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Until the age of 10 Paul Chang considered ‘nature’ to be the tiny patches of grass he occasionally spotted sprouting beneath crisscrossing train lines near his home.

Home was an apartment building in the heart of Taipei, one of the world’s most densely populated cities.

It seems fitting then that today ‘nature’ is literally the backdrop to Paul’s life working as a Rural Generalist caring for patients in outback Queensland.

Travelling along the Warrego Highway for his short commute to work each day (he lives on a 10 acre property just outside the town of Charleville), the bitumen is framed by clear blue sky, red earth, spinifex, and mulga trees as far as the eye can see.

“The dichotomy between my childhood and the one my three children are now living isn’t lost on me,” Paul says.

“I realise this is kind of a dream life and I love it.”

 

How does a boy from Taipei end up in the Aussie outback?

Given his obvious enthral with life in the bush, it is surprising to learn that a career in medicine — pursuing the pathway of a Rural Generalist at that — wasn’t something Paul even considered until the age of 29.

The son of two school teachers, he was settling into a career in research when he moved to Australia at 24 to work at Melbourne University’s Centre for Molecular, Environmental, Genetic and Analytic Epidemiology [Paul’s family moved from Taipei to Auckland, New Zealand when he was 10 and he graduated from Auckland University with a masters degree in Science].

In Melbourne Paul moved into a share house and it was there he met a girl named Katie.

Katie and Paul hit it off, began dating, and within a year were engaged.

Paul says Katie was unlike anyone he had ever met. She hailed from outback Queensland — the daughter of a cattle farmer and a country GP — and to him her stories of growing up on a farm were magic; the stuff of sweeping novels and big screen films.

A key detail in their love story is that when Paul proposed Katie made it clear her dream was to return to the bush and work as a rural GP like her mum, so if he couldn’t see himself trading rush hour and restaurants on every corner for steaks at the local pub and an endless supply of serenity, it was time to say so.

Paul wasn’t perturbed, in fact he was immediately on board with the idea of adventure in the outback, but at this stage the idea of pursuing a career in medicine himself still hadn’t occurred to him.

It wouldn’t for a few years yet.

Not long after their engagement Katie returned to Queensland to study medicine while Paul continued working at Melbourne University, where he was considering beginning a PhD in breast cancer research.

Long distance proved difficult and after 12 months he was able to transfer his research project to the Queensland Institute of Medical Research in Brisbane.

As Katie’s medical training progressed Paul turned his mind to finding a career that would make sense once they were living in a rural setting — lab research didn’t really fit the bill.

He decided on physiotherapy and began a post-graduate degree at the University of Queensland.

Paul says he was comfortable with this choice but, on a whim, a year into the course he applied to study medicine at Griffith University.

“I wasn’t expecting to get in,” he explains.

“I was thinking only that rural communities were crying out for doctors more than they were physiotherapists.”

The rest, as they say, is history because Paul made the cut.

 

The boy most unlikely

“I never imagined I would be a doctor,” Paul says, reflecting on the job that has become his passion.

“English is not my first language and the communication side of medical training, both spoken and written, was something I had to battle with.”

He remembers the first two years of his medical degree as a particularly challenging time.

“I’d come from a background of research which is all about analysing data, not interacting with people. Add to this how full-on those first couple of years of study are,” Paul explains.

“By then Katie was in her intern year. So, while she was busy adjusting to working in the hospital environment I was trying to decide if I could really do this,” he says.

It is interesting to hear him recount his struggle, because today it’s clear Paul’s communication skills are a big part of what makes him a great rural doctor.

Paul Fellowed as an ACRRM Rural Generalist in 2020 and he and Katie have been part of the rural medical team serving Charleville and surrounds since 2018 (Katie is also an ACRRM Rural Generalist).

Paul’s specialist training is in emergency medicine, while Katie is trained in anaesthetics.

“Being able to do this job is amazing,” he says.

“I get to make such strong connections with people and be a part of their lives.

“It is very humbling and an incredible privilege.”

In a relatively remote community like Charleville this means care that runs the gamut of cuts and colds, emergency situations involving horrific injuries, and palliative care.

“Patients die and it’s hard, but my job is to give them my all and to make them feel safe and looked after,” he says.

 

When you learn from the best

Having Fellowed only a couple of years ago, Paul readily admits he is still learning on the job.

He has a feeling this might always be the case, but adds that when challenge comes knocking, he often finds himself recalling pearls of wisdom imparted to him by a man he considers a hero of rural medicine — Dr Colin Owen.

Back in his study days at Griffith University, Paul was part of the first intake for the now established Rural Longlook Program, a restructured approach to student learning that eliminates the traditional short block training rotations in favour of longitudinal care exposure (seeing patients through all phases of diagnosis and treatment).

Paul spent time learning from Dr Owen at Inglewood Medical Centre as part of the program.

Dr Owen has been a rural GP for close to 60 years and was the founding president of both the Rural Doctors Association of Queensland (RDAQ) and the Rural Doctors Association of Australia (RDAA), and is a foundation fellow of ACRRM.

“He taught me what deep dedication to healthcare in rural and remote communities means,” Paul says.

“Which is caring for patients with humility, love and kindness.

“Though Col has been based in Inglewood for the majority of his Rural Generalist career, he also worked in Charleville for three years, which is a nice link too,” Paul adds.

 

Living and working as a Rural Generalist duo

Paul and Katie made the dream a reality: they have managed to carve out careers that allow them to care for patients in rural communities while living on the land and raising a family.

We explore more of their day-to-day lives as Rural Generalists and how they make what they would call an ‘imperfectly perfect’ medical partnership work in our follow-up story, which you can read here.

 

A week in Paul’s life

What does an average working week look like for Paul?

If you ask, he will say ‘busy’.

“Things change all the time,” he says. “We have to be flexible and cover gaps when they open up.”

Generally though, Paul’s week goes a bit like this:

  • 2 days consulting with patients at the Charleville Health Clinic — one of two stand-alone General Practice facilities in town
  • 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 three nights a week (from 5pm-8am)
  • Add on responsibilities include everything from ward rounds, and nursing home visits, to providing outreach or video-linked consultation services to nearby towns when they are without a doctor and working alongside QAS paramedics to attend roadside or remote cattle station emergencies.

Paul works in a team of seven GPs who care for the communities of Charleville, Morven, Augathella, Cunnamulla and Quilpie.

Paul and Katie, along with one other local GP are permanent, while two of the team are fly-in-fly-out workers and two are locums.

 

Could Rural Generalism be the career for you?

Explore training on the AGPT Rural Pathway here.

 

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