Ballarat Health emergency doctor Elyssia Bourke wins prestigious Buchanan Prize | The Courier

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Ballarat emergency department doctor Elyssia Bourke has topped the country in the final exams to become an emergency consultant after one of the toughest years in the medical profession. Amid the COVID pandemic and the changes it forced in hospitals, particularly hospital emergency departments, she held down two jobs, worked on her PhD and studied 20 hours a week for the all-important final exam. For the past 18 months, Dr Bourke has been working in the Ballarat Health Services emergency department and recently she finished her emergency medicine exams after six years of study and training to specialise in this area. That six years is in addition to her six years of medical school at Monash University, and intern year and residency before specialising is an option. After a rigorous two-day evaluation of her practical skills and knowledge, Dr Bourke received the Buchanan Prize – the top mark in the fellowship exams in Australia and New Zealand administered by the Australasian College for Emergency Medicine. It is the first time someone from Ballarat ED has won the prestigious prize. Dr Bourke is working full-time in Ballarat across four days a week, and two days a week at the Royal Children’s Hospital where she is working on her PhD, running trials looking at the best medication to give young people who present to the ED with acute behaviour disturbance such as agitation. The results will be applicable not just at the RCH but at Ballarat Health and anywhere young people present with mental health issues. Dr Bourke grew up in Ballarat, having attended Alfredton Primary and Ballarat and Clarendon College, before completing medicine at Monash University. Since then she’s worked as a doctor in various hospitals including Bendigo, the Royal Melbourne and Austin Hospitals. But her studies still aren’t complete with more than four years of part-time study on her PhD to go and plans to complete a further two-year specialisation in toxicology. Dr Bourke plans to stay in Ballarat after her training is completed this year, and the emergency department is where she has always seen herself practising medicine. “There’s definitely an advantage about working somewhere smaller – you get to know all the staff really well and there’s much more of a collegiate atmosphere,” she said. “All of the tertiary hospitals now have a specific specialty interest and the reason I do emergency medicine is I love to be able to do a bit of all sorts of things, to be a generalist. “I like being able to do a bit of everything and in regional places, like Ballarat, we see everything – paediatrics, trauma, toxicology, obstetrics and gynaecology, mental health. I just love that variety, and I love doing procedures, and ED is the place to do lots of interesting procedures. “Particularly in Ballarat our emergency department has a big catchment with nowhere else for people to go.” That big and growing catchment is also a downside, with Ballarat’s burgeoning population putting increasing pressure on the ED and a new emergency department not expected to be built until 2027. “It’s disappointing when people have been waiting a long time, as patients sitting in the waiting room can’t see what’s happening behind closed doors,” she said. “We are working hard but can only see x number of patients – we want to make sure we give the best possible care and people having to wait is certainly not ideal,” she said. The changes in practice that COVID wreaked on the ED have also contributed to waiting times and stress on the doctors, nurses and other staff. The ED remains split in two – respiratory and non-respiratory sections – with no crossover. “It was tough work, especially in the first lockdown when things changed so rapidly. There are lots of normal procedures we would do in the ED that were no longer allowed to do in the way we would normally do, and just putting PPE (personal protective equipment) on was very draining. “The masks were horrible. I ended up with the whole bridge of my nose abraded and bleeding, and we got so thirsty because with the PPE you can’t pull it off to have a drink unless you completely strip it off. “The increase in mental health presentations was phenomenal and very distressing for us as clinicians. It’s very hard to see so many people suffer from worsening anxiety or after losing their job. We saw a lot of domestic violence, people trapped in violence and lots of substance use – it was distressing and at times very tough.” But she noticed a difference in presentations during the last lockdown. “The most recent lockdown in Ballarat, people attending the ED almost seemed used to it, almost accepting that until the vaccination program has been a little bit more widespread that this is the new normal,” she said. “People didn’t seem to be as outwardly distressed as previously.” Lockdowns did make study much harder. Dr Bourke was part of a study group preparing for the final exam and because much of it relates to interpersonal bedside skills it was difficult to match the intensity of face-to-face interactions with patients on Zoom. The final test involved two days in Melbourne working through 12 ‘stations’ with two examiners/emergency consultants in each station marking the doctors. “It’s trying to emulate what you do in an ED on a day to day basis,” she said. “You have actors pretending to have a problem, or another emergency consultant pretending to be a junior doctor who you have to help teach how to do a procedure or explain how to interpret a test, completing each station in seven minutes.” IN OTHER NEWS When Dr Bourke’s training is finished later this year, she hopes to work part time in the Ballarat ED and the RCH while completing her PhD. “Full time in the ED, because it’s so emotionally and physically draining, I don’t think I could work full time in the ED. I get really bad compassion fatigue,” she said. And she hopes to further medical research in Ballarat. “I’ll finish off the PhD and the hope is that myself and another clinician who is also interested in research in Ballarat, that we’ll get more studies up and running here relevant to regional and rural populations,” she said. “There are key differences in terms of how we access health care in regional centres that people in the city don’t really appreciate.” Our team of local journalists work hard to provide local, up-to-date news to the Ballarat community. This is how you can continue to access our trusted content:

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