Motivational talk on specialist training and Emergency Medicine

Last month I had the pleasure of talking with the UOW 2015 graduating medical at their “welcome to the real world” workshop lecture series. It was a real honour to be invited to speak about Emergency Medicine with this group of future doctors.

I decided to offer some reflections about my own diverse journey which has spanned several countries and a few different disciplines including surgery (which I embarked on many years ago), research (which led to a PhD that was complted this year) and emergency medicine (which I am currently in the process of completing).

2. My journey

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Some of the highlights of the talk for me was to be able to use a bit of simulation and creative to highlight through direct experience what some of the key elements of Emergency Medicine include. To this end I used a bit of shaking and laughter yoga, an audience surprise, and finally a short guided meditaiton to let the group exeprience the calm within the storm. I was lucky this was such a willing audience.

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The actual talk was a good chance to highlight the importance of knowing onself when chosing a medical speciality, as well as knowing what that speciality is about, and understanding what the job entails; both positives and negatives. For me the key reasons to chose a speciality is related to inspiration, and taking a path towards following an inner dream. Mentorship is key for this long journey, and I am every grateful to have had many great mentors along the way.

1. Why we chose a career path

The talk ended with a guitar peformance of a song I wrote whilst doing field work for my PhD titled Peaceful Revolution. It’s an interesting song about some of the wisdom I learned in the villages of rural Sri Lanka. Part of the song is about how there seems to be much more harmony between nature and human existing in the rural areas, and in the cities where I’ve spent most of my life it is easy to have so much in material wealth, but at the same time so easy to forget to touch the hearts of others.

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The gratitude List

There are always so many people to thank for every talk I give. First and foremost I am grateful to my many wonderful mentors – without whom a talk of this nature would not be possible. Then there was the audience, not only for being a kind and generous audience, but also for participating with some of the off-the-beaten-track interactions that I had schemed into this particular talk. Thanks also to the new graduates;- Dr Hayley Dyke who helped me out with being an improptu back up guitarist for the performance, and of course to the lovely Dr Beatrice Dowsett, a member of the class and workshop organiser who invited me to speak. Bea is such amazing person, talented both within and outside the medical arena. I’ve had the pleasure of meeting her at the local hospital acting/film/drama forum created by Dr Tony Chu with the help of other keen artistic doctors at Wollongong Hospital, who meet up monthly for the what we call Fry Day Drama (read more to find out).

I am also very thankful for the clinical team of which I am part of at at the Wollongong hospital, for supporting me to get across to the university campus to deliver the talk during a busy – (Thanks Dr Venita Visvalingam, my supervising Consultant Physician and Dr Annie McKean our hard working Intern!).

Thanks to Dr Nemeshi Fernando who was one of class who gave me some feedback (which I put on my You Tube channel) about the talk. It’s always wondeful to get nice feedback from the audience, and to know that your message is understood.

But finally – Congratulations to the UOW 2015 class – Well done – You made it!!

and… “welcome to the real world!”

Extra web-links

Please leave your “feedback” below:-

I have included the entire talk above, with some additional slides that include a few medical related poems that I once submitted to an Australasian College of Emergency Medicine (ACEM) conference.

If you are reading this and attended the talk, please leave your feedback in the comments section below. I would love to know what was helpful and what resonated most with you as I endeavour to develop this talk further in the future and your feedback is warmly appreciated. 🙂

