Rural health in his sights

27 July 2020

Diplomate Joshua Thomas’s love for obstetrics and gynaecology can be traced back to his time working as an intern in Malaysia in 2010 where he realised his true calling while rotating through the busy department of obstetrics and gynaecology at Kuala Lumpur General Hospital.

“I was working in a very busy hospital with up to 20,000 deliveries a year which gave me immense insight into the field of O&G,” says Josh, who was born and grew up in the Southeast Asian country.

“I was working long hours and was exposed to complex obstetrics and gynaecology care, and the interest came specifically when I was in this one particular delivery which was rather harrowing and in the minutes that were passing, the urgency for a delivery was imminent. I observed how calmly yet graciously, the obstetric consultant performed an operative vaginal delivery, delivering a beautiful baby girl into the arms of the mother who wept with joy.

“Mum and dad were ecstatic, and that moment was really a lightbulb moment for me. That’s when I realised that this is the outcome I want to see in my daily work. This is the perfect combination of medicine and surgery and the nature of adrenaline that I crave. I want to put smiles on people’s faces. I want people to experience that sense of euphoria on a daily basis.”

From Malaysia to Perth

After working in Malaysia for six years, Josh arrived in Perth in 2016. Initially based at King Edward Memorial Hospital, Josh left to undertake rural obstetrics work for two years in Kalgoorlie. He now works as a Registrar at Osborne Park Hospital.

“I was actually supposed to be going to Kalgoorlie for only six months,” Josh says of his time in the Outback City. “I loved it, I loved the people, my colleagues, the patients. I loved working with the Indigenous communities. Eventually the lines between workmates, and family became a blur, making my decision to stay on longer, a much more memorable and rewarding experience.

“In the long run, that’s what I want to do. I want to work in rural medicine for a very long time, to implement changes based on evidence-based medicine and make profound improvements.”

Off to Zambia

Volunteering overseas and helping those less fortunate has always appealed to Josh, so when an opportunity arose to work in Zambia, he jumped at it.

“I felt it would be very worthwhile to stretch out a helping hand,” he says. “They were looking for someone with obstetrics and gynaecology experience who was able to run a small unit staffed by midwives only with the bare minimum. And I was used to that in Malaysia, when I was doing rural work.

“So, I thought ‘yeah, let’s sign up for this’.

“When I arrived, I have to say I was in awe at the simplicities of life yet the absolute abundance of joy the people of Zambia had. Despite their lack in resources, they made it up in grit, resilience, love and humanity. It was one of the most amazing experiences I have ever had. I loved working in settings where you have minimum resources because you really learn how to improvise. And secondly, you work closely with people who have been in these situations and you learn a lot about how mentally, emotionally and physically strong they are and how they are able to overcome all these hurdles and obstacles.”

During his time in Zambia, Josh took the time to explain and demonstrate to his patients the importance of maternal and fetal wellbeing by running morning education sessions for mothers. “And for the midwives, I organised an ultrasound tutorial from a donated ultrasound machine from an American obstetrician and upskilled the midwives by and teaching them the basics of fetal viability, presentation and basic well-being scans,” he says.

Back in Australia, Josh is always on the hunt to raise money so vital drugs can be bought and supplied to maternity hospitals in Zambia, places that are always on his mind. “I have told them they can continue to contact me, and I am happy to help and provide advice in any way I can,” he says.

His stint in volunteering has been “food for my soul” as he simply puts it. Josh now routinely and actively volunteers with the Australian Red Cross Society via soup patrol runs for the less fortunate, as well as integration programs for refugees and migrants. “This has unlocked a passion that has an emotional reward that surmounts any other,” he says.

Aiming for specialist training

Right now, Josh, 34, is busy preparing himself as a candidate in RANZCOG’s National Trainee Selection Process.

When asked what his advice is to medical students or those who are just starting their medical careers, Josh is clear: do not rush when making decisions. “We all go through medical school thinking we have an idea of what we want to do, but occasionally the interest and passion changes. For example, in medical school I wanted to be an orthopedic surgeon, until I invested time and experience and realised it wasn’t suited for me,” he says.

“My advice is: give yourself some time. Give yourself some options and discover your true passion. Because you want to go to work and do something that you absolutely enjoy. For me, obstetrics and gynaecology triggered that passion and awoke the ‘women’s health advocate’ in me.”

Josh, wife Sara and kids Jacob and Jordan

Josh during his time in Zambia with the midwives of Maramba
health district clinic, Zambia



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