A Day in the Life of an ED Junior Doctor in Brisbane, Australia
To give you a first-hand look at what it's like working in Australian Emergency Department, we have interviewed an ED junior doctor currently working in Brisbane, Australia.
Dr Mark Coulson moved out to Australia in his F3 year in 2019, and is now entering his third year working in ED at Princess Alexandra Hospital.
Mark is also the author of Messly's Guide to Working in Emergency Medicine in Australia as a UK Junior Doctor.
🧳 When did you move to Australia?
I did my Foundation Training in London, and moved to Australia after my F2 year. I had lined up job offers by January of my final year with the plan to come out with my partner in August straight after completing foundation training.
Unfortunately, plans were delayed slightly as the first wave of COVID-19 was just receding, and Australia’s strict isolation strategy - with immigration caps, reduced flight availability, and mandatory hotel quarantine periods, meant we actually began work in October of 2019.
🤔 Why did you choose to move?
I had actually always intended to come out for an F3, and used my med school elective as a ‘trial run’ - coming to Melbourne and Auckland to get a feel for life in the southern hemisphere. I started seriously looking into finding a job here during my first rotation of F2.
When the first wave of the pandemic hit London, it hit hard, and the hospital I was working in was quickly overwhelmed. I still think of it as a crucible that helped forge the doctor I am today, but looking back on it, I was burnt out and emotionally exhausted from breaking bad news all day. Having the promised land of Australia to look forward to helped me get through it, and I’ve not regretted the decision since - it lived up to my expectations.
🩺 Where are you working now? Have you moved hospitals or stayed in one place?
I have been here for over 2 years now, and I am still working at the hospital that I started at (Princess Alexandra Hospital, Brisbane). From sponsoring visa and paying relocation costs, to continuing to support my training, they have been exceedingly good to me, and they have a great ED which I love working in. I am glad I made the choice - although my contract is up and I am moving on in January 2023.
Others that I have met since arriving have tended to move from their original positions to centres more suited to their career goals. After 1 year and with General registration (check out this guide if you're unsure on how registration works in Australia), you're a more appealing candidate and this can open up more options in where you work. Those that plan on returning to the UK at some point have mostly switched to locuming so they can earn the big bucks whilst having the flexibility to see the country.
🇦🇺 How did you find settling in? Were the first few months challenging?
There was definitely a moment off the plane where I was sitting in an Airbnb in a new city, in a country where I didn’t know anyone, where I was wondering if I’d made a huge mistake, but the nerves were pretty short-lived. Moving here with a partner helped, and we were placed on matched shifts with all the same days off - but even those that have moved out alone have quickly found a good social group.
There were a lot of other British medics I met, either starting work at the same time as me or through friends of friends. There is a really strong culture of us coming out and Australian hospitals are generally keen to hire us - so there is a lot here. That really helped to give a ready-made social group of people who were keen to explore and trial all that Aus has to offer, and understood when you had struggles at work or with missing home. It’s not dissimilar to University freshers’.
For their part, my hospital was amazing at helping us settle in. The colleagues were friendly and, thankfully were expecting the lag in my efficiency at work until I had been shown the ropes. They also helped with funding flights over and paying for our temporary accommodation before we signed a lease here. Helping with relocation costs seems fairly commonplace here, but it’s worth asking about if you hold an offer and it’s not been mentioned.
💉 How has the clinical work differed? How is it better or worse?
I’ve spent the majority of my time working in ED, and I’ve written Messly's Guide to Working in Emergency Medicine in Australia as a UK Junior Doctor, which explains the differences between Australia and the UK in terms of clinical experience, supervision and pay.
For my part, I have found the clinical work equates fairly well. The management of some specific conditions is a little different, and there are a few differences in prescribing, but this is no real challenge. I have an interest in critical care, and so far in Australia, aside from ED, I have also been able to request rotations out in Anaesthetics and ICU. I have found that the amount and the quality of the teaching I have received have been excellent - there is often just more time for seniors to teach than there is back home. ‘Service provision’-type roles do still exist, but they are less common.
🏥 What has your rota been like?
There are not generally many staffing shortages. I am contracted to work full time - which works out as 38 hours a week, split into 4 x 10 hour shifts (including a 30min meal break).
With enough notice and negotiation, we can often stack these so we get long weekends or runs of 3 or 4 days off in a row.
Working in ED, there is a balance between day, evening, and night shifts. Rostering rules are fairly rigid here - I am required to have a sufficient break between shifts and after night shifts, for example. If I was required to break those rules, the hospital would pay me ‘fatigue pay’ at a higher rate for that whole shift. I’ve not had to do this yet - I figure they are as reluctant for me to work those hours as I would be!
