Flying start for new exam committee chair

11 July 2023

Dr Min-Qi Lee knows all too well the impact of the postcode lottery of health on patients living in regional, rural and remote areas.

While she lives in Adelaide on Kaurna Country and works as a consultant anaesthetist with an interest in trauma, obstetrics and perioperative medicine at the Royal Adelaide Hospital and the Adelaide Women’s and Children’s Hospital, she is also a medical retrieval consultant for the South Australian Ambulance Service’s MedSTAR, the state’s 24-hour emergency medical retrieval service.

As a medical retrieval specialist, Min-Qi’s MedSTAR role involves bringing critical care services to rural and remote locations across South Australia. This can be as part of a team transporting patients who require transfer to a higher level of care or working with nursing and paramedic colleagues located in the ambulance service’s nerve centre to provide clinical advice and logistical support for patients requiring critical care transport.

“It's a job that really opens your eyes to the inequalities of access to healthcare across the country,” she explains.

“Some patients will of course need to have more specialised treatment in metropolitan centres, but I would love to see more patients be able to have prompt and appropriate care in their local communities, close to their support networks rather than having to wait long periods of time and travel vast distances to access care.

“Aeromedical transport is a limited resource and optimising its allocation can only be a positive for the patients, their families, the health system as a whole and also the environment.”

Min-Qi completed her anaesthesia training through the South Australia and Northern Territory rotational anaesthesia training scheme and received fellowship in 2012. In addition to her clinical roles she has been an ANZCA Educators Program facilitator and an ANZCA Workplace-based Assessment regional lead since 2018.

On top of her MedSTAR role, she has been a visiting rural and regional anaesthetist since 2014. She has spent countless hours – often as the only anaesthetist − in Port Augusta, a town with a population of 14,000 located 300 kilometres north-west of Adelaide and South Australia's gateway to the outback.

"What I now know is that you don’t have to live and work in a rural area to support rural practice." 

A passionate supporter of rural access to healthcare Min-Qi is the newly appointed chair of the examination committee for the Diploma of Rural Generalist Anaesthesia (DipRGA), a joint initiative of ANZCA, the Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM). The 12-month program covers the education, training, and assessment of rural generalist doctors providing anaesthesia services in rural locations.

“I’m very lucky to have such a diversity of practice in both metropolitan and regional South Australia,” she says.

“I’ve always been interested in rural practice but it’s not easy to practice a sub-specialty in rural areas. It has been nearly 10 years since I began working in Port Augusta and I have since been able to mentor practitioners and solo anaesthetists there and in other rural settings, so that side of my practice is very fulfilling.

“I was first contracted to a metropolitan hospital with links to a health network rural hospital in 2014 and this sparked my interest in rural medicine. Every 10 weeks I would do a week at a time in a rural or remote location so over time you not only end up building up a strong relationship with clinicians there but also an understanding of the needs of rural patients.

“We know there is a postcode lottery in health so it’s important that we ensure the needs of those communities
living outside metropolitan areas are well supported and patients are promptly transferred to metropolitan hospitals when needed. It can be challenging and expensive to transfer a patient with the retrieval service but most patients don’t have a choice.”

Min-Qi says health resourcing for patients outside metropolitan areas has worsened since the pandemic.

“We now have sicker and older patients who are finding it increasingly difficult to access appropriate healthcare close to home and consequently there is now increasing pressure on metropolitan health providers.

“I would love to see metropolitan health networks expand their outreach to regional areas because we know that 30 per cent of the population do not live in a metropolitan area.”



In one example of how the provision of regional medical services has diminished over time she notes that an increasing number of small towns are losing their doctors especially those with advanced skills in anaesthesia,
emergency medicine or obstetrics − meaning locals from those towns must travel hundreds of kilometres for surgery or to give birth.

Min-Qi believes the DipRGA will enhance clinical practice and benefit patients living in regional, rural and remote areas because of its stringent standards for safe anaesthesia and sedation.

“We need to support rural, remote and regional medical teams, not just anaesthetists, so patients receive the best healthcare.

“The DipRGA supports this with education, resourcing and continuing professional development and we have been able to do this because the collaboration between all three colleges has been fantastic.”

Forty-seven candidates from across Australia have enrolled in the 2023 inaugural diploma intake. The first group of trainees who began the DipRGA program in February this year will sit for the new national exam in early December as part of the diploma’s assessment process.

Min-Qi says there is a growing need for rural generalists with skills in anaesthesia practice.

Some rural generalists are already taking a proactive role and have established a network for collegiate support and posting job advertisements.

She encourages ANZCA fellows to consider how they can support their rural colleagues such as through visiting consultant posts or education and training activities.

This story originally appeared in the winter 2023 edition of the ANZCA Bulletin.