Indescribably and memorably, the best 7 weeks of my Life!
Advice/stories of my medical placement in Cairns [LONG blog entry] in June-July 2012.
My 2 weeks in Brisbane, Sunshine Coast/Noosa, Gold Coast and Sydney is another story.
Initial Aims - Why Cairns?
Cairns is a small city on the east coast of Far
North of Queensland, Australia, with a population of approximately 150,000. The city has such an outdoorsy and sporty
vibe, and is the most popular city for tourists wanting to experience the Great
Barrier Reef, a tropical climate, and adrenaline activities. North Australia is warmer than the South in
the Winter. Cairns experiences
temperatures of 20-26 C, no humidity, little rain, blue skies and sun in
June-August. It was a safe and welcoming
city for an active, lone female traveller, who could easily meet the likes of
other elective/hospital students and backpackers. Cairns also has Aboriginal inhabitants and
nearby villages/communities, and I wanted to witness the differences in
healthcare services and issues.
I'm admittedly the adrenaline-junkie, active, outdoorsy type, who loves the thrill of socialising and meeting new people. I wanted to sky dive, scuba dive, bungee jump, water raft, surf,... and be a local. This was the perfect place for all my agendas. My weekends were full-up, and I did go to placement.
Along the Esplanade (a long stretch on the coast) is literally physically active. Free
sessions of Pilates, Yoga, Zumba, (coached) volleyball on sand pits,
BodyFit/Bootcamp, Boxing Fun, bouldering, Aqua Aerobics, VPR,
skateboard area,... the swimming pool/lagoon ! The Zumba was
amazing - held in a park and easily about 150-200 people doing it
altogether: men, women, children, tourists... such a brilliant
atmosphere, no one is laughing at you, but laughing altogether! Numerous people jogging and cycling. Really can't fault the 'active' scene.Perfect weather: apparently I brought the sunshine when I arrived. The previous 2 weeks had been rainy. But my weeks there were blue skies, sun shine, warm... perfect British Summer weather. Not humid at all. This is their winter and it was bliss!
Why this placement?
My aims included gaining hands-on experience in a whole range of medical conditions in hospital and community Non-Aboriginal and Aboriginal settings. General Medicine seemed an appropriate specialty choice, providing me much freedom and range of clinical cases and experiences.
I applied via James Cook University to work at
Cairns Base Hospital. The hospital is
Tropical North Queensland’s major referral centre and its major provider of
specialist hospital and community (outreach to remote and rural areas) services, with a capacity of 491 beds. I applied in July 2011, and my placement commenced in June 2012. You need to arrange almost a year in advance with medical electives in Australia.
Admin fee was £64.58
Placement fee (4-8 weeks) £301.57
When I arrived, the registrar I spoke to was in General Medicine/Endocrinology. Despite not having an interest in Endocrinology as such, I just got a good vibe off him... so agreed with General Medicine with Endocrinology, and then met the team... and I was on a win. [I didn't see that registrar again though! He went on holiday... for a long time.] But my team: another registrar and 2 house officers - I loved them. They were super nice, chilled, easy-going, smiley ... and 'cruisey', a word I picked up. I had an aim of not being a 'medical student' nor a 'come-and-go-person' on my elective, but I don't think I quite broke that barrier (always going to be there) but am glad we managed to take photos, go eat out together and still be in contact with them.
We had coffee and cake almost every day - midway through ward rounds. Needless to say, I made them cake too - the Mango Napoleon. There are other medical students from JCU there too. I met a few of them and went for meals/nightout. They were lovely people too. There were 2 Newcastle medical students joining my second week in. They coincidentally lived in the same apartment/complex as me too, and they were muchos fun...and lovely too. (Met too many 'lovelies'.) I met some great and really sound physiotherapy students from Brisbane/Gold Coast (through the accommodation) who were doing a placement at the hospital too. With my team, we attended to and followed up patients in the Emergency Department, 6 floor levels of wards, Intensive Care Unit, Coronary Care Unit and Women’s Health. I also attended Endocrinology and General Medicine clinics in the hospital and Community Health Centre (381 Sheridan Street), and Outreach clinics in Innisfail (2 hr drive, in consultants' car) and Yarrabah (1.5 hr drive). I missed out majorly apparently on a Wuuchoppren outreach. The consultant said the day before that he'll pick me up from a Community Health Centre, which was 35 minutes walk from my accommodation... and he forgot me. When I went to find him, he said, "Oh so sorry. I forgot. Oh, you missed out. It was the best Indigenous Gnereal Clinic I have ever done. The best. Saw everything. Oh sorry... you really missed out." Hm. I spent that day at the Health Centre in a paediatrics diabetes clinic.
