Locuming in Australia VS the UK

Emergency Medicine? HELL NO.

Dr Ambi Sud never wanted to become an ED doctor. But her experience moving from the UK’s NHS to the Australian healthcare system changed her mind and she’s now an ED registrar in Brisbane.
“I went to medical school wanting to be a surgeon (ENT or O&G) funnily enough! When I realised the level of dedication and commitment, I gradually got put off,” she says.
She dabbled in a number of areas – including in dentistry (like her dad), sexual health, and dermatology, but ED won her heart in the end. She says ED in Australia is very different from the UK. We talked to her about the ups and downs of locuming in Australia and how the two healthcare systems compare.

What’s the biggest difference you find between medicine in the UK and Australia?

There’s a lot of differences but in short:- Relatively liberal prescription of opioids/benzodiazepines and even antibiotics in Australia - The patient expectation of healthcare is much higher in Australia - I’ve been yelled at for “making someone wait” for an hour..! - Less understanding of what is appropriate to present to ED for in Australia and what should be seen and managed by a GP (this is not limited to patients, I’ve had some very inappropriate referrals from GPS themselves)- Patients are far more readily imaged with CTs and other modalities in Australia than in the UK

What’s your favourite thing about locum work?

The flexibility is amazing. Being able to have a holiday when I want, decide how long for and when to work, or if I want to work at all each month is really liberating.

What’s your least favourite thing about locum work?

Some hospitals can be really unfair with rostering and give you shifts they wouldn’t ordinarily give their permanent staff e.g. 10-night shifts straight as I was once told I was getting. Ultimately, it shoots themselves in the foot as a lot of locums will then not want to work there or will end up being off sick due to fatigue (which you don’t get paid for as a locum).

For anyone considering locum work – what would be your top 3 tips?

1. It’s a good idea to save a good portion of your money each month in the event work is a little more scarce. During COVID, patient numbers dropped significantly and I had a few jobs cancelled. There’s also sometimes less work at the start of the RMO year as most positions have been filled.

2. I personally prefer to work for short stints often e.g. 6-8 shifts twice a month than working for a month-long block - I’ve done the latter and it was totally pointless for me, I was bored and miserable on my days off. This is a personal preference.

3. Stand your ground with your agency - their job is to fill rosters, and ultimately they want you to book work (regardless of where!) so they get paid. Be sure to read up on the role, how rural the hospital is, if airway skills are required etc, and DO NOT accept jobs that are above and beyond what you are comfortable with no matter how much you’re being pushed to!