Shift work means I am able to hand over and generally leave on time, and there are usually provisions built into the roster to cover any sick leave. I do occasionally have to stay late to finish up notes or transfer sick patients etc., but there is a strong culture of being paid for the hours you work, and I have had no problem claiming (double rate) pay for any overtime.
💰 How much are you paid? What does this equal in take-home pay each month?
Pay is fairly generous, and my basic salary after moving out was just under $90,000 a year, paid out in fortnightly instalments.
I receive additional loading for any antisocial hours or covering sick leave on top of that - I get double time rates on Sundays, for example.
After tax and mandatory pension contributions etc, I will usually end up with take-home pay of $3,000-4,000 a fortnight. There are other bonuses, such as salary packaging, which I am eligible for by working in a public hospital - a proportion of my rent money comes out of my payslip before tax and is then paid back to me separately by a salary packaging company.
From speaking to friends, salary is banded according to your postgraduate level in some states, meaning it increases after August each year. However, this is state-specific to some states only if you take on more senior roles after your first year, pay increases accordingly.
👩 Are there lots of other British doctors working with you?
Yes! There were about 10 of us that started at the same time at my hospital and several on the same flight out. As people have moved back home or come out, the number I work with has fluctuated and recruitment numbers each year are dependent on the number of rota gaps that hospitals have. In areas like ED especially, there are a lot of Brits who have ended up staying, and a good number of my seniors are doctors who came out like we did and ended up staying to train here.
🙋 Have you managed to make friends easily?
Being on the other side of the world from your friends and family can be very isolating, and having a great social network out here has gone a long way to making it a home. Moving here, there has been a wealth of new experiences to try and things to do - and there has been a fantastic bunch of people who are just as eager to try them as we were.
Perhaps as a product of being away from family and old friends, people form strong bonds with the other British medics who also come out here - and I have loved celebrating Birthdays and Christmases together with my ‘Australia family’. There are lots of social gatherings. We have even set up a regular 6-a-side football team with a rotating squad of players sourced from nearby hospitals. I have made a few friends amongst the natives along the way too.
🦘 Have you considered locuming in Australia?
Locuming here can be very lucrative, and can afford more flexibility to explore the country. After a year of supervised practice and being granted full registration to practice, then a lot of people choose to locum, many of my colleagues and friends included.
Personally, I have not yet explored this option. I have found my department to be a great place to work - I am happy there and am offered regular opportunities for learning and improving my skills. Whilst I could leverage my position for better pay, I personally feel my pay and leave allowances are already more than fair, and whilst I consider my options for future training, I have found it rewarding and sensible to stay somewhere that is invested in developing my skill-set.
🇬🇧 Do you have any plans to come back? Do you think you’ll stay long term?
This is the big question - stay and train or head home to family and friends. On one hand, the work here is rewarding, training options are great, and the work-life balance is better. However, I am a long way from home and friends and family who aren’t getting younger. Settling down and starting a family without an immediate support network is a big call.
If I’m being honest, I think everyone who has come here has felt the pull to stay, and it’s a question everyone wrestles with. My partner and I are currently in the process of deciding what our next few years will look like. We are lucky to be in a position where there are no overtly bad options.
☝️ What are your tips for anyone considering a move to Australia?
Be prepared to re-evaluate your biases. Things are different here, and I am loathed to say it, but having witnessed the healthcare system here, I have concluded that the NHS model is not necessarily better. The political and economic environment of the UK at the moment is sure to result in a growing appetite for time in Australia and I would strongly encourage anyone considering it to give it a go. For me, the promise of a better working environment, better pay, and better work-life balance have all been true and I have no regrets.
📚 Continue Reading
🚀 This article is part of Messly's Ultimate Guide to Working in Australia. The guide covers all you need to know as a UK doctor to understand your options, research your move, find work, get registered and move out to Australia.
❓ If you are still weighing up whether a move to Australia is right for you, our article To Aus or not to Aus breaks down the pros and cons, so you can make an informed decision. Read this with Common Questions on Moving to Australia as a UK Junior Doctor.
🤔 Confused about how the grades work in Australia, and which roles you should be applying for? This article breaks down the grade system and explains which roles might be suitable for you.
✈️ There are four routes to finding a job in Australia. In this detailed guide, we explain how each works and the pros and cons of each, so you can kick-start your search for your dream job Down Under.