Regarding the Outreach clinics though, Yarrabah was the only Outreach consisting of entirely Aboriginal patients. I was told to expect the Indigenous communities and health services to be ‘Third World’ within ‘First World’ Australia. This was definitely not witnessed from my (limited) experiences. The centres were well-equipped/financed and clean. Patients wore clean clothes and were respectful (although in Cairns Base Hospital, I cam across a few not so agreeable patients). I was told Wuchoppren and Aurukun are ‘more Indigenous’. An overnight Outreach trip to Aurukun, very north of Queensland, would have been a great opportunity, however as it required flying and overnight accommodation, I could not be accommodated on the private plane, neither could I afford to self-fund if I had the option.
Other teaching opportunities:
- Tuesday morning General Medicine teaching to Interns (UK equivalent to F1s).
Tuesday lunchtime teaching to Interns: presented by interns. FREE LUNCH! - Thursday lunchtime: Endocrinology team teaching. No free lunch.
Thursday lunchtime teaching to Interns. FREE LUNCH! - Friday Professional Grand Round. FREE LUNCH!
Summary of the medical placement, I saw everything pretty much. Indeed General Medicine. Awesome team. Lots of free time/flexibility. Lovely hospital - on the Esplanade.
My Two-Cents about Cairns
Flight: LONG! I had to get the train to London airport (3.5 hours). Wait around. London to Singapore to Sydney to Cairns. Departure from London was Saturday 9pm UK time, and arrived in Cairns Monday 12pm AUS time : 26 hours according to the itinerary of flight and transfers time. It wasn't that bad though.
Social: You'll make new friends every day. Lots of backpackers, students, young people touristing or with working visas... can't go wrong. Everyone was just really friendly and outgoing. Not one moment did I feel lonely, it was actually the other end of the spectrum! Through volleyball, bouldering, skydiving, scuba diving, bungee jumping, etc., despite going by myself, I made new friends there who I hung out with later. It was also nice to know that I had a luxurious (one of the cheapest in Cairns) apartment to return to and just chill and kick-back.
Alcohol/Clubbing/Pubs/Bars: I only went clubbing ONCE in Cairns (Gilligan's) and that was on my very final night in Cairns with some other medical students, where we stayed out until 3.30am, then I got a 5am flight to Brisbane! I went for social drinks. Pier Bar, Rattle & Hum, and The Courthouse were nice. Checked out Woolshed and O Paddy's, but went home with my housemates at 10.30 or midnight. Main backpacker's areas are Gilligan's and Woolshed - lots of freebies, competitions (I won a free diving trip in a raffle), discounts, vouchers, cheap drinks. There was an air guitar competition for a diving trip worth £500. Shame I was wearing a denim mini-skirt, otherwise I would have been all over it.
I got into my wine during the whole Australia trip. Just chilling in good company. Mind, I bought a £2.50-3 bottle of red wine... and it was genuinely really good, and was from the off-license 'One Stop' (Grafton St). So now I quite like my Australian wine.
Australians don't drink Foster's. They don't have it (rare). 'XX' is probably their equivalent.
Coles and Woolworths are equally priced supermarkets. (I did sadly go to both shops and note down and compare the prices.) They are like Tescos. They have 'Tesco Value' stuff. Food in Australia IS NOT that more expensive than UK. Bread is though... and some dairy stuff. They have ever changing offers and discounts. Also there's Rusty's market - super cheap! I only ate out 3-4 times, so I hardly spent much on food (budgeting).
BBQs are big in Australia. Lots of free BBQ cookers along the Esplanade. It is a man's job.
