Open to adventure

A temporary primary school teaching job was the launching pad for Dr Ineka Booth’s rural generalist career in the Aboriginal and Torres Strait Islander community of Palm Island (Bwgcolman).

Dr Booth was training as an emergency registrar at The Tweed Hospital when her partner, Adrian, got the opportunity to do a six-week teaching contract on Palm Island in 2020.

“He really loved it. He thought the community was amazing and that I would really enjoy working in this environment,” she says. “At that stage I was I was already thinking of making the switch to rural generalism training and looking at the possibility of doing a fellowship through ACRRM (Australian College of Rural and Remote Medicine). We decided to move here together and have both had fulltime jobs on the island for the past 14 months.”

Her two and a half years of training with the Australasian College of Emergency Medicine (ACEM) have helped her gain accreditation for an advanced skill in emergency medicine.

“It’s an amazing and unique experience to come to Palm Island as a registrar,” Dr Booth says. “There are a lot of examples of the challenges of remote medicine and the problems facing Indigenous people, but that makes the job interesting and rewarding. Sometimes, the little successes feel like big wins. In terms of my development as a registrar, it's been a really fantastic step and it has come at the right stage in my career, being able to have that broader scope of experience.”

Dr Booth has been one of the Queensland Health doctors supporting the transition of the island’s GP services to the Palm Island Community Company (PICC).

“As part of the overall Palm Island Action Plan, we were always planning to transition away from having a Queensland Health-run primary care practice,” she says.

“It's been really lovely to see this transition because we have a strong emerging Aboriginal Community-Controlled Health Organisation (ACCHO) that's taking leadership and ownership of primary health care amongst other broader community services.

“We've maintained a strong medical workforce at Joyce Palmer Health Service, the hospital here, and the idea is that over the next few years, they become complementary but separate services.”

Remote medicine brings leadership roles

For Dr Booth, the excitement of emergency medicine as a provisional Senior Medical Officer and the rewarding work of general practice are a perfect mix.

“I’ve really enjoyed the broader scope of practice associated with rural and remote work, and the fact that I have some lovely continuity of care within the primary care centre and some clients I've made progress with over the last 12 months in terms of their chronic health conditions,” she says.

“I like the fact that I can keep my skills up in emergency medicine and still get some good emergency cases. Remote medicine exposes you to leadership roles that you would never be exposed to in a bigger centre.

“It has been nice to have the opportunity to step up into those leadership roles and start to think of health in a holistic way where it's not just about the patient in front of you, but it's about the cultural implications of what you're doing and how we're going to overcome the unique challenges that face us here on the island due to various things like remoteness.”

She says excellent mentors on the island do a great job of initiating cultural education and giving feedback.

“We have some fantastic Aboriginal Health Workers and Indigenous Liaison Officers who help us provide culturally appropriate care,” Dr Booth says. “The community has been incredibly welcoming to people who come here and show this place the respect it deserves.”

Bettering population health

Dr Booth studied medical sciences at Australian National University, with an exchange year at Stockholm University in Sweden, before completing medical school at Deakin University in Geelong. She also holds a University of Melbourne honours degree in autoimmune diseases.

“I really wanted to secure my skills in emergency medicine before I exposed myself to this kind of role,” she says. “Going into the ACEM qualification, I wasn't entirely sure whether I'd end up completing it or going into rural medicine with an emergency skill. I'm quite happy now that I've had the exposure to a remote job that gives me the best of both worlds.

“The learning curve has been steep but looking back on the last 14 months, it's really progressed me a lot in terms of my career and skills and understanding of Indigenous health, remote health and how to tackle health from more than just what’s in front of you, but from an entire population or community point of view.

Country and community

“There are plenty of things outside of work that we really enjoy about the island – there's amazing snorkelling, there’s hiking, there are beautiful beaches dotted all around the island, waterfalls that you can swim in.

“The physical beauty of the island is a nice part of living and working here. I also really enjoy living and working in a small community. The people who live here are very social, both locals and people who are here mainly just for work. On weekends, we're all off adventuring together. You do have to make your own fun half the time.

“This is my first experience living in a small community in which I work, and you get to know people very quickly. You run into your patients or patients’ families all the time in the supermarket, at the airport, on the ferry, at the pub.

“I thought it might have been a bit more of a challenge to deal with the barrier between work and non-work activities, but it's actually lovely. I've had patients approach me at the pub saying, ‘Doc, I've lost 10 kilos, you'd be so proud of me,’ or ‘Can I can I come see you tomorrow – I've been taking my blood pressure medication all this week, like you said, and I just want to check it again.’ I enjoy that sense of closeness and familiarity.”

‘One of the uniting things about coming here’

“The people who seem to come to Palm Island and enjoy Palm Island all have a bit of a sense of adventure,” Dr Booth says.

“A lot of them have maybe travelled through foreign countries and are open to these kinds of new cultural experiences. It's probably one of the uniting things about coming here.

“It’s not always an easy place to live and it's not always the most comfortable place to live. We do have problems with access to fresh food and it is logistically difficult to get off the island if you need a bit of a mental health break. But all in all, there's a certain type of person that it attracts and who ends up thriving here.”