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Mayara Floss: the challenges for women working in rural health

Mayara Floss

This video of Dr Mayara Floss – rural doctor in Brazil and passionate advocate for international rural health – has recently been publicised via the Rural WONCA email list by Dr John Wynn Jones, chair of the WONCA Working Party on Rural Health.

Mayara was invited to give her perspective on the issue of “Investing in rural health workers for the economic participation and empowerment of rural women and girls” at a meeting of the joint Commission on the Status of Women: a side-event of the World Health Organisation, International Labour Organisation, Permanent Mission of Ireland to the United Nations and Women in Global Health.

John introduced the video more eloquently than I could, and so with his permission, here’s what he said:

Dear All

I want to congratulate Mayara and thank her on behalf of Rural Wonca and all the rural health workers around the world for her presentation and wise words at the United Nations Commission on the Status of Women. Mayara is an exceptional person. I can’t even call her a future leader because despite the fact that this is her first year as a doctor she is already a world leader and an example to us all. It will be the Mayara’s of this world who will take up the mantle for the next generation and its our duty to support them.

Please look at the video of her session. She describes how medical schools in the largely rural country of Brazil do little to promote and teach rural health care. She eloquently describes her own journey against the odds and her quest to work among rural communities and the barriers that she encountered. Everyone needs to watch her presentation! 

During the panel session she implores us first to listen to our patients and are communities before coming up with ” so called helpfull solutions”.

She also asks us to think about the political tragedy that is happening in Brazil and the dismantling of one of the most enlightened primary care systems in the world and its replacement with private health.

We are all very proud of her and the many other members of Rural Seeds who are working so hard around the world to build their careers and make a difference for rural communities.

Kind regards

John

Mayara speaks in the video below for 20 minutes, at 30 minutes in, and there are subsequent (excellent!) contributions to the discussion thereafter.

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Applications invited now for Scottish Rural GP Fellowships 2018

NES Logo 2005Applications are now being invited for the GP Rural Fellowship Scheme, overseen by NHS Education for Scotland.

The Fellowships offer a fantastic opportunity to build skills and experience in rural general practice, whilst experiencing the challenges and opportunities first-hand – during a well-supported year which includes nine weeks of study leave and a generous study budget.

The Fellowships are located across rural Scotland, from Dumfries & Galloway, to the Shetland Isles, including islands such as Islay, Arran, Skye and the Uists.

Many previous rural fellows have stayed in rural practice, and this article published in the Journal of Rural & Remote Health highlights the strengths and successes of the programme which has been running for over ten years.

Rural Fellowship Facebook Page     Rural Fellowship – Official Information

Closing date for applications: Wednesday 11th April 2018

Fellowships (one year) commence in August 2018.

Watch the latest video about the Fellowships…

Former Rural Fellow Gemma Munro explains more about her time as a Rural Fellow.

Why be a rural GP?

This video, as part of the RCGP #ThinkGP project, featured the range of rural GP duties on the Isle of Arran.

 

… and here’s a video from 2016 featuring some of the Fellows and others involved with the scheme…

Interested?  We want to hear from you…

All the Rural Fellowship sites will welcome you to chat on the phone or visit and tour round what’s on offer.  We can fix up a chat with current or previous rural fellows, and you can ask questions on the Fellowship Facebook page.  There is a lot of information available from the websites mentioned already, but sometimes it’s easier to arrange a chat on the phone or Skype… all descriptors of the Fellowships (on the official fellowships page) have contact details where you can find out more.

A couple of years ago we interviewed some of those involved in running the Rural Fellowships.  Hear more from them about what they think the fellowships can offer recently qualified GPs…

Gill Clarke – Fellowships Co-ordinator

gillGill has been running the fellowship scheme now for several years.  I asked her about the opportunities available, and why she thinks the fellowship scheme is a good way to enable recently-qualified GPs to experience rural practice.

Gill is very happy to be contacted about any of the fellowship options.  gillian.clarke1@nhs.net


Angus MacTaggart – Islay Rural GP

angusAngus is one of two principals of Islay Medical Services, which now delivers primary health care across the island, as well as out of hours and hospital services.  He describes the attractions and challenges that he identifies with rural practice.

You can contact Angus at: Angus.mactaggart@nhs.net


 

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Dumfries & Galloway GP event – invitation to come visit!

Calling all GPs with itchy feet…

We invite you to come and spend a night in the lovely Creebridge House Hotel in Newton Stewart on
Saturday 28 April 2018.

Dinner, bed and breakfast for you and a partner will all be paid for.

All we ask is that you share dinner on the Saturday evening with a few local GPs.  We would also like to treat you to lunch at the Crown Hotel in Portpatrick on the Sunday.

How you spend the rest of your weekend is up to you…

For more information, please contact Lucy Gurling (GP Liaison Officer) at lucy.gurling@nhs.net

There is no cost to you for this event. We want to make it easy for you to come and experience the beauty and feel-good nature of Wigtownshire. Our hope is that, once you have had a taste of the place, you may consider coming to live and work here.

