Previous roles pave a different path to becoming a GP

21 July 2018

Dr Vicki Mount is the first to point out the circuitous route she has had to becoming a GP. She is a College-employed first-year GP registrar at Greenstone Family Clinic in Manurewa, South Auckland.

Vicki worked in the health sector for more than 10 years before embarking on her medical training, including roles as regulatory affairs manager at AFT Pharmaceuticals, medical writer at Adis International and policy analyst for the Ministry of Health.

Growing up on a Waikato dairy farm meant she learnt a lot about biology, lifecycles and treating illnesses, and always had a general interest in health. This was reinforced by her part-time job at a Papakura pharmacy while at high school.

“It was a real old-fashioned pharmacy where they knew all the patients and there was lots of face-to-face contact and things like delivering medicines to patient’s homes. People couldn’t always pay, so they’d bring you in jam or a bag of fruit, that sort of thing. I really loved it.

“Increasingly, I’ve realised that the things I like about being a GP are the things I liked about that pharmacy job too, especially the longitudinal contact with people.”

Vicki was also interested in research, so her first step was a conjoint Bachelor of Science in pharmacology and Bachelor of Commerce in international business.

“To me, that combination was a no-brainer, but it was very unusual at the time and I had to get permission from both deans to do it.

“I had an uncle who suggested I study medicine after I graduated – he’d had to leave medical school to look after his family. But, I was in my 20s, had just finished a conjoint degree and just wanted a break from studying, so I went in another direction.”

It was several years later while working at the Ministry of Health that Vicki was encouraged to reconsider becoming a doctor.

“I’d learned that you can be so much more effective in a policy world if you have the clinical qualifications and experience; you really need to be able to ‘walk the talk’. But I’d decided that it wasn’t realistic at my age and stage of life.

“I had been thinking about doing a PhD, but I met Dr Bruce Arroll, Professor of General Practice at Auckland Medical School, who said ‘you could spend five years doing a PhD and really narrow your field, but if you go the medical route, you get to practice, which is so satisfying’.

“Bruce helped me see the value in studying medicine and was a really big influence on my decision. He has a really good balance of face-to-face clinical work while contributing to strategy and policy, which is my ideal.” Things have gone full circle, and years later, Bruce is now Vicki’s academic supervisor.

Her husband Simon, a lawyer, also encouraged her. Vicki was 31 and their eldest daughter Sylvia, now eight, just three months old when she was offered her place. She took a year out from medical school between 3rd and 4th year when their second daughter, Emily, now six, was born

“It’s a big change from hospital medicine. I love the daily patient contact and getting to know families. Each patient usually offers some kind of learning opportunity, and I'm yet to encounter a day when I can say I've learned nothing.

After two years as a house officer, she’s now in the College’s general practice education programme (GPEP) and is loving it.

The GPEP promotes research and academic activity. It works with academics to find ways of involving GPEP1 registrars in research while they are in practice. In GPEP2, some clinical time can be devoted to research and all registrars have to do audits during their training.

Vicki’s research interest is in vaccines and child health. In 2008, she had completed a Postgraduate Diploma in Development Studies, investigating determinants of health and socioeconomic inequalities. In 2017 she completed the Diploma of Paediatrics.

“I’ve always been interested in looking at vaccine-preventable diseases, especially where there is inequality. The groups that we already know are high risk are the ones that seem to be more heavily burdened by these diseases.”

Vicki and paediatrician Dr Emma Best undertook a retrospective study of non-type B haemophilus influenzae invasive disease (NTbHi) in children aged under 15 in the Auckland region from 1995-2016.

“We looked at the strains of Haemophilus influenzae that aren’t in the vaccine to see if we’re changing the ones people are being affected by, because non-vaccine strains sometimes become more prevalent. That interaction is fascinating to me.

“The data suggest that possible risk factors for invasive NTbHi may include children less than a year old, Pacific ethnicity, low socioeconomic status and lack of or incomplete vaccination status.”

The results of the study were presented to the Australian Society for Infectious diseases conference in May, which Vicki says she enjoyed.

Her current research focus is meningococcal disease in the post-MeNZB vaccine era, and trying to better understand risk, which may inform the vaccine schedule in the future for those at high risk.

“General practice is a wonderful, practical career and a really nice counterbalance to research. I want to do both because each informs the other."