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Under the Sydney Clouds

Dr Eoin Fogarty

Graduated from UCD in 2004.He has just completed a one year rotation as a HEMS registrar in Sydney.

He is currently about to start a 6 month secondment in Geelong hospital, Victoria and is working towards his FACEM.

To start with I graduated from UCD in 2004 and over the next ten years I worked in various posts in mainly Emergency all over the country.

I like to think I got a good and bad experience of emergency medicine in Ireland.

In the latter stages of my SPR scheme I got introduced to prehospital and retrieval medicine by doing supervision shifts with training Advanced Paramedics in rapid response vehicles and doing retrieval with Aeromedevac Ireland.
One thing led to another and before I knew it I had a job lined up in Sydney for Careflight doing HEMS and fixed wing retrievals, to start in August 2014. I had one year left on my SPR scheme in Ireland after I got the job offer and the thought of moving to Sydney and leaving behind the dysfunctional and overcrowded emergency departments really kept me going. I remember being semi obsessed with following social media about Careflight during this period. The work they did was exciting and really satisfying. The paperwork for registration and visas was quite trying and expensive at this stage but I battled through as I was very enthusiastic.

I finished work in St. Vincent’s in early July 2014, got my pass in the FCEM on July 11th, got married on July 12th and then flew by myself on the 28th to Sydney leaving behind my slightly annoyed new wife. She was to fly out 6 weeks later.

My first experiences of Sydney were very positive. I went into the administration people in Careflight on my first day who literally greeted me with open arms and a hug. They also handed me a breathalyser and a urine specimen pot for drug testing. I was told that this is normal and happens frequently in aeromedicine.

The next 5 weeks or so involved intensive training typically up at 5:30 each morning and getting home around 9 exhausted and fit for bed. The training was like doing an ATLS course non-stop. The medicine is quite different to Ireland including a low threshold to do rapid sequence induction and blood being the resuscitation fluid of choice for all trauma patients in the prehospital setting. We then did a one week helicopter familiarisation and Helicopter Underwater Escape Training course (HUET). The winch training was definitely the bit scary. I tried to play it off with my crewman but one look at my white knuckles when I would hold the firm handles of the cabin gave it all away. When I thought we were done we then had to restart it all again doing it at night time with the crew using night vision goggles.


I went live on our rota in early September. One of my first jobs was an elderly patient about two hours flying on a fixed wing west of Sydney. He was in complete heart block and needed to be retrieved to a Sydney hospital. The runway we were to land on was something similar to an ordinary road, well actually it was just an ordinary road with a few extra lights that the pilot could turn on from his cockpit. The pilot flew over once to scare away any kangaroos lying on the runway and then landed. It was a short hop to the local Emergency Department / GP surgery. This hospital had a capacity for two patients and I remember the nurse said if anyone was “sick” they were transferred out. The flight back was uneventful but a real eye opener for rural medicine in outback Australia.
Over the next four months I did about forty jobs. These were about 50:50 interhospital / primary tasking’s, the term interhospital being used very loosely as a number of hospitals I attended did not have basic facilities like X-rays out of hours. Most tasking’s were to trauma patients primarily with a helicopter response. I did a small number of jobs in road ambulances and fixed wings. There is a lot of downtime in this job but when you’re busy your usually really busy. I have ended up watching and learning a lot about cricket in the helicopter base during the downtime.

I have yet to do an actual live winch but have done some amazing flying including flying under the clouds through the valleys in the Blue Mountains and landing on a 69,000 ton cargo ship off the coast of Newcastle where I got out to pick up an injured sailor. The Emergency Departments here are very different to back home where you are unlikely to come across inpatients and trolleys and you are generally greeted here by multiple senior doctors in varying specialties on your arrival.

I work about two shifts on base and two shifts on call a week. These are usually 12 hours long but can be extended depending on the cases going on. There is usually at least one other doctor to call and if you’re fatigued and you are expected to say so and go home. The idea of going home early during a 12 hour shift is completely foreign to me but I have seen it happen here.

The take home pay is almost twice what I earned as a senior registrar back home. You will need this though as Australia is expensive.

I am quite happy here at the moment but definitely miss home. We are very conscience that family and friends back home are realistically a day and a half away if we need to go home in a hurry.
My plan is to move to Melbourne next August to continue in Emergency medicine and work towards my FACEM.
Overall I loved the move to Australia and regret a little not moving over sooner. When the conditions are right back home we’ll be moving home.

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