Katie and Paul Cheng decided early in their relationship that their future together would have a rural backdrop.
Katie had grown up on a Queensland cattle farm and revelled in her country childhood, and Paul, who had spent his early years in Taiwan, was drawn to the idea of life in the Australian bush.
Back then the couple didn’t know the path to an idyllic outback existence would involve both of them studying medicine and then training to become Rural Generalists.
But, 16 years later and with ACRRM Fellowship credentials to both their names, Katie and Paul are living the rural life of their dreams in Western Queensland.
You can read more about Paul and Katie’s pathway to rural General Practice in our companion story here.
The couple, along with their three children, live on a 10 acre property just outside Charleville (population 3,300).
Since 2018 they have been working together as a key part of the rural medical team servicing the Murweh region.
Their roles as Senior Medical Officers mean they are caring not just for people living in Charleville, but also the nearby communities of Morven, Augathella, Cunnamulla and Quilpie.
Katie’s specialist training is in anaesthetics, while Paul is trained in emergency medicine.
Both work between one of Charleville’s two stand-alone General Practice facilities and the local hospital.
The rhythm of life as rural doctors
When we spoke to the couple for this story Katie had just arrived back in Charleville after being called south to Cunnamulla for the weekend because the town (population 1,500) was short of a doctor.
While Katie was away Paul took to juggling the care of their children, his on-call commitments as Charleville’s emergency care specialist relieved for the weekend by the couple’s understanding boss.
The situation had cropped up without warning, and while it did throw the family’s weekend plans out the window, both Katie and Paul say they have learned to embrace the unpredictability of their lives as rural doctors.
“Scenarios like this aren’t ideal, but they happen and you have to manage them,” Katie explains.
“From a medical standpoint it can get tricky, because for two weeks out of every month I am the only GP anaesthetist in Charleville [the remaining time is covered by a fly-in-fly-out specialist], so while I am away there is no-one to cover me back in town,” she says.
“On the home front though, we have become very good at making sure when we aren’t at work we are doing things as a family.”
Katie and Paul represent two of four ’permanent’ Rural Generalists in their Charleville-based medical team who live in town full-time.
Two other Rural Generalists work on fly-in-fly-out rotations and the team is completed by the support of one to two locum GPs at a time, depending on locum availability.
Paul admits ensuring that rosters and doctor numbers always line up isn’t easy.
“We are lucky though to have a boss who is very understanding and who works hard to keep everyone happy, knowing that having the right work life balance is essential to retaining staff,” he says.
“Working in a somewhat unpredictable environment can at times be stressful, but having everything you need, all of the time isn’t really what rural medicine is about,” Paul says.
“We do get used to managing difficult situations and have learned to focus on being able to deliver whatever care a patient needs at the time.”
Katie adds that the constant motion and variety of working as a Rural Generalist is what she loves.
“I chose to become a rural doctor because I grew up watching my mum doing amazing things as a country GP,” she says.
“Out here the clinical work is very diverse. I find that exciting,” she explains.
“And I love that a day at work can take me from the clinic seeing patients to the hospital where I am supporting in the delivery of a baby or assisting with an operation.”
Juggling family life
Living in an outback community and away from family support can be challenging with a young family.
Paul and Katie have three children between the ages of four and nine, and accessing childcare services to support the demands of their medical roles has at times proven difficult.
Paul explains that one of the town’s childcare centres recently closed, while affordable babysitting is generally in short supply.
“Katie and I can occasionally find ourselves on-call at the same time so we need babysitting support,” he says.
“It is hard not to have the luxury of calling on family who live close by.”
However, Katie is quick to add that in the end they always manage to make the ‘juggle’ work.
She puts this down to good planning and organisation, and working as a team.
“As a couple we are always talking and planning ahead,” she says.
“There is some trial and error, but then when you can pull off something like a weekend camping trip where our whole family is together enjoying what is on offer out here it’s all worth it.”
When they aren’t working Katie and Paul say their focus is the children, and agree that living in a tight-knit rural community is the perfect environment for this.
“We have loved becoming part of this community,” Katie says.
“Everyone looks out for each other,” she adds.
“We have been able to give our time to the school through the P&F Association and get involved in the Scouts Association, which the boys love.
“It feels good to be contributing to what makes this town such a great place to live in.”
An average working week for Katie and Paul
As we’ve discovered, plans can change — often without warning — but in general Paul and Katie’s working week goes like this:
Katie works a seven day fortnight, with each week made up of:
- 1 day covering the Emergency Department at Charleville Hospital (treating category 1-5 patients)
- 1 day consulting with patients at the Charleville Health Clinic
- 1 day in theatre at Charleville Hospital as the GP anaesthetist
- 1/2 a day catching up administration or back at the Charleville Health Clinic consulting
- Covering on call one in every two days
- 2 days consulting with patients at the Charleville Health Clinic
- 2 days covering the Emergency Department at Charleville Hospital (treating category 1-5 patients)
- 1 day providing an outreach clinic in the nearby town of Morven
- Paul is on on-call two nights a week (from 5pm-8am)
- Add on responsibilities include: ward rounds, nursing home visits and outreach and telehealth consults to nearby towns when they are short-staffed
Why this couple believe life’s better in the bush
The rural life Paul and Katie have built in Charleville certainly isn’t their first rodeo.
In the 14-and-a-half years that it took between them to train as Rural Generalists the couple has explored plenty of other rural and remote settings, their experiences helping to equip them for almost any medical scenario you can imagine.
The list of places includes Dalby, Oakey, Inglewood, and Toowoomba in Queensland, as well as Katherine in the Northern Territory.
“We love country communities,” Katie says.
“The support and friendship people offer is really special. There is always a friendly smile, a hot cuppa or a cold beer there for you when you need it,” she says.
“And we couldn’t do our jobs without the great staff we work with.”
A job that can take them anywhere
Paul and Katie are both cognisant that a time could (and probably will) come when they need to be located closer to a major metropolitan centre.
For example, as their children reach secondary school age, there will be a decision to make on whether they attend the local high school, a boarding school, or if the family moves to a larger centre where a range of schooling options is available.
As strong planners, the couple has already worked through what they might do in this scenario, which is relocate to Toowoomba where they already own a home.
Both know that they will have no difficulty finding new medical roles — the demand for their rounded skillsets as Rural Generalists is high.
In fact, Paul says both he and Katie find themselves regularly being contacted by former colleagues and acquaintances about job openings all over the country.
“I get messages about jobs in Sydney and Melbourne quite a bit,” Paul says.
“I think it is important to highlight this because a lot of times Rural Generalism is not recognised as a gateway to both country and city jobs —and it is!
“I love being a rural doctor, but I also know that as a Rural Generalist I can work anywhere. I could take a city job, or I could do locum work in a rural or remote community,” he says.
Could Rural Generalism be the career for you?
Explore training on the AGPT Rural Pathway here.