Dogs run wild


Dogs run wild
Dogs run wild,
The winter weather hits so mild,
Upon the cheeks of my soul.
Sunshine fills my heart,
And lines up the path,
To a magical and mystical destiny.
Many bridges have been crossed,
But the paddock still seems lost,
Drifting into the eternity of time,
Dissolve seconds with a breath,
And move beyond the test, 
Through a dimension that leaves all  worries behind.
“Look” and “Ye shall find”!,
As the dog run free from bind, 
And then you’ll know that all we need is LOVE.  
21/8/13 sitting in this beautiful park where I feel the mystic charm of possibility for knowledge and dreams, which are more real than thy seem!
When time dissolves, the universe opens up!
Just now I was touched by a nice person in the coffee shop. 
I walked down for my usual afternoon coffee break, and then realise when I went to pay, that I had no money (I’d left in such a rush because I just needed some fresh air to get away from the writing and mental effort).
“Oh no!” I said, almost thinking aloud as I reaching into my jacket pocket and found it empty, “I think I’ve left my wallet back in the office” I continued, as my whole body started to make an about turn… 
But the friendly Barista standing in front of me stopped me short and said, “well… we can take it out of here” (pointing to the tip jar), “as long as you remember to put it back next time”, in a relaxed way.
“Is that okay!?”, I said in astonishment, but also in deep appreciation, like a kid who’d just been given a birthday present. 
“Why sure, you come here everyday”, she justified with simplicity.
I was so touch by this act of generosity, and the complete turn around in my “assumption system” about people in big cities, and people in Sydney. 
Thank you so much for that that random act of kindness – it really made my day, but more than that- it touched the world in some small but big way!
(Well i’ve had my coffee, said hello to the park, and seen the dogs run – now it’s back to the office!)
Peace out
Bishan 🙂

Interesting interview from the “Godfather of Emergency Medicine”

I was just about to go to sleep at 5am after doing my research when I check the Life in the Fast lane’s list of recommended medical blogs. I clicked on a blog called “residing in the ER” and ended up watching a 3 minute video clip which was an interview with Peter Rosen, known for being the chief editor of one of the most highly recommended text books of Emergency Medicine (“Emergency Medicine: Concepts and Clinical Practice). The truncated interview that follows is taken from an in-progress documentary called “Heal Thyself”, and from what I can gather from this clip, explores a physicians struggle through the realities of modern medical practice that perhaps lead to “burn out”. 

The inteview illustrates this physician’s passion for treating patients, with care, and his inspiration of knowing “what to do” in the delivery of acute care. One of the things that moved me perhaps the most was the wise message given as a strategy to avoid burn out – which was  to “revitalise your ideals” and to connect with the “gift of affection”. However, as I watched this video I couldn’t help wondering “have the current systems of medical care changed so much that it is having effects on even the most passionate within the profession?”

I think the answer to this question is “maybe” as the pressures in hospital medicne and particularly emergency medicine are high, and increasing. Why is this? I think it is to do with the mismatch between the expectations of society, the legal system, hospital manangement, and what the doctors themself expect should constiute health care. 

I have had a special interest in burn out for many years now becuase I have always considered myself to be quite an enthusiastic and caring doctor, and, I am very keen that these qualities do not “burn out” – yet although the challenge is worthy, I feel the road is rocky, in todays high pressured hospital environment, and consequently today’s ‘training’ enviroment. Reading what is out there on the blogosphere I started to realise that I was not alone, and now seeing this clip from Peter Rosen it appears that this sentiment perhaps could be in association with esteemed company.

It has been of great interest to me to try and find tools to avoid burn out, and to maintaining the passion whilst walking the difficult path of training and medical practice. In my view the solution lies in “taking care of oneself” – and for me that involves, ensuring rest and satisfying the soul, through the journey of training. But I guess everyone’s path is different? Nevertheless, the concept of “Healing Thyself”, the proposed title of this documentary (from which the above video clip was taken), is of paramount importance if we are to be able to heal others, and this is something I certainly teach or mentor to those more junior than I whenever possible.

Perhaps those of us who are in medical education are familiar with the CanMEDS principles which are thought to strategically address some of these challenging situations created by modern health care – thorugh a more well rounded training of doctors. I think this is a very noble cause, one that I am very enthusiastic about – and the You Tube clip below shows some of these goals nicely played out with acting and music:-

However, whilst I’m optimist by this framework of training, I believe that at the same time there needs to be the development of “collaborative” common-sense expectations of health care delivery, that involve the ‘entire’ society, as a whole, if we are to avoid the mismatch from persisiting.  


Physician Heal Thyself

Physician Heal thyself,

Or you will feel like you are stranded on the shelf,

There is pain you seek to heal, 

But try not to deny what you feel,


How can it not affect me,

When it was ‘feeling’ that taught me to see?

How can it not deject me,

When suffering lives on the other side?


The change of tide is arriving,

Integration is thriving,

For a new age of understanding,

Is collaboratively re-expanding. 


Well there’s my poem for the night – Good night 🙂