Dr Louise Finnel
Louise Finnel is co-chair of the Emergency Medicine Vocational Training Committee in the Auckland region. She has been working as an Emergency Medicine specialist for over 10 years now and has extensive experience in the field...
Dr Finnel is based out at Middlemore Hospital and is also an
Australasian College for Emergency Medicine (ACEM) examiner and the
ACEMNZ Censor. She has some great advice for you if you are
planning a career in Emergency Medicine...
I decided to specialise in Emergency Medicine because I like the
variety it provides. Working in ED also means you work shifts so
it's great if you want to do other things like teach, play sport or
spend time with your children. It was a great specialty to do for
me as a woman because the nature of the shift work meant that I
could work part time with young children. ED is full of challenging
undifferentiated critically ill patients, and I enjoy working in an
environment where calm can turn to chaos within minutes. ED is also
a great career as there is huge scope for sub specialising -
(toxicology, ultrasound, medical education, research..)
I graduated from Auckland Medical School and have done most of my
training at Middlemore Hospital and hence have seen a unique
demographic of patients some of whom have advanced stages of
disease. We also see major trauma cases and deal with both
paediatrics and adults. It's very busy at Middlemore Hospital but
if you are a team player and a "procedures" junkie, then you will
enjoy the speciality.
There are various differences between the ED's across the
Auckland regional hospitals. I did some of my Registrar runs at
Auckland City Hospital and you get exposure to Cardio Thoracics and
Neuro cases whereas in North Shore Hospital you see a more elderly
patient mix. They are all busy environments and hence you get
fantastic exposure to a variety of cases and patient mix.
If you are undecided about a career in Emergency Medicine you
should think about a few things - do you like shift work, can you
work night shifts, can you deal with uncertainty (you don't always
end up with a clear patient diagnosis), can you multi task (see
more than one patient at a time), can you prioritise tasks, can you
communicate effectively with not only medical staff and team
members but also patients and their families, can you work knowing
that you may never be able to do everything for the patient? If you
say yes to most of the questions above then you will enjoy working
in Emergency Medicine.
You need to do 2 years as a House Officer with at least 3 months
in Emergency Medicine to apply for a Registrar post. Other useful
rotations to do as a House Officer include Paeds, HDU/ICU,
Anaesthesia, General Medicine and O&G. As a Registrar, you can
register with the Australasian College for Emergency Medicine and
you will do 1 year as a provisional trainee which includes 12
months in Emergency Medicine or 6 months in Emergency Medicine and
6 months in another speciality. You need to pass your Part 1 exam
within this year post which you start your advanced training of
around 4 years. This means you do 30 months of Emergency Medicine
and 18 months non Emergency Medicine attachements such as
ICU/Anaesthesia/PICU etc. It is good to gain some overseas
experience as well though Middlemore and Auckland City Hospital are
each accredited to provide training for up to 24 months. You also
need to do a rotation in an urban district r ED (North Shore,
Whangarei) to complete your training.
With regards to teaching; from April 2010, House Officers will
have protected teaching days and currently Registrars have teaching
on Tuesdays every 4-5 weeks apart from normal CME teaching.
At Middlemore Hospital, the Emergency Medicine department is
quite social. This includes the department Christmas party, end of
run drinks, social events every 3-4 months and the occasional quiz
night. There is also a band that has an Emergency Physician and an
Emergency Medicine registrar as members that plays at some of the
social events.