To register for this event, we need an assurance from you that you are a fully qualified GP who is actively considering a move within the next year, and that you are open minded about moving to rural Wigtownshire.

Anyone interested should contact Lucy Gurling by emailing lucy.gurling@nhs.net describing in a couple of paragraphs a little about you and why you would like to come to this event.

In terms of plans for the weekend, we would be more than happy to point you in the direction of places of interest in the area, and also happy to organise informal tours of GP premises if requested.

Please come armed with questions about living and working here, and also about family life – we will do our best to answer you. But if, having visited, you decide this area is not for you, we will respect that and will be pleased that you came to explore what Wigtownshire has to offer.

For more information you can view this PDF or watch the clip below…

Banner image above courtesy of JMiall
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@GURRMS 2018 Conference: Skye, 23-25 March

Tickets for the 2018 GURRMS (Glasgow University Remote & Rural Medicine Society) are set to go on sale for students tomorrow evening.  Following on from the highly successful GURRMS 2017 conference that was held on Islay last year, GURRMS 2018 is set to take place in Portree on the Isle of Skye, at the Aros Centre from 23-25 March, and another action-packed and stimulating programme is taking shape.

James whilst on an Isle of Arran Medical elective.

I caught up with the chair of GURRMS, James McHugh, this afternoon to find out more about how plans are coming together.  Once again a full range of speakers has been organised, and the committee are busy sorting out finances and logistics to ensure that this year’s event runs smoothly.  Kudos to them given that these guys are also coming up to their final exams, with the stresses and time involved with that.

Full details will be announced over the next while on the GURRMS Facebook page, and tickets are due to become available in the next day or so.  Last year’s event sold out within hours and so be sure to keep an eye out for the tickets being launched.

GURRMS 2018 is receiving financial support from RGPAS (the Rural GP Association of Scotland) along with a number of other funding streams, and RGPAS has been keen to support and encourage student activities like this, so we’re delighted to see plans take shape so promisingly.

We wish the best of luck to GURRMS in running their second conference, and we’re looking forward to meeting students who are keen to find out more about rural practice – see you in Skye!

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Prof Paul Worley – Rural Health Commissioner for Australia

In a really interesting development for rural health internationally, Australia has appointed its first Rural Health Commissioner.

Charged with the responsibility of overseeing and driving a wide range of activities around supporting ‘rural generalism’ the post offers a chance to provide more co-ordinated leadership across domains, regions and disciplines to make rural health strategy more cohesive in Australia.

Professor Paul Worley has been appointed as the first Rural Health Commissioner and this move has been widely welcomed across the rural health community.  He brings an impressive portfolio of experience to the post, including in clinical, academic, educational and strategic development aspects of rural health.  You can watch Dr David Gillespie MP announce the post, and Prof Worley outline some of his visions for the future (at 5min 55s), in the video below.

Twitter and other social networks – including the WONCA Working Party on Rural Health international email list – have been buzzing with positivity about the new post, and it is likely that this approach might pave the way for similar developments in other countries.

In Scotland, we are watching developments with interest.  Rural medicine and health services are of significant importance in Scotland’s National Health Service – 98% of Scotland’s land mass is rural, and 18% of Scotland’s population live in a rural area, with many more flocking to rural areas during holidays.  And yet despite considerable aspects of medical care being delivered by GPs and primary care teams, within community hospitals, A&E units and facilities outwith the usual remit of GPs, there continues to be relatively little in the way of co-ordinated clinical governance and strategic unity to link rural and isolated practitioners together.  These services provided by rural GPs remain considered to be on the ‘fringes’ of general medical practice.  Therefore the opportunities created by appointing an experienced individual to provide leadership, stimulate innovation and inspire positive approaches, are sorely needed in areas other than Australia.

Having met Paul at the WONCA World Rural Health conference in Cairns this year, I’m delighted to hear this news and inspired to think that this is a situation to watch closely.  I have little doubt that we will be reflecting that Scotland could benefit from a similar approach in the near future.

Well done Australia, and all the folks involved in making this happen.  These are exciting times.

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Students present Bright Ideas for Rural Practice

This year, the Rural GP Association of Scotland has once again run its student conference scholarship programme.  This is a significant investment for RGPAS, which uses money raised into its Educational Trust fund to support these scholarships.  The scholarships offer heavily-subsidised tickets to enable undergraduate students in the UK to attend and participate in the annual RGPAS conference.

To apply, students were asked to submit a 60 second sound or video clip explaining their Bright Idea for Rural Practice.  We are delighted to feature the winning entries below.

A number of these will be selected for PechaKucha-style presentation at our conference in November.  You can read more about the scholarships here, and also a great write-up of last year’s conference by one of the scholarship holders then, Catherine Lawrence from Hull & York Medical School.

