Dr Marco Giuseppin is a 33 year-old Rural Generalist.
Less than a decade into his medical career he has worked as a practice-based GP, an emergency doctor, an anaesthetist, a retrieval specialist, and a medical politician.
In March this year he added medical leader into the mix, accepting a new role as Clinical Director, Community and Preventive Health for the Sunshine Coast Hospital and Health Service.
It is an exhaustive job list and one that belies Marco’s years, so how has this young GP done so much in such a short amount of time?
Well, you will be surprised to learn that none of it came about by design.
“So far my career has been a series of happy accidents,” Marco says.
“Back in medical school I had something of a 10 year plan mapped out, but then life happened and none of what I’d planned played out,” he says.
“I think that’s because early on I decided to take opportunities as they come and each one has led me in directions I could never have imagined.”
Marco describes himself as a ‘non-traditional’ Rural Generalist.
He qualifies this by adding that he has been able to utilise his Rural Generalist skillset in a range of ways, not just in medical practice.
“They say the beauty of a career in General Practice is that you can choose your own adventure,” Marco says.
“I think that is really true. So far I have followed my gut and I’ve been able to explore lots of different avenues.”
Discovering Rural Generalism
Born and raised in Brisbane, Marco began his medical degree at the University of Queensland and, starting out, figured his career path as a doctor would likely follow a city-based route.
Then, in his third year of study he learned about an opportunity to transfer his studies to UQ’s Toowoomba-based teaching and learning centre, the Rural Clinical School, where he could close out his degree.
“I was excited at the prospect of new experiences—ones I knew I wouldn’t have if I stayed in Brisbane,” Marco explains.
“An added bonus was that I’d get two years of very low cost accommodation!” he says.
The move proved plan-altering.
Marco says he quickly found the style and scope of regional and rural healthcare suited his sensibilities, both as a person and as an emerging doctor.
“I’ve always been someone who wants to try everything,” he explains.
“And the mixture of primary and secondary care on offer really fed that need in me.”
Marco recalls that, at the time, the Queensland Rural Generalist Pathway was still relatively new.
He says had he not been based at the Rural Clinical School he would likely not have considered it a viable GP training option.
Despite feeling a little unsure rural medicine would indeed be what he wanted to do long-term, Marco acted on instinct and applied for the AGPT Rural Pathway with ACRRM in 2015.
“Honestly, I didn’t think I would be accepted into the program, so when I was I felt incredibly lucky,” he says.
“Things opened up to me from there.”
Learning to fly
While in Toowoomba completing his medical degree Marco discovered more than just rural medicine.
Keen to overcome a life-long fear of flying he enrolled in aviation lessons and fear quickly turned to exhilaration.
Before long Marco was completing a pilot’s license and imagining himself one day working for the Royal Flying Doctor Service.
The day would come, but not for a handful of years.
In the interim Marco spent his hospital internship and residency years working in regional hospitals in Rockhampton, Gladstone and Toowoomba.
He completed his rural anaesthetic training in the seaside town of Hervey Bay in 2017 and then moved west to the melon-growing town of Chinchilla to undertake his Community General Practice training.
Marco spent two years in the bush community soaking up all of the skills development and local experiences on offer.
In 2020, with his Rural Generalist Fellowship completed, he knew he was ready to join the RFDS.
Marco was offered a medical officer position with the Charleville RFDS Base, which services more than 600,000 square kilometres of southwest Queensland.
The job was everything he had hoped for and more.
“There was never a dull day,” Marco says.
“Work could take me from GP clinics in remote halls in small towns to landing at a station in the middle of the night to retrieve a critically-ill patient.
“Rural Queenslanders are some of the most stoic and resilient people I have met. Helping them gave me so much satisfaction,” he says.
For just over two years Marco worked as a fly-in-fly-out RFDS medico, providing a combination of primary health care and retrieval medicine services.
A second fly-in-fly-out appointment followed, this time as Medical Lead – Primary Health Care with the RFDS Base in Mt Isa.
Since 2019 Marco has also been Academic Lead, Rural and Remote Medicine with the University of Queensland Medical School, a position he was offered while completing a rural GP Academic post.
A political advocate emerges
As Marco was carving out his place in the rural medical workforce and learning about the systems that govern healthcare delivery in rural and regional communities, he says there were times when frustrations arose.
“Factors such as geography and funding have always been a challenge in rural healthcare,” he concedes.
“But, in Chinchilla and then in my roles with the RFDS, I was noticing ways the system was letting patients down and that didn’t sit well with me,” he says.
“I wanted to see how I could contribute to addressing some of them,” Marco says.
Not long after he had arrived in Chinchilla for his GP training placement in 2018 the local maternity service ceased operation.
Marco remembers this as one of the first times he felt so angered for rural patients he knew he had to find a way to help.
“The community was very upset,” he says.
“A service that had been around for decades was suddenly gone and they were unsure about the future for local women needing to give birth. I was at the coalface, but not in a position where I could make the decisions or make a difference to the system. That was frustrating.”
Marco decided to galvanise his membership with the Australian Medical Association.
He joined various committees, both in the Association’s Queensland branch and federally.
These included the AMA Queensland Council of Doctors in Training and the AMA Council of General Practice.
In 2020 Marco says he felt ready to take on a more substantial advocacy role within the AMA and became a member of the Queensland Council, representing the Darling Downs and West Area through policy advice, political advocacy and government and stakeholder relations. He was also elected Chair of the AMA Federal Council of Rural Doctors.
“This is where things really began to snowball in a positive way,” he says.
“My work with the AMA brought me in to contact with some of the brightest policy minds in Australia. I have met with and briefed Ministers and senior Department officials on issues that matter and have seen the work I do influence government policy in a positive way.
“It is often slow and painstaking work, but it is where you can make the biggest difference to a large number of people,” he says.
Over time, as Marco’s advocacy and medico-political voice has strengthened, he says he has found himself gravitating towards jobs in medicine that allow him to continue to practice as a GP while occupying the health leadership and governance space.
“I have discovered that I really enjoy working on systems and policy for large cohorts,” he says.
“But, I am still a GP and a Rural Generalist. My work is and will likely remain a mixture of clinical and non-clinical work.”
In his new role with the Sunshine Coast Hospital and Health Service Marco is working in residential aged care, as well as rekindling his love of GP Anaesthesia.
“I think it is critically important not to lose touch with patients. It is a special relationship that drives me to be the best doctor and leader that I can be every day,” he says.
Why Rural Generalism is a golden ticket
Marco credits his selection of the Rural Generalism training pathway with the diverse range of opportunities that have characterised his medical career to-date.
“Choosing rural General Practice has made a lot happen for me,” he says.
“I know that if I had stayed in the city I would not have developed the skills I rely on today and I wouldn’t be working in these dynamic roles, where I feel like I am making a difference each day.”
With the need for greater rural doctor numbers never far from news headlines in Australia, Marco says he wants to be part of a push to ‘re-imagine’ the narrative on careers in rural and remote medicine.
“The traditional model of the male doctor who moves out to the bush with his wife who is a stay-at-home mum doesn’t exist anymore,” he says.
“It is time to push that messaging aside and embrace the far more exciting reality—a career in Rural Generalism can be so many different things for anyone who chooses it.”
What the future holds
As well as settling into his new appointment, Marco is currently training towards a second Fellowship in Medical Administration.
He says this will support him with his work in clinical leadership, but adds that caring directly for patients is something he will never give up.
“I will continue to find a way to do both, as well as retain my advocacy work,” he explains.
Could Rural Generalism be the career for you?
Explore training on the AGPT Rural Pathway here.