Remote registrar ‘never felt more supported’

When a family member sent Dr Daniel Mastroianni and his wife a news article about a doctor shortage in regional New South Wales, it piqued his interest.
 
After emailing one of the clinics from the news, West Armidale Medical Centre, he discovered the practice was looking to take on a registrar for the Remote Supervision Program through the RACGP, to help address the local workforce issue.
 
Just over five months later and Dr Mastroianni is now the new remote supervision registrar at West Armidale Medical Centre, where he has ‘never felt more supported’.
 
‘The orientation has been fantastic,’ he told newsGP. ‘From the moment I first messaged [to apply for the registrar role] I have felt looked after.
 
‘The RACGP training team in New England have made me feel very welcomed, and my GP supervisor Dr Maree Puxty and her husband, Dr Terry Bohlsen, have both been excellent mentors and are exceptionally approachable.’
 
The initial days of Dr Mastroianni’s term were spent training in Tamworth with Dr Donna Quinn, the RACGP’s Senior Local Medical Educator and Head of Training for the New England Northwest area.
 
Dr Quinn welcomed the town securing placement of Dr Mastroianni and his supervisors when it was announced last month.
 
‘The fact that a registrar will be able to practise here with remote supervision means that the patients at the clinic can continue to access care, and that makes a huge difference for a community,’ she said.
 
‘It’s also extremely fortunate that the two supervisors who signed up to do the remote supervision used to own the practice and lived in Armidale for years, so they know the patients and community.’
 
The structure of a remote supervision placement with the RACGP involves a face-to-face orientation at the beginning of term with the remote supervisor onsite during this time.
 
During orientation they will get to know each other, plan the supervision and teaching, develop a ‘call for help’ list and get orientated to the community and other people/staff that are onsite at the practice. The orientation is followed by structured remote supervision time throughout the term.
 
Being a registrar in the program means Dr Mastroianni will usually be the only doctor onsite at the clinic, and instead of having his supervisor in the neighbouring room, they will instead be available remotely via telephone/videoconference.
 
‘As I am still relatively junior in my training, if I have a clinical question or require knowledge on local referral pathways I can contact Dr Puxty at any time,’ Dr Mastroianni said.
 
‘I am undeniably confident that I will continue to be supported for the rest of my term. I truly feel that the RACGP team … my supervisors, and all of the staff members at West Armidale Medical Centre have my best interests at heart.’
 
A general practice registrar on a composite training pathway – which requires completion of a
six-month term in the New England region – Dr Mastroianni says general practice has always been on his radar.
 
Dr Mastroianni was born in Melbourne into a ‘big Italian family’ who moved to Brisbane, where he completed his schooling and a Bachelor of Science at the University of Queensland. He then got into postgraduate medicine at the University of Notre Dame in Sydney, where he met his now wife, who is also a general practice registrar.
 
He feels fortunate they have both ended up working in the same town.
 
‘It would have been a gamble if both of us applied to large city hospitals in Sydney after medical school, so we applied to the HETI Direct Regional Program and both completed internship and residency at Gosford and Wyong Hospitals on the Central Coast,’ he said.
 
‘I then commenced my general practice training on the Central Coast in Terrigal at Complete Health at Crossways, before now moving to Armidale to continue my training.
 
‘My wife, Kris, also received a general practice training position in Armidale with Armajun Aboriginal Health Service so we’ve been able to move out here together.
 
‘It is an absolute privilege looking after people of all ages and stages of life with different backgrounds and a variety of medical issues. Not only this, but life in the hospital as a junior doctor was pretty rough and I wasn’t really able to strike the same work–life balance that I have now.’
 
As part of helping to tackle the remote, rural and regional GP shortage, remote supervision placement is expected to incentivise more GPs staying on to live in the community they trained in, with the registrars in the program’s pilot locations both staying on as GPs in the community after their training.
 
RACGP National Lead Medical Educator for remote supervision, Dr Jill Benson, recently told newsGP the ‘ultimate aim’ of supporting a registrar in a rural or remote location is that the registrar stays on after they have Fellowed.
 
Additionally, ‘remote supervision will allow the expertise of those GPs to continue to be utilised if they choose to remotely supervise registrars in their old practices,’ she said.
 
While Dr Mastroianni believes he has a found a good work–life balance in Armidale and feels very supported as a registrar, he remains unsure as to whether he will stay once training finishes.
 
‘Both [my wife] and I are definitely open to the idea, but there are many other factors outside of work that come into that equation,’ he said.
 
‘Regardless, we know that we’ll be spending more of our careers in regional/rural/remote Australia.
 
‘I like to think there’s far more to my life than medicine alone. I have a phenomenal wife, a big family and a beautiful Border Collie dog, and in my spare time I enjoy playing soccer, water-skiing, surfing, and playing alto saxophone.
 
‘General practice allows me to combine an exceptionally rewarding and mentally stimulating career with my life outside of work.’
 
The RACGP’s newly released Guidelines for remote supervision provide guidance for registrars, practices and supervisors in the program.
 
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