Rural placement gives Julia a new appreciation for rural life

From vaccinating over 300 people to skiing every weekend, Julia Kerr had an extraordinary time during her rural placement in Otago.

Julia, a sixth-year medical student from the University of Otago, finished a 12-week rural placement in November 2021 split between Wakatipu Medical Centre in Queenstown and Dunstan Hospital in Clyde, where she discovered a new perspective on rural healthcare and a new appreciation for rural life.

When asked what her biggest learning experience was from her placement, Julia says it was coming to grips with the barriers to providing healthcare in rural areas.

“You just don’t have the same backstops that you do in big places,” she says.

“You have to treat people differently in a practice in ways I hadn’t really thought about because you’ve only got a tiny hospital there to help you and you can’t just send someone home.”

“You just have to be more cautious about things,” she says.

While Julia was aware of the barriers people face in accessing healthcare in rural towns, she also discovered how much harder it is for people in rural areas to get the same care that they would usually get in a city.

“It’s just not quite equivalent,” she admits.

Queenstown also has its own set of unique challenges, given that it is a holiday destination and typically has a large tourist population.

“With tourism, you have this transitory population that is quite big and that puts a lot of pressure on the health system,” she says.

Julia recalls that in the early stages of lockdown, there were a lot of people fleeing to their holiday homes in Queenstown, which she says adds to the strain on the limited health services available.

Tourists tend to present with more injuries, and with the heightened risk of Covid, this adds a lot of pressure to the health system.

Julia says this particularly makes it harder for the population that live there permanently to access healthcare and that they almost become “invisible.”

“With big tourist populations and particularly with the pandemic, if COVID does get out in Queenstown, then it will be really challenging,” she says.

Julia’s placement began one week after the South Island came out of Level 4 Lockdown in September, which Julia says impacted on care for patients in the practice.

“At level 3 and 4 it’s really hard because it’s all over the phone which just isn’t good for so many people particularly older people, so it’s really hard.”

Despite this challenge, due to being at the peak of the COVID-19 vaccine rollout, Julia became a vaccinator and joined the practice’s vaccination team to deliver the COVID-19 vaccine both in the practice’s drive-through clinic and at the local high school and some local businesses.

Julia says having the chance to do COVID vaccinating was her most valuable learning experience.

“Getting to be a part of that rollout was a really cool experience and hearing some of the concerns people had about vaccinations and talking them through and listening.”

“I think I maybe wouldn’t have had that opportunity in a bigger place, and it was a really good lesson for a lot of other areas of medicine too,” she says.

During her six weeks at Dunstan hospital, Julia was struck by the variety of issues that patients presented with compared to urban hospitals and the practice.

“You just don’t know what’s going to walk through the door,” she says.

Julia also developed a deeper respect for rural hospital doctors, saying “you have to be pretty brave to be a rural hospital doctor because you really don’t have much back up at all.”

“You can’t really hand over like you can in a city hospital, you’re kind of all there is,” she says.

While this can seem daunting, Julia admits that it’s exciting “because there’s such a big variety and you get more continuity of care because you know all the patients.”

Reflecting on her rural placement, Julia says because it was such a valuable learning experience for her she thinks that “it should be mandatory for everyone to do a rural placement during their medical school.”

“It’s that feeling of being part of a community that I loved, and I didn’t really think I would get that from working rurally,” she says.

“I’m so glad I came and did this placement because now I’ve seen what it would actually be like, and I definitely am interested in possibly working rurally.”

Not only has Julia come away from her placement with the experience needed to complete her degree but she was also able to make the most of her passion for the outdoors while in Otago and has found a new love for skiing.

Having now finished her degree, Julia is looking forward the next stage of her training as a House Officer at Wellington Hospital in 2022.