My first rotation in 2025 was my Emergency Department rotation, and I found it to be quite a useful rotation. I was placed at the Angliss Hospital, a smaller, peripheral hospital located in Upper Ferntree Gully. This hospital was such smaller than Maroondah and Box Hill. It had a gen med and gen surg ward, and a birthing suite, as well as an ICU. However, the ICU would be closed in the weeks after I finished my rotation due to construction.

My days at the Angliss consisted of going in when my allocated consultant was in. For me, this was around twice a week. They recommended shifts of 6-8 hours, but given that it was a bit of a hit or miss whether something interesting happen, and in order to tick off our modules and logbooks, most of my group of five stayed for longer.

The parking situation around the hospital was dire. There was 4P and 2P, which for us students meant we needed to move out cars. Otherwise, the station was a 15 minute walk away, but this also filled up quickly in the morning. We saw nurses going to move their cars often, but for doctors who don’t necessarily have consistent, protected and allocated lunch breaks, this was unrealistic.

During my ED rotation, I realised that there were only a few presenting complaints. What I mean is, many patients came in with similar complaints and thus a similar pattern of cluster questions could be posed. Presentations like chest pain, abdominal pain, urinary difficulties, shortness of breath, headache, for example were common. I realised as well, many patients were not rapidly deteriorating. Even though there is a stereotype of the ED being an intense, fast paced environment, which it can be, those ‘excitinf’, complex cases are much rarer than I had expected.

We got to see patients across a range of demographics as well, for example paediatric patients, and many geriatric patients. Many geriatric patients came in via ambulance because they had had a fall, for example, and we saw patients ramped up in the corridors, waiting for a bed. I’ve begun to understand what has been portrayed in the media as ramping, even though I didn’t explicit see the ambulance vehicles themselves being ramped.

I also got to understand the triage system. For example, most patients with suspected cardiac related chest pain get a triage level of at least 2, while triage level of 5 is for relatively minor cases. For some patients I saw, they had spent a long time in the ED and were on the verge of leaving. Many patients also had been referred