There is still time to sign up to the conference, which takes place from 2-4 November 2017 in Inverness.  £130 for GPs or £65 for trainees gets you two-and-a-half days of quality CPD, along with a conference dinner (and wine).  It’s a great way to catch up with like-minded colleagues, and hear updates on clinical and non-clinical topics that are relevant to rural practice in Scotland.

Well done to all our scholarship winners.  We look forward to meeting you in Inverness!

Rohan Bald (Glasgow): Tackling Loneliness

Emma Bean (Glasgow 5th Year): Drones

Josephine Bellhouse (Glasgow): Improving Use of Communication Technology

Katherine Cox (Glasgow 4th Year): Developing Videoconferencing Peer Support

David Gibson (Glasgow): Awareness of Rural Medicine as a Career

Haiyang Hu (Glasgow): Access to Mental Health Services

Saskia Loysen (Glasgow): Increasing the use of Telemedicine (and pyjama bottoms)

https://www.youtube.com/watch?v=yypuV6xNxrU&feature=youtu.be

Eloise Miller (Glasgow): Develop Rural Medicine Intercalated Degrees

Danielle Parsons (Aberdeen 4th Year): a Rural Medical School for Scotland

Gregor Stark (Glasgow 5th Year): Rural Research Consortium

Rosslyn Waite (Dundee): Improving Connectivity

Hannah Webb (Glasgow 2nd Year): Access to Sexual Health Services

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Podcast from @fakethom and @RuralGPScot highlights #ruralLGBTQ work in #ruralGP

Back in March, the Rural GP Association of Scotland (RGPAS) launched a range of guidance designed to make rural practice in Scotland more accessible to lesbian, gay, bisexual, transgender (LGBTQ+) patients.

At the annual RGPAS Conference last year, held in Inverness, we were delighted to welcome Dr Thom O’Neill to talk about LGBTQ+ inequalities in rural areas, and some of the practical ways that as GPs we can reduce barriers to healthcare.

Thom’s presentation stimulated a lot of discussion, and led to a project whereby he worked with RGPAS to develop factsheets, posters and other materials to help rural GP practices ensure that their services are welcoming to LGBTQ+ patients – especially younger patients.

You can find out more about these resources at: www.ruralgp.scot/lgbtq-plus.

We are aware that since then a number of GP practices have had discussions in their teams about how to make their health services more LGBTQ+ accessible.  We’ve also had a number of international enquiries about this work – including from Canada, New Zealand and Australia – who have been keen to use this work to increase awareness.

Thom has also been asked to adapt the factsheets for secondary care use in some parts of Scotland too.  So, as expected, the theme seems to have resonated with a wide number of clinicians and service managers.

Thom and David recently caught up to discuss how these guidelines came about, and to explore some of the themes of why LGBTQ+ patients seem to face specific inequalities of access to health care – and how rural practice has some unique opportunities to improve this.  We hope to have Thom back to this year’s RGPAS Conference (2-4 November, once again in Inverness – details soon) for an update on what how this work has been developing.

You can listen to the podcast here:

In the podcast above, we make reference to the work of Alex Bertie about recording his experience of seeking help and assistance with gender dysphoria.  Alex’s videos make for some insightful and compelling viewing, but this one is specifically about his thoughts about the GP consultation – and the difference that a more supportive and informed consultation can make particularly at a challenging and difficult time.

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Highland innovations in eHealth

Thanks to RGPAS member Dr Richard Weekes for highlighting some fantastic work going on in NHS Highland to innovate eHealth applications aimed at improving access to healthcare in rural settings.

Here’s an introductory video showcasing some of the projects…

…an STV news item about the PILLCAM project in Ullapool to provide easy access to endoscopy facilities – using some very novel technology…

… and more about bringing endoscopy to rural communities…

… and the RAPID project to overcome connectivity challenges in rural Scotland…

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RRH Guide to Getting your work Published

One of the sessions at #ruralwonca was delivered by some of the team at the Journal for Remote & Rural Health.  I was really sorry to miss it, due to presenting in another session, but my tweeted request to make the advice available online was answered quickly and the presentation is now available – see below.

The journal team are keen to encourage and motivate rural healthcare professionals to share their research, and seem genuinely interested in helping budding writers to put pen-to-paper or finger-to-keyboard.

There is a lot of great innovation and problem-solving going on in rural practice.  Rural healthcare professionals tend to know their communities well, are used to dealing with limited resources, and some of the best examples of teamwork are to be found in rural settings.  However ‘being academic does not come easy to everyone, and the process of writing up evaluation and research can sometimes feel tedious and time-consuming.

However, it is now easier than ever to find interested journals, and there seems to be a drive to make the steps to getting work published more accessible.

Watch the presentation below for the RRH team’s top tips on getting your research out to a wider audience.  You can find the guidelines for authors available here.

Also, on the theme of research, here’s a great project that aims to enable rural doctors to develop their research activity through pragmatic and direct support.  Delivered by the Faculty of Medicine at Memorial University in Newfoundland, it’s called the ‘6 for 6’ programme.  Click here for more details or watch the video below.

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