Tim Tams. I ate 10 packets of 9 biscuits in 5 days (They were on
offer!! Like £1 a package). Addictive. Think I bought a total of
about 30 packets...and consumed about 20 of them in 5 weeks. Managed to bring 5
back to England. Think of penguins - but beyond penguins. The Tim Tam Slam
- nibble the ends of the biscuit and then suck up a hot drink (hot
milk/tea/coffee) like a straw and it melts heavenly in your mouth. An experience one should have. [Double Choc Caramel displayed.] There are 9 different flavours of which all have entered my tum.
Think it's an over-exaggerated perception that Australia is more expensive. Certainly in Queensland it is not the case. Sydney (major/capital cities) are definitely going to be more expensive, as London is. You just have to do the research and know where to shop. UK has it's expensive supermarkets like Waitrose and M&S afterall.
Transport is really good and not expensive at all either - bus and train pricing (taking distance into terms) is similar to England. You can hire a car and drive around quite easily too (drives on same side of the road and accepts UK driving license), but you can easily get around Cairns on foot or bike. I walked everywhere. Hiring bikes is really cheap. Most tour activities picked you up from your accommodation.
Mobile: I got a pre-paid SIM card from Woolworths. 5GB 3G connection (so important!) and 1000 mins and 1000 texts for 7 weeks for ~£30. I didn't even manage to use half the quota, even with some international calls. There was a package for half that too.
Planking: I did not witness anyone (else) doing it. Think it's a bit out of fashion.
Being a girl appeared to have its advantages. Putting it simply, sweet-talk/flirting to get favours, discounts, freebies, attention etc. Quite incapable of doing that and only capable of friendly banter, there were countless opportunities and I certainly saw lots of it. It is a youthful touristy city and turnover rates of people/tourists/backpackers are quite high. Just sharing. It was simply an eye-opener ... real world perhaps. You're definitely more approachable as an individual or lone female traveler.
In Australia, everyone likes openness, friendliness and light-hearted banter. It's the culture. On all of my touristy escapades, I would mingle with other tourists and the staff, joke about, share stories/opinions, help, etc. It really made the experiences more fun and memorable. A thing I noticed - there's a difference between 'nice' and 'friendly', I prefer the latter.
Another thing I noticed in Australia is that they just seemed more generous and not stingy at all. No offense, but Britain is a bit stingy... especially amongst the student population. The strangers/new friends/housemates (also students) just readily offered a hand: free rides, food, accommodation, going out of their way,... a nurse I just met for 2 minutes gave me a big load of fresh frozen mango the next morning after I was just casually asking the staff during lunchtime where I could find mangoes after scouring everywhere and failing [Since it wasn't the season, there were no mangoes available at all. Mango Puree was a rarity... managed to find a tin in an Indian shop in Brisbane and Sydney later along my journeys.] Generosity without expecting something back is not a common personality attribute nowadays, and I have always wanted to stumble upon more of those, so the generosity was something I aimed to bring back and share with England...
that and the cruisey-spirit, approachable-friendliness, ...and the few packets of Tim Tams that survived.
That said, I think being in a new place is like 'Freshers' again : you become more bright-eyed, eager and pro-active to make new friends. Once you've settled in a place and have your set of friends, you 'settle' and unconsciously adopt an unapproachable body language. Having always been certain of the city of where I wanted my first job as a doctor to be, I came back re-considering. I also came back from electives having formed a special interest and actually wanting to intercalate... but as that was too late, I can only say now 'I wish I intercalated'.Cultural diversity I had heard of some 'dislike' towards SE Asians and Aboriginals in Australia. The former because there's been a tremendous influx of them and their businesses. The main complaint being that some don't learn English and have manners, which are considered 'bad manners' in the 'Western world', but the norm in some parts of Asia. I hardly saw SE Asians in Cairns: 3 doctors in the hospital, a handful of SE Asian tourists strolling about... I hadn't made a 'friend' in Cairns who was SE Asian actually. Brisbane: Reasonable amount. Gold Coast - I didn't see many. Sydney was where I understood. There were many areas where it was entirely SE Asian. The population overall in Queensland seemed predominately Caucasian, whereas NSW (esp Sydney) was more multicultural.
