Georgia's Elective Diary – Part 2 (Thoughts from the Medicine Cupboard)

I thought today I would write a little bit about differences. For the non-medical among you, I apologise if there are words or concepts that don’t mean anything to you – skip over it and we’ll be back to your regular scheduled programming next (or read on, and as I heard so delightfully from Lily – you might learn a new word or phrase!!)

Coming to a new country, with a different medical system there are bound to be differences in the way medicine is practiced and the procedures and systems in place. Even Australia, in all its similarities to New Zealand is bound to have a few differences. In amongst the chaos of finishing exams, packing up and moving somewhere new however, I somehow managed to forget this simple fact.

It was probably my second day of ward rounds when I was reminded of this. We were seeing yet another patient with appendicitis who was scheduled for surgery.

“…And he’s got IV Tazocin going?” the consultant asked, as a final remark.

“TAZOCIN?!?!?!?!” I exclaimed (internally, to myself, with no change in my affect of course)

Why were they giving a 12 year old boy, who was otherwise fit and well, a high potency, extremely broad spectrum antibiotic to treat appendicitis? This is the drug we use in NZ for febrile neutropenia! Its special! Turns out, it is special in Australia too, and you do need a special authority to prescribe it, but the paeds surgeons have their special authority for its use in cases of appendicitis.

A second oddity I’ve so far come across in Adelaide is the Public/Private divide. Within the one (public) hospital, a patient can (assuming they have medical insurance) have their operation performed “privately”. This is regardless of whether their procedure is elective, or an emergency. This doesn’t mean a different ward to stay on, or higher quality nursing care, better quality facilities, it means only that their operation will be performed by a consultant, with a consultant anaesthetist, instead of a registrar. This is a concept I still can’t quite get my head around.

A few other notable differences include the major predominance of EBSL over MRSA as the “contact isolation bug of interest”, “interns” and “residents” as discrete junior doctor roles, and the fluorescent yellow “MEDICAL STUDENT” stickers we are required to wear every time we go to theatres. These stickers, we have decided amongst the team this week act as a beacon for the scrub nurses to choose whom to target with their abuse, and that perhaps concentric circles, somewhat like a bulls-eye would be a more appropriate sticker for us to wear.

All in all though, the medicine is pretty much the same. Asked to do a hand examination on my consultant in front of all the other surgical RMOs (the equivalent of house surgeons) on Friday, and I was able to answer most of the questions, especially the ones he was asking the RMOs to answer. My hand exam was a little rusty - turns out its easy to forget lots of medical knowledge in the three short weeks since exams finished, but I don't feel like a complete fool of myself in front of others anymore, so we're making progress. And in case you’re wondering – Osler's nodes and Janeway lesions are just as important in Australia as they are in NZ – Thanks Galletly!