There is a plethora of courses out there for rural doctors – the vast majority of which are useful…but are not cutting edge nor flexible enough to embrace FOAMed concepts and teach them until those changes or concepts have been endorsed by State or National bodies.
So whilst course like EMST, APLS, ALSO, ELS, REST (or RESP in South Australia) make up a minimum standard, there is a need for a rural doctor masterclass.
Many of us get annual upskilling – whether by clinical attachment or attendance at workshops or short two-day procedural workshops. But of course these are generally mentored by city specialists – no doubt on the top of their game in their environment – but not always aware of the needs of the rural proceduralist.
This was brought home to me in 2012 on an annual anaesthetic upskilling conference, where one of my colleagues asked both FANZCA and FACEM facilitators about “apnoeic diffusion oxygenation” and “delayed sequence intubation” – concepts that many were discussing in 2012 after the Weingart & Levitan paper.vSadly none of the anaesthetists were aware of these…which is a shame as they are highly useful tools for the rural doctor faced with a dynamic evolving airway.
Similarly on a recent RESP course in 2013, aimed as the standard required for credentialling in SA rural hospitals, attending doctors were instructed in how to deliver CPAP. Country hospital nursing staff are also trained by annual updates. So it was a surprise to be called into hospital as the clinical team on call were not familiar with how to use the Oxylog for CPAP despite being “trained” less than a fortnight prior.
These sort of events cemented my (and others) desire for a ‘masterclass’ aimed at the rural doctor.