A talk delivered to the 2015 Graduating class of medical students from the University of Wollongong, Graduate School of Medicine by Dr Bishan Rajapakse. Bishan holds a doctorate from ANU is also currently finishing off his training as an Emergency Medicine specialist. At this forum he delivered a motivational talk about his reflections on emergency medicine given his own diverse training journey, and provided some practical advice to the future doctors of the Illawarra region which include surprise, laughter, music and a bit of poetry... Most doctors are on the superhighway of career success, are not on a medical pathway that address global issues, Bishan also talked a bit about the importance of addressing such challenges, which are one of many factors that led him to take a detour from the traditional path of medical training into a world of adventure and research http://lifeinthefastlane.com/alternative-emergency-medicine-training/ https://bishansworld.wordpress.com/2015/05/06/a-phd-thesis-in-knowledge-translation-improving-medical-management-through-research-and-training/ @trainthetrainer

1. Emergency
Medicine
Training
“Welcome
to
the
real
world”
–
2015
UOW
gradua?ng
class
Dr
Bishan
Rajapakse
-­‐
MBChB,
PhD
Honorary
Clinical
Lecturer
–
GSM,
UOW
Emergency
Medicine
Advanced
Trainee
-­‐
ACEM
27th
November
2015

2. Overview
• What
is
EM?
– Start
with
a
simulaKon
• My
EM
training
journey
• ACEM
training
• Work
life
balance,
compassionate
health
educaKon
&
following
your
DREAMS!

5. to
be
the
“Calm
within
the
storm”
To create some“Structure from the Chaos”
find the “Signal within
the noise”
to take action given
limited resources

6. “a field of practice based on the knowledge and skills
required for the prevention, diagnosis, and
management of acute and urgent aspects of
illness and injury affecting patients of all age
groups with a full spectrum of episodic
undifferentiated physical and behavioural disorders;
it further encompasses an understanding of the
development of pre-hospital and in-hospital
medical systems and the skills necessary for this
development”
IFEM
definiKon
of
EM

7. “a field of practice based on the knowledge and skills
required for the prevention, diagnosis, and
management of acute and urgent aspects of
illness and injury affecting patients of all age
groups with a full spectrum of episodic
undifferentiated physical and behavioural disorders;
it further encompasses an understanding of the
development of pre-hospital and in-hospital
medical systems and the skills necessary for this
development”
IFEM
definiKon
of
EM
Acute
and
Urgent
aspects
of
illness
Full
spectrum
of
undifferen?ated
physical
and
behavioral
disorders
Development
of
in-­‐hospital
and
pre
hospital
systems
all
age
groups

8. My
educaKonal
Journey
–
“the
scenic
route”
1997-­‐2000
Exploring
the
way
(undecided)
2001-­‐04
Romance
with
surgery
2005-­‐06
Changing
to
EM
2006-­‐10
Beyond
the
endpoints
2010
–
2016
Finishing
specializaKon

9. PhD
-­‐
“Improving
the
emergency
management
of
OP
poisoning
through
medical
educa?on
&
research”
(2006-­‐2012)
• Advanced
Trainee
EM
(ACEM)
• PhD
in
“Knowledge
transla?on”
– Use
of
biomarkers
in
OP
poisoning
(RBC-­‐AChE)
– Rural
doctor
resuscita?on

11. ACEM:
Official
Training
Pathway

12. Pre
voca?onal
training
(24
Months)
24
Months
Gen
Reg
NZ/
Aus
Provisional
Training
(12
Months)
12
Months
6/12
ED
6/12
ED
or
Non
ED
Advanced
Training
-­‐ 30
Months
ED
-­‐ 6
Months
Non-­‐ED
-­‐ 6
Months
Discre?onary
48
Months
-­‐ 6/12
Major
Referral
-­‐ 6/12
Rural
Regional
-­‐ 6/12
CriKcal
care
-­‐ PAED
logbook
or
6/12
paeds
ED
-­‐ Special
skills
-­‐ Overseas
opKon
Interrupted
Training
-­‐
During
advanced
training
Upto
2
years
-­‐ Rest/recuperate
-­‐ Do
what
ever!

13. Pre
voca?onal
training
(24
Months)
Provisional
Training
(12
Months)
Advanced
Training
-­‐ 30
Months
ED
-­‐ 6
Months
Non-­‐ED
-­‐ 6
Months
Discre?onary
Interrupted
Training
-­‐
During
advanced
training
Years
PT
PYG
2
-­‐
PGY
3
-­‐
PGY
7
11
PGY
9
13
But
how
long
will
it
take?

14. “Life
is
not
a
race..
But
unfortunately
we
live
on
a
race
course”
The
journey
of
a
thousand
miles
begins
with
one
step.
Lao
Tzu

15. Assessment
in
ACEM
• Primary
Exam
– Anatomy
– Physiology
– Pathology
– Biochemistry
• Fellowship
Exam
– Wrihen/SAQ
– Clinical
• Work
Based
Assessments

16. Perks
of
EM
-­‐
Flexibility
• Training
anywhere
– 5
countries
– MulKple
hospitals
• OpKon
of
non-­‐training
Kme
– (upto
2
years)
• Interna?onal
EM
– Making
a
difference
globally