Muscles on girls : A bit of a tongue-in-cheek sub-header. But muscles and (quote) 'an outdoorsy glow' on girls are positive attributes in Australia (the generally discouraged attributes in SE Asia culture). I felt right at home =)
Accommodation: I've attached the table I made of all the accommodation in Cairns 2012. I recommend staying at a long-stay accommodation like Cairns Sharehouse or Red Key which are both close to the hospital. NOT Gilligan's and those party Hostels - they're more expensive, loud (you want sleep for placement) and were further from the hospital. I will go back to Cairns Sharehouse any day, any time. Like-minded students and workers from Australia and abroad stay there. I stayed at the Martyn Complex: clean, double bed, ceiling fan, personal outside garden space, (small) swimming pool, BBQ, 2 bathrooms, kitchen lounge, own little TV/DVD player in bedroom, 6 people to an apartment. My housemates were unbelievably sound: from Newcastle UK, Gold Coast and Brisbane. I ended up staying at theirs and hanging out with them when I went down the coast (Brisbane & Gold Coast). Fate is an amazing coincidence.
Slang:
Thongs = Flip Flops.
Bogan = Chav.
Pommies = English
Ozzies = Australians
Kiwis = New Zealand-ers
[I'll remember more later]
Started to say 'Good Day!' and 'Mate'.
Organizing Touristy stuff
Do it there and then when you are in Cairns and have settled. There are always lots of offers and hostels often do 10% off tour bookings. If you're a 'local' you get 20% off (general tourism). I waved my swipe medical card, and got offered a discounted trip. Didn't work another time. Hit and try.
I did most of mine through a tourist agency as you can haggle. I've never haggled before... yet managed to (woop!). You can create your own packages and it always ended up being the cheapest option. Literally I went to every tourist agency and compared prices (a lot of time invested) and Happy Travels on Abbott Street were great. I was told about 'Wicked Travels' but didn't get as good of a vibe and attention/help as I did from Happy Travels (the main guy who helped me was from Cardiff). I think by the end of my Cairns trip, they maybe got fed up of me as I would always have found a better offer on the internet or something which they had to then try to beat ;) I don't like being cheated. Every dollar brings me a step closer to cake/good food.
Things I did:
- Bungee Jump : Did 2 jumps; satisfied by Jump 2 - Running off the roof. I befriended a English guy there (now a Leeds Fresher) who gave me a 'Free 2nd jump' voucher.
- Sky Dive : Cairns (Innisfail): There's the choice of landing in the Park or on the Beach. Both offer stunning views. Must do the 14 000 ft. Worth every penny. (Another location is Mission Beach which is further away though and a bit more expensive)
- Atherton/Tableland Waterfalls: Swimming in waterfalls, including Peter Andre's Mysterious Girl Milla Milla Falls. Rock jumping/sliding. Super cold yet refreshing and fun. There are 3 companies doing tours $105, $88 and $48/55. They always advertise the 2 more expensive one's (Uncle Brian's & Barefoot Tours) which are also highly rated, but the cheapest one seemed to be similar and not had a bad review! I had 3 people wanting to go with, so we decided to hire a car for the day and go around by ourselves.
- Scuba Dive trip : see below.
- Kuranda : zoo, skyrail/cable car, Aboriginal culture/dance show, rainforests, feeding kangaroos. Found a cheaper deal on the internet than the ones in the brouchures.
- Palm Cove Beach: Just hopped on a bus (Cairns doesn't have a beachy sandy coastline by the way), 20 minutes, on a reputable beach.
- Tully River White Water Rafting
- Port Douglas: 4 mile beach, scuba dive, snorkel,
- Quad biking in Daintree Rainforest (I chose to go on an Outreach trip instead...)
Diving
There are the following companies if you want a PADI, from most expensive/reputable: Prodive, Diver's Den, Deep Down Under, Cairns Diving Centre. I visited all these shops to check out their vibe.
I went with ProDive in the end because they discounted AUS $100 off their 5 day (2 classroom, 3 liveaboard) trips (usually about AUS $850/£540 ... inclusive of all meals, drinks, accommodation, teachings, transport, equipment, tax/insurance/levy) ...and were just £20 GBP more expensive than the next option. Everyone kept on highly rating and raving about them too. I split mine PADI course between 2 weekends as I wanted to still go to placement.
I wouldn't RAVE about ProDive to be honest - unfortunately 1-2 staff were really 'sell-sell-sell', 'really-don't care-about-your-safety-but-just-for-your-money.' =/ The diving itself was fantastic. I had a great diving buddy too. My instructor on the second weekend/diving weekend was nice (and much better). Food was plentiful and yummy. You meet people from all over the world. 9 dives including a night dive with just a torch. Diving is surprisingly tiring! Saw turtles, sting rays, sharks (friendly ones), Finding Nemo, etc.
I later did a Day Reef Trip with Cairns Diving Centre (the cheapest), and couldn't fault it either. Just maybe has a higher ratio of people:instructors, so if you're the panicky or slow-learner type, you might want to favour the companies that will give you more attention.
The weekend I did my PADI dives, the water surface were SUPER rocky and choppy, and the weather was rainy and windy cold, whereas the weekend before that it was calm and my friend got sunburned. You do have to be a confident swimmer. The Day Trip on shallower reefs was calm.
My advice is just to go around these places (there's loads of companies if you already have your PADI), talk to them, see what vibe you get and what offers they have. There are Day trips (no PADI qualification or Medical needed), 4 day, and 5 day trips offering diving and snorkeling. Snorkeling IS harder. The journey there was SUPER rocky (literally 90 degrees rock), so do take your sea-sickness tablets and SIT OUTSIDE! (I was fine...just about.) You may get ear pain from constant/repetitive equalizing of your ears. Some people are born to be able to easily equalise. I think I had the sensation of water in my ears for a good week afterwards.... alongside sea-legs!
There are so many islands near Cairns that you can go to for snorkelling trips: Fitzroy, Green, etc. Quite cheap. Just go into a tourist shop for brochures/pictures.
The Great Barrier Reef is simply stunning.
Breakdown of costs - The Basics
- Placement fees: £365
- Flights £850 for 3 trips [[London-(Singapore-Sydney)-Cairns]] [[Sydney-Hong Kong]] [[Hong Kong- London]]
Cairns-Brisbane £90-100
Gold Coast to Sydney ~£45-50
[Use http://www.webjet.com.au/flights as it reliably compares both JetStar, Qantas, Virgin.] - Accommodation ~£550
- Visa: "at your own discretion." Free E-visitor - OR - Visitor Visa Subclass 676 (need CXR/medical done privately in UK ~£300)
Social/institutional/culture difference
The universal Australian health care system, hospital,
life as a doctor and social culture are very similar to the UK. The Australian health care system ‘Medicare’
includes both private and government institutions.
Australia was ‘discovered’ or invaded by Captain Cook and
the Europeans in 1788, and the differences of culture, economics, social
manners, and religion resulted in “culture clash, culture conflict and culture
shock”, leading to the oppression of the Aboriginal people. In 2008, the government made a formal apology
to the Aboriginal people for the wrongs, but the on-going process of reconciliation
has not been easy. The predominant Indigenous health problems presented during
this elective included alcoholism and type 2 diabetes.
Those from Torres Strait Island are called ‘Torres Strait
Islanders’ people, and those not from there are called ‘Indigenous’
people. ‘Aboriginal’ can be used to term
either communities. Some TSIs may be
sensitive, if (wrongly) termed ‘Indigenous’.
Summary/Reflection/Last two-cents
Going to the other side of the world alone does demand self-efficiency, organisation, maturity, courage
and mental, emotional and physical stamina. I still remember my first day - 'lost' and overwhelmed. I constantly put myself out there, being outgoing (it did get tiring) and bantering with doctors, students and strangers. I formed some amazing friendships (thankful for Facebook in these circumstances), had the
most unforgettably indescribable experiences (especially down the coast), and made the most out of every
given opportunity, time and situation - I didn't waste any.
The people made the place and I could not be any more appreciative. I gratefully and greatly thank my parents for all their hard work to be able to fund me. Sadly, money can/does open opportunities.
Most students treat medical electives 'as a holiday'. A minority treat it 'seriously as a placement'. I took it more as an opportunity to challenge myself to fit in as a local, get the real deal of what it'd be like to live/work there. Not that I definitely have Australia on the cards in the future
(although I never say never)
but it is just how I treat traveling in general. There is the quote:
"The traveler sees what he sees, the tourist sees what he has come to see." - Gilbert K Chesterton.
I had a lot of eye-openers... and I do believe that traveling (especially alone) really matures you culturally and as a person.
I still miss Cairns.
