visiting:http://jobs.griffi th.edu.au/cw/en/#/job/499555/associate-professor-senior-lecturer-clinical-skills-and-assessment

Confi dential enquiries should be made to Professor Simon Broadley, Dean & Head, School of Medicine: simon.broadley@griffi th.edu.au

Closing date: All applications must be submitted online by 4.30pm Friday 13 June 2014.

University Appointments

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