The Longitudinal Integrated Clerkship (LIC) program is a 19-week apprenticeship model of experiential learning in a rural community for Year 5 JMP students. Students see patients with their GP supervisor and then follow the patient journey to hospital, allied health services, rehabilitation, aged care and returning home to their community.
Here, we meet LIC supervising doctor (Inverell), Dr Mary Elsley, of Armajun Aboriginal Health Service and Inverell Hospital.
Tell us a little about yourself.
I grew up in Newcastle before moving to Sydney for university. I have an undergraduate Advanced Science Degree with a double major in Microbiology and Biochemistry from the University of Sydney. I then went on to study medicine at the University of Sydney, completing my whole final year at the Dubbo School of Rural Health.
During my medical degree I was involved with MIRAGE (Rural Health Club) and GlobalHOME (International health/health equity club). I was also fortunate to undertake a John Flynn Placement in Atherton Hospital in far north Queensland and to be a RDN NSW Rural Medical Officer Cadet. I then went on to complete my internship and residency at Tamworth Rural Referral Hospital before completing my FARGP Advanced Skill year in Paediatrics at Port Macquarie Base Hospital.
The fantastic experiences during my medical training, as well as my own family background (my mother's family is from the Tamworth/New England region and my grandparents lived on a farm in Tasmania for much of my childhood), led me to pursue a career in rural medicine. I had a very supportive learning experience in Inverell during my years as a GP registrar and have continued in my role at Armajun Aboriginal Health Service, as well as working as a GP VMO at Inverell District Hospital.
How are you involved with the LIC program?
I am a GP supervisor at Armajun Aboriginal Health Service and Inverell District Hospital (inpatient unit).
Why should med students participate in the LIC? Why should they train in Inverell?
Inverell is a lovely town in the New England region with a diverse population, nice boutique shops, cultural activities, multiple sporting teams and lots of opportunities for outdoor activities. There are also a number of destinations nearby for some weekend road trips.
The students that have come to train in Inverell have been able to become part of the local community. Inverell is big enough to allow students to experience the breadth of rural healthcare while still allowing for much more hands-on experience and more one-to-one supervision than is possible in a larger centre.
The LIC program provides an immersive experience for students. They get to experience the range of health care provided in rural towns like Inverell. The longitudinal approach means that students get the opportunity to follow patients through their health journey and really understand what is meant by "continuity of care". Students gain valuable experience in both a GP and hospital setting, and I think this helps them be well prepared for their coming internship.
Tell us about the facilities you work in.
Armajun Aboriginal Health Service is, as the name states, a health service. This means that there are a wide variety of services offered, not just general practice. These services include dental, social and emotional wellbeing, exercise programs, women's/men's groups, drug and alcohol case management, and more. There are also a number of visiting specialist medical and allied health services that attend Armajun regularly. Armajun has outreach clinics to Tingha, Glen Innes and Tenterfield. The local clinical team includes GPs, nurses and Aboriginal health workers.
Medical students can expect to see a range of patients, many of whom have more health care needs or are more complicated to manage than in mainstream general practice. They get the opportunity to work with the clinical team day-to-day where they can develop their clinical and minor procedural skills. They are also welcome to attend visiting specialist clinics.
Students are also able to attend Inverell District Hospital. With me, they can attend patients on the inpatient ward. They can practice being an intern including performing history/examination, note taking, minor procedures, helping develop a treatment plan, and completing discharge paperwork. Students also get the opportunity to assist in theatre and the emergency department with other supervisors.
What do you consider the benefits of practicing medicine in country areas?
Holistic care, deeply valued service for the local community, wider variety of practice with opportunities to develop skills and knowledge in a range of areas and expand scope of practice if desired
Why did you get into medicine?
I fell into medicine as it included the areas of study I had most enjoyed during my undergraduate degree.
What is one piece of advice you might offer upcoming medical students?
Put yourself out there and take the opportunities that are offered - you never know when you might find a new passion, and everything you do and experience will make you a more confident, well-rounded doctor in the future.
What do you enjoy doing outside of your work?
I sing in several of the local choirs and play with the local concert band. I also attend pilates and yoga classes, and enjoy going for walks down by Lake Inverell. I become a passionate gardener each year during tomato season, and enjoy cooking and baking (including anything sourdough). With my remaining spare time, I laze on my couch and read, play games, or watch far too much YouTube.
What do you hope the future of the LIC program looks like?
I hope that the LIC program continues long term and expands to include other sites, so that more medical students get the opportunity to experience rural medicine and rural life.
