Future Focus: John Awad

John Awad, a final year medical student at James Cook University, Townsville, recently completed two electives at the Royal Victorian Eye and Ear Hospital (RVEEH) in Melbourne, and the Wesley Private Hospital in Brisbane. 

These two electives provided John with exposure to the different health systems between states, as well as highlighting the differences between public and private hospitals in Australia.

Royal Victorian Eye and Ear Hospital, Melbourne

Given the limited time spent on ophthalmology during the medical degree, the opportunity to spend 4 weeks at RVEEH was nothing short of fascinating. As a specialist area of medicine, ophthalmology is often perceived as out-of-reach, so experiencing this access to it was very beneficial to my learning, as well as my clinical skills. During my placement, I was able to achieve and exceed the objectives I had set for myself. This is due to a combination of a busy timetable and the willingness of the staff at RVEEH to be involved in my teaching. Perhaps the most useful experience from my learning was my time in the emergency department. In Victoria, RVEEH is the central location where patient referrals from optometrists and general practitioners for eye concerns are directed to. This is owing to the small size of the state, and the concentrated population in metropolitan Melbourne. In the emergency department I was able to conduct examinations on a combination of simple and complex ophthalmological presentations under the supervision of registrars and consultants training in the field.

Hands-on experience

Many memorable cases from my time at RVEEH are worth reflecting on, however, most notable is a case that I was allowed to treat independently, with the supervision of the attending consultant. A 19-year-old man (he/him) presented to the emergency department with a foreign object in his right eye. The patient described feeling the object enter his eye while working with concrete during his job as an apprentice builder. Immediately I was concerned about the alkaline nature of wet concrete and the impact it could have on the integrity of his cornea, and ultimately his vision. As such, I quickly proceeded to use a pH indicator to ascertain the nature of the foreign object. This was followed by a slit lamp examination with the use of fluorescein dye to identify any corneal damage secondary to wet concrete being lodged in his eye. Thankfully the patient’s overall eye condition was acceptable, with only minor grazing in the cornea. This allowed me to remove the foreign object under local anaesthesia and organise a follow-up via the acute ophthalmology service (AOS) clinic, to ensure no further damage ensues from this incident. As a future intern, with presentations like this likely to occur within my practice, I was pleased with my ability to handle this patient from beginning to end. Further, I was able to examine the objectives I have set out in the proposal prior to my clinical elective, whereby I highlighted the importance of achieving eye skills that can be replicated in my future practice as a doctor. Moreover, given my recent offer of internship at Eastern Health in Victoria, I am thankful to have been exposed to the Victorian health system in my clinical elective - a system that works quite differently from Queensland, with more centralised services in Melbourne, as opposed to the many capable centres in the regions of Queensland.

Wesley Private Hospital, Brisbane

My elective at Wesley Private Hospital further deepened my aspirations to establish a career in obstetrics and gynaecology. As an area of consistent need, I often find myself gravitating towards this field, as evidenced by my on-going research in preventing post-menopausal UTIs, as well as improving access to cervical cancer screening in transgender and gender-diverse individuals. Throughout this elective I spent considerable time allocated to theatre lists with a variety of consultants, including a week in the birthing unit, as well as with specialists in the field of fertility medicine that I have not previously experienced. During this time I received mentorship from many senior specialists, forming lasting connections that I will continue to nurture throughout my specialty training and beyond. The most memorable week for me was with the head practitioner for Monash IVF at the Wesley. Serving as part of the queer division of the Australian Medical Student Association (QAMSA), I participated in the formulation of the LGBTQIA+SB queer curriculum review, during which I was part of consultations with peak-body groups, many of which were quite vocal about the reproductive rights of individuals within this community. As such, my experience in IVF was valuable in giving me an insight into the processes involved in fertility planning for same-sex couples, including access to donor eggs or sperm, as well as the laws surrounding surrogacy in Australia. Much of my experience was later incorporated into the curriculum review, and will be part of my future advocacy in the space of queer health throughout my career as a medical practitioner.

Delivering babies

As for my clinical skills, this elective has provided me with an unprecedented level of independence, given the lack of clinical hierarchy in private hospitals. At the Wesley, I was able to assist in the caesarean delivery of five babies, with an opportunity to assist in suturing the uterus and abdomen following the delivery in an emergency caesarean. Additionally, during my time at the birthing unit I was able to participate in more than 10 vaginal deliveries, whilst also shadowing midwives and obstetricians in a different environment to that of my home clinical school. The independence in clinical decision making, and the training opportunities that are often rightfully given exclusively to registrars, accelerated my skills in this area of medicine, and my interest in a life-long career in obstetrics and gynaecology.

Developed exclusively for medical and dental students, each year the BOQ Specialist FutureFocus grants provide students with the opportunity to undertake an elective so that their commitment to helping others can be realised. Applications for our FutureFocus Grant open in May and close in August. 

You can also access funds to help undertake an overseas placement, with our Student Banking Package.