The following courses are considered entry-level for rural doctors in Australia
ALS – Advanced Life Support (Australian Resuscitation Council)
EMST / ATLS – Early Management of Severe Trauma / Advanced Trauma Life Support (College of Surgeons)
APLS – Advanced Paediatric Life Support
ELS – Emergency Life Support
RESP – Rural Emergency Skills Course (Rural Doctors Workforce Agency, South Australia)
REST – Rural Emergency Skills Training (ACRRM)
ALSO – Advanced Life Support Obstetrics
[Review from Dr Mandie Villis who attended REACT, Albany (WA) June 2015]
The Rural Emergency Assessment and Clinical Training (REACT) course is run by Rural Health West and is designed to assist WA GPs to maintain/improve their emergency knowledge and skills, and also assist in gaining credentialing with the WA country health service.
The two day course is jam packed, covering basic skills, basic life support, advanced life support and management of trauma. The course covers both adult and child scenarios. That’s a lot to cover!
The pre-course learning material is fantastic, with a really useful collection of videos on USB showing each skill in detail. There are also a couple of demonstration scenarios, which were great to watch. This will be a handy resource in the future to refresh my memory of emergency skills that I don’t use every day.
The REACT course is put together by Professor Tony Celenza, a FACEM from WA, and I loved that my course leader was a GP anaesthetist with extensive rural experience –Dr Scott Teasedale. The local element and rural GP focus was excellent, all of the scenarios felt very real and the challenges of our specific usual working locations were taken into account.
The best bit of the course? All the info was in the pre-course material, so during the weekend there were only 3 short lectures – the rest of the time was spent actually DOING stuff! The larger group (15) was split into 3 groups, so we had plenty of time with the instructors at each skill station. We each took at least 3 turns to manage a major scenario, including ALS, trauma and paediatrics. I really liked the supportive learning environment and the instructors were really friendly, which made the scenarios much more about fun and learning rather than fear!
Overall, I think this is an excellent entry level course for GPs heading rural (either on locums or permanently), or GPs who do occasional hospital work and are looking to refresh their skills. It is a little on the basic side for experienced rural docs who deal with emergencies regularly. I found myself wanting a surgical airway station and more complex scenarios, however the weekend was a fantastic learning experience and well worth my time and money!
Generally these courses are completed early in training – preferably before heading out to a rural area. Most are valid for 4 years and some can be re-certified on a shorter (and more advanced) refresher course.
However new concepts (such as those discussed in FOAMed) may take several years to filter down to these entry-level courses, although things are changing…slowly!
The following are considered more Advanced Courses
EMAC – Effective Management of Anaesthetic Crises
Useful course for GP-Anaesthetists, embracing high-fidelity simulation, human factors and anaesthetic crisis management. offered at several centres, see links below :
RACRM – Rural Anaesthetic Crises Resource Management
Designed specifically for rural anaesthetic teams, doctors and nurses, via Monash Sim
MOET – Managing Obstetric Emergencies & Trauma
Aimed at those with significant exposure to obstetrics (anaesthetists and obstetricians). The course specifies that is NOT SUITABLE for those less than senior registrar level
STAR – Specialised Training in Aeromedical Retrieval (RFDS Queensland)
Part of RFDS Queensland’s induction program for doctors embarking on aeromedical retrieval work. I attended this course in November 2013 at the excellent Queensland Emergency Services Combined Academy at Whyte Island, Brisbane – read the review HERE
ETM – Emergency Trauma Management
Recognising the deficits in EMST for trauma management, Andy Buck’s team have developed a course embracing FOAMed resources for the emergency physician and experienced rural clinician. Read a review here or visit the ETMcourse website.
In contrast to EMST-ATLS, the ETMCourse offers high-repetition simulation cases, of increasing complexity incorporating latest FOAMed concepts delivered by a credible and experienced Faculty. Scenarios also focus on critical decision-making under pressure and team dynamics – a mix of the best bits of EMAC and EMST.
I would recommend this as the most useful course for rural doctors who manage trauma
Critically Ill Airway (CIA) course
This is a CICM approved course for airway management relevant to critical care – whether in austere or in the ED or ICU. Held at The Alfred in Melbourne, the CIA course offers a credible faculty and plenty f hands on, infused with FOAMed and in situ simulation. Recommended for rural doctors, intensivists, EM physicians and so on.
Whilst these courses are excellent, they are aimed at particular clinical arenas (anaesthetics, obstetrics, retrieval, emergency). In late 2013 we ran in inaugural ‘Masterclass in Rural Medicine’ on Kangaroo Island with 24 delegates from around Australia with interesting speakers and interactive skills stations across the fields of emergency, obstetrics, anaesthetics & surgery as relevant to rural doctors. Read a review from KIDocs here and a review from Nomadic GP here. The RDASA now continue to include elements of such a ‘masterclass’ as part of their annual conference, to offer relevant upskilling alternatives to courses delivered by other organisations or metro-centric. Watch this space!