Northern Territory General Practice Education 2020 GP Registrar of the Year, Dr Aly Knell, became captivated by the NT working as a tour guide in the Alice Springs region.
As someone who enjoyed the outdoors and was always interested in studying medicine, Aly was keen to combine aspects of the two by training to be a rural and remote general practitioner.
Originally hailing from Renmark, South Australia, Aly originally thought about doing medicine when she was in high school.
“My dad’s a rural GP, so I’ve always been exposed to and interested in medicine, but I decided to initially study in a completely different area.
“Then when I moved to Alice Springs, I fell in love with the NT – the lifestyle, the country, camping out bush, and the friendly people.
“I learnt a lot through my tour guide job about Indigenous culture, and through that learnt about the health inequalities and poor health outcomes that Indigenous people faced.
“I also worked for a while at the Centre for Remote Health in research. So, I did all that and then decided to do medicine, going into it with a different motivation than when I had considered it before.”
Aly chose to complete her final two years of medical school in the NT, which included placements in rural and remote centres across the Top End.
Following a couple of years as a junior doctor at Royal Darwin Hospital, Aly was accepted to train as a GP with the Australian College for Rural and Remote Medicine.
Since then, she has completed her emergency medicine certificate, a six-month term in Wurrumiyanga on the Tiwi Islands, advanced skills training in anaesthetics, and is now awaiting her fellowship after finishing her final year of training in Katherine.
“All my placements have been useful steps along the way to becoming a rural or remote GP,” Aly said. “But the first one, which was truly a highlight, was when I first got out of the hospital system as a medical student and did a community placement in Nhulunbuy,” Aly said.
“I did a few days’ placement with Laynhapuy Aboriginal Community Controlled Health Services doing outreach clinics, where I got to experience super interesting remote medicine combined with the outdoor aspects of packing a troop carrier with medical supplies and four-wheel-driving into work,” Aly said.
“It was the exact type of job I had envisaged doing when I first thought about starting medicine.
“My placement in the remote clinic on the Tiwi Islands was also much cherished, as it was my first long-term remote experience as a graduated doctor. Being immersed in the community and being welcomed by local staff and patients was a real privilege.”
Aly now works as a GP in Katherine with her husband, who she met while tour guiding, and their three-year-old identical twin girls.
“The job I’m doing now in Katherine is the job I always envisaged doing when I started medical school, and that is being a rural GP working out bush, also doing part-time procedural work,” she said.
“It’s great living in a small town with good access to camping and four-wheel driving – I love the Territory.”
Aly said that although she’s enjoyed most specialties she’s encountered during her placements so far, rural and remote general practice offered the ability to have a broad range of skills and knowledge.
“Days can range from cases managing chronic disease, to doing a surgical procedure, to resuscitations in very sick patients,” Aly said.
“There is no career quite like rural generalism. You have the chance to have an impact on people’s lives as both their primary health care provider, as well as treating their acute illness in hospital or providing anaesthetic services if they need an operation,” Aly said.
“I think doctors practising in remote areas need to be organised, proactive, willing to learn, and have good problem-solving skills. They also should be adaptable when things don’t go according to plan, and willing to ask for help when its needed.”
The challenges Aly has faced along her path to becoming a general practitioner have evolved throughout her career, from fitting in study and part-time work as a medical student, to juggling shift work as a junior doctor.
“At times, it’s been challenging to study for GP exams while working full time and having a young family, while at the same time starting to practice as an independent doctor,” Aly said.
“For me, overcoming these challenges has involved having support from family and colleagues, being organised, and taking some time out to do the things I enjoy.”
From working in an urban-based clinic, to being based in a remote community, to living in a small town and combining hospital and community work, Aly said being a GP in the Northern Territory can be whatever you want it to be.
“The opportunity for varied and interesting medicine here in the NT is second to none, with presentations including tropical medicine and conditions not ever seen down South,” Aly said.
“As a rural/remote GP, your day can jump from a consult for chronic disease management, to seeing a septic child who requires urgent management, to a women’s health check, to an abscess drainage, and then an unconscious trauma patient – all in one morning!
“Being able to master a new skill such as cannulating a newborn baby or doing an epidural – things that looked so difficult the first time you saw them being done – is very rewarding.
“For anyone who has any interest in Indigenous health or rural work, the NT has to be one of the best places to train in Australia.”
Aly said NTGPE had been instrumental in her training to become a GP, assisting with organising all of her placements.
“They’ve provided lots of support when I’ve done rural placements such as on the Tiwi Islands, providing accommodation and the logistics of moving over there and back again,” she said.
“They really go the extra mile to provide the support you need.”
Aly believes that one of the best aspects of her job is working across the hospital and community to ensure continuity of care for patients.
“For example, when I was doing primary care in a small remote community, I was seeing a lot of antenatal patients on a semi-regular basis, every few weeks for their antenatal care,” she said.
“Then they would come to Katherine to birth in the hospital, and sometimes I happened to be on anaesthetics in the hospital on the day when they needed an epidural or caesarean, so I’d be there for that as well.
“Then following up, you get to see them and their baby for their six-week check, and I really love having those kinds of relationships when you don’t just see them as a once-off.”
Aly said she was surprised when she was named GP Registrar of the Year, but thrilled to be recognised for her dedication.
“I think I received the award because I am passionate and committed about working in the Territory, and working with rural and remote patients,” she said.
“I was very honoured to receive it. I always strive to have a high standard in my medical studies and career, so I was proud, humbled, and over the moon when I heard.
“I hope I can use it to encourage more people to do rural and remote medicine, or use it to do something positive in the community.”