17. Downsides
of
ED
Light
at
the
end
of
the
Tunnel!..
Perhaps?
• Teaching
Training
• Conferences
/
InternaKonal
work
• MAKING
A
Difference
in
the
world!
Downsides
Remedy
(for
some)
Shij
work
Can
surf
during
the
week?!
HARD/Stressful
Off-­‐Kme
is
your
own!
Lack
of
respect
Humility
is
a
virtue
Limited
specialist
pathways
Established
&
Evolving
fields:
-­‐ Paediatric
EM
-­‐ Toxicology
Special
interest
gropus
-­‐ InternaKonal
EM
-­‐ Geriatric
EM
-­‐ Public
Health
EM

18. My
educaKon
Journey!
Born
in
Sri
Lanka
–
Paradise!!
Research
in
Sri
Lanka
“Learning
outside
the
box”
2006
2010
1997
1975
(13yo)
MBChB
Otago,
NZ
(22
yo)
Sri
Lanka
U
K
New
Zealand
Saudi
Oz
UK
USA
(16yo)
NZ
Oz
1st
Year
Uni
Psychology
World
Religions
Anthropology
T
s
u
n
a
m
i
PGY
14!!
Fun
Surgery
Emergency
Medicine
Research
FUN,
Adventure
&
Learning!
NZ

19. Part
Kme
ED
My
educaKon
Journey!
(cont..)
Emergency
Medicine
EducaKon
&
Research
InnovaKon
2016
2017
2015
2010
2011
PhD
gradua?on
“knowledge
transla?on”
Fellowship
exam
Sydney
POW
Swe
den
2013
Research:
Part
Kme
Research
2012
2014
Full
Kme
ED
Part
Kme
ED
Wollongong
-­‐
TWH
Res:Full
Kme
Sydney
-­‐
Locuming
in
Aus
2014:
ED
6/12,
Anes/ICU
6/12
2015:
PhD
3/12
ED
6/12,
Med
3/12

20. Why
I
chose
EM?
• Inspired
by
– “Many
Mentors”
– ImprovisaKon/CriKcal
thinking
(under
pressure)
– CreaKvity
&
spontaneity
– EM
is
the
“King
of
Simula?on”
• Type
of
work
– Diverse
range
of
clinical
contact
– Team
dynamics
– Procedures
/
resuscitaKon/
minor
surgery/
– Public
Health
&
psychological
health
– Systems/Research

22. Why
do
we
chose
a
career
path?
• InspiraKon
– Many
mentors
• Type
of
work
• Dreams
“Know
thyself”

23. It’s
good
to
know
your
plan
from
the
start,
But
someKmes….

24. “Life
is
what
happens
whilst
you
are
making
other
plans”

25. “Life
/
Work”
-­‐
balance
• Looking
ajer
ones
mental(emoKonal)
/
physical
and
social
health
• Compassionate
Health
EducaKon

26. My
Secret
• Follow
your
passions
• Be
“kind”
to
others
(paKents,
staff,
seniors,
juniors)
– And
YOURSELF
;
daily
• Know
Thyself
• Many
Mentors
– People
(in
and
out
of
medicine)
– Books
– Social
groups
/media
/
conferences

27. Compassionate
Health
EducaKon
• Psychological
Health?
• Depression?
• Burn
out?
Be part of a new evolving culture of
‘heart-centred’ clinicians,
“Be part of the change!!”
Why
not..
hhps://compassionatehealtheducaKon.wordpress.com

28. Summary
• EM
is
interes?ng/dynamic/inspiring!
• Find
many
mentors
• Know
thyself
– What
inspires
you
– Who
inspires
you
• EM
is
approx
8-­‐10
years
of
study
and
training
– Its
not
a
race,
but
do
finish!
• Oh,
one
more
thing….
– How
about
regularly
sparing
a
thought
for
“our
planet”…
and
the
peaceful
revolu,on?

30. Thank
you
for
invi.ng
me
J

31. Extra
Slides

32. Links
to
click
on!
hhps://bishansworld.wordpress.com/tag/
emergencymedicine/
hhp://lifeinthefastlane.com/alternaKve-­‐
emergency-­‐medicine-­‐training/
hhps://rxcreaKves.wordpress.com/
2014/10/01/fry-­‐day-­‐drama-­‐club-­‐meeKng-­‐2/
hhps://vimeo.com/50003925
hhps://www.researchgate.net/profile/Bishan_Rajapakse
hhp://journals.plos.org/plosone/arKcle?
id=10.1371/journal.pone.0079491
hhps://bishansworld.wordpress.com/tag/phd/
hhps://soundcloud.com/acousKc-­‐funkster

33. A
story
from
a
recent
arKcle
published
in
“the
Rounds”
(Our
local
hospital
newsleher
–
TWH).
Thanks
to
Ivana
Goluza
from
Research
Central
for
conducKng
this
interview!
Research
Central
ar?cle

34. Selected
Poems
submihed
to
the
ACEM
2012
conference
(Hobart)
HEADING
T H E A R T A N D S C I E N C E O F E M E R G E N C Y M E D I C I N E
AC EM
AUST
RALASAINCO
LLEGE FOR EM
ERGENCYMED
ICINE
A U S T R A L A S I A N C O L L E G E
FO R E M E R G E N C Y M E D I C I N E
ANNUAL SCIENTIFIC MEETING
The Hotel Grand Chancellor, Hobart
Monday 19 – Thursday 22 November 2012
INVITATION TO SUBMIT
It is with much pleasure that I invite delegates to submit
PROGRAM TOPICS
There have been a number of key developments in
Invitation
CALL FOR ABSTRACTS

35. Bishan
Rajapakse