From working 24 hours a day saving lives in the Amazon, to now leading regional medical services in the Northern Territory, Dr Marco Briceno’s story is one of adventure, passion, and education.
Based in Nhulunbuy, Marco’s skills mean he is a man in demand – a rural generalist surgeon, a supervisor with Northern Territory General Practice Education (NTGPE) and Flinders University, the Director of Clinical Training and Education for the East Arnhem region, Director of Medical Services at Gove District Hospital, and now in charge of establishing the formal Rural Generalist Training pathway in the Territory.
Marco’s journey began in his native Venezuela, completing medical school, working in the city, and then being exposed to Indigenous health through a stint delivering remote health care to Amazonian tribes.
“One thing I really liked about working in the Amazon was practising medicine for people who really needed our help. We had to become very resourceful and skilled to cover the breadth of things that came our way,” said Marco.
“One of the things that surprised me when I first arrived in Nhulunbuy was that we had similar health challenges as in the Amazon, but had first-world resources to meet those challenges.
“I had specialists who supported me, and I was blown away by the quality of doctors and nurses in such a remote location!.
“I’ve worked around the world, in England, Wales, Spain, Venezuela, and Colombia, and I also have strong links with the USA, but I’ve never met more capable, resourceful, passionate, and committed colleagues than the ones I have met here over the years.”
A Member of the Royal College of Surgeons in England, Marco first arrived in the Territory with his wife in 2008, intending to enjoy a six-month adventure before a return to Europe. That was 12 years ago.
After a few years, Marco decided to formalise his interest in rural and remote medicine, joining the ACRRM training program to commit to a rural generalist career.
“There was a time when I thought ‘Am I giving away the prestige of being a specialist in a big university hospital to be a rural generalist?’,” he said.
“So, I decided that I would infuse my passion for excellence into rural generalist work, and nowadays I’m an Associate Professor of Rural Generalist Medicine at Flinders University, the regional Director of Medical Services, and now the Director of Rural Generalist training for the NT.
“I’m still a clinician, living the dream in Nhulunbuy, and raising my kids in a beautiful community.
“My children get exposed to a strong Indigenous culture in this region, and they’re not missing out on anything. For me, it’s a fantastic journey and I’m doing what I love. I’m being recognised and remunerated well, and I’ve got job satisfaction from what I do for a living.
“I’ve got work-life balance, and I’ve not seen any barriers from me progressing in my career as a Rural Generalist, as a Medical Educator or as a Medical Administrator. I am not in a lesser position than my surgeon colleagues, and that is very important to me.”
At the heart of Marco’s drive for better health care is medical education and rural generalist training.
“I am very, very passionate about the training of the next generation of doctors, but more than that, my passion really lies in raising the profile of general practice and rural generalists to the level of any other specialty,” Marco said.
“I want to make sure that contemporary standards are adapted and applied in remote medicine.
“Through my role as a NTGPE supervisor and other educational roles, I have had the opportunity to share my knowledge and skills, by training, mentoring and educating young doctors”.
“Good doctors don’t grow on trees, they need to be nurtured. Mentoring young doctors through their journey in a rural area like ours as part of their training is very important, even if they will not pursue a career in rural and remote medicine.”
When Marco first arrived in the NT, the clinical workforce in East Arnhem was scarce, transient, and dominated by career medical officers trained overseas.
Now, the golf-mad family man is just one of a few of the 45 doctors in the region to have been trained overseas. All senior doctors in the region are Fellows of ACRRM, RACGP, or ACEM, a regional GP registrar training program has been strengthened, and pre-vocational rotations for interns and residents have been established.
“It’s about creating an environment where you’re an employee of choice, and a place where people want to come to work or train. We’ve created a good reputation and allowed the word of mouth to do the work for us,” he said.
“One of the most satisfying things for me is seeing people who came to us for the first time as third year students, then fourth year students, they came back as interns, they came back as residents, they came back as registrars, and then I gave them a job as fully-qualified registrars and GPs.
“Seeing how they’ve developed their careers is very satisfactory, as is seeing them confident and gaining independence in their skills. We have become a very popular location for medical training.”
Marco is a big believer in having junior doctors and registrars work across a variety of health services.
“I think we have a fantastic training program in the NT. We have the opportunity to do mainstream general practice, Indigenous health with a strong focus on public health, rural generalism in hospitals like Tennant Creek and Katherine, and to work across different services,” he said.
“In Nhulunbuy we have an original approach where trainee doctors must work in two different areas.
“So, for example, they might work for two days a week in general practice and three days a week in a hospital. It’s important to ensure our future doctors have an understanding of the whole health service, which allows for better continuity of care for patients.
“The ideal scenario would be for our doctors to see their patient in general practice in Indigenous communities, jump in the retrieval plane with them to take them to hospital, see them in the emergency space and admit them to the hospital, be their caring doctor in the hospital while they’re a patient, and then discharge them to primary care, and receive them on the other end to continue their care.
“The ability to offer our doctors a taste of that is something they cannot experience anywhere else.
“It’s the holistic role of a GP and rural generalist to provide that patient-centred care, and it’s quite unique in the Territory.”
Through the passion of clinicians and supervisors such as Marco, they deliver the message that anything is possible in the NT.