I graduated from Cardiff Medical School in 2018, did my F1 year at Withybush General in Pembrokeshire, F2 in Cardiff before an ED SHO job in Bristol and an ICU SHO job in Bath. During my F3 year I have also completed a Diploma in Expedition and Wilderness Medicine with the University of South Wales and taken some time out to pursue some personal adventures, paddling the River Wye and walking the Cotswold Way and Hadrian’s Wall.
Having done my elective at the MacKinnon Memorial Hospital on the Isle of Skye in 2018, my career has already come full circle and brought me back to Scotland. I had been looking for a route back to the Highlands and Islands and I’m about to start at Caithness General in August.
Looking back, it is hard to pinpoint exactly where my excitement and drive for rural medicine evolved from. The literature suggests that a rural upbringing is a key factor in the pursuit of rural medical roles1, but having been brought up in the urban sprawls of London, Santiago and Bristol this doesn’t fit my upbringing at all.
For me, rural medicine marries my two passions. Firstly, the lifestyle opportunities of being close to the mountains, the sea and all the other biomes that I like to play in outdoors, running, hiking, kayaking, surfing and so on. Secondly, the challenge of the job, with a lack of equipment and resources, your own clinical judgement and thus the ethical clarity that this brings to the role. These two factors are what really draw me to the rural medical field and also drive me in the pursuit of expedition medicine.
My elective on Skye opened my eyes to this purely clinical style of medicine. No CT scanner, an X-ray during 9-5 and on-call overnight, a blood machine that ran a gas, a troponin and some U&Es only. Drinking in the experiences of the doctors working there I heard tales from an ex-South African SEAL, an Antarctic expedition doctor, a Falkland Islands doctor, stories like being on the end of a piece of string, dangling from a helicopter over a military ship in a gale force wind and sideways rain. Skye also brought to the fore the holistic nature of medical care and the power of the doctor, nurse, physio, OT and auxiliary care provider axis. This colleague interaction and support is something that I value hugely and have worked on maximising in my own clinical practice; I also certainly believe in this being a two-way relationship.
While I was on my elective, I was invited to attend a Rural Medical Conference run by Glasgow University. Interestingly there was a Professor from Ontario, Canada speaking about a newly developed course for the delivery of undergraduate medical education focussed on the development of rural practitioners on graduation. I asked him whether he had heard of C21, the new course that Cardiff had launched in 2013, of which I was in the first cohort… he said he had designed it. Another speaker was a GP from Tiree, again offering up a taste of his world, medical emergencies in his one-bed GP resus bay and sometimes unable to get helicopter support due to weather conditions.
For me, all of these people have a number of desirable qualities in common, they are practical and resilient people who are well aware of their own skills but also go well above and beyond their scope of practice to provide quality medical care2. They are also incredibly friendly people, who lead fulfilling and exciting lives outside of work. Skye really opened my eyes to the opportunities for the personal development available through working in NHS Highland as well as other rural centres around the world.
So, having already bought most of the OS maps for the north of Scotland, circled all the bothies and traced out the Cape Wrath Trail, it’s going to be a great year for learning and also for being back in the countryside and out on the surfboard. Since working and living in Pembrokeshire, I have realised how important it is to get sand between your toes as often as you can to bring a balance to the life inside the four walls of work.
Dr Benjamin Alba is working as a Clinical Development Fellow at Caithness General Hospital in Wick from August 2021.
Email Benjamin at: [email protected]
Connect with Benjamin on: https://www.linkedin.com/in/benjamin-alba-228a2b217
Visit his website at: https://benjamingjalba.wixsite.com/adventure
- Hancock, C., Steinbach, A., Nesbitt, T.S., Adler, S.R., Auerswald, (2009). Why doctors choose small towns: a developmental model of rural physician recruitment and retention, Social Science and Medicine, 69: 1368-76. [Online]. Available at: https://ruralprep.org/wp-content/uploads/2019/04/Why-Doctors-Choose-Small-Towns.pdf (Accessed 22 July 2021).
- Konkin, J., Grave, L., Cockburn, E., Couper, I., Stewart, R.A., Campbell, D., Walters, L., (2020). Exploration of rural physicians’ lived experience of practicing outside their usual scope of practice to provide access to essential medical care (clinical courage): an international phenomenological study, British Medical Journal, 10(8): e037705 [Online]. Available at: https://bmjopen.bmj.com/content/10/8/e037705.info (Accessed 22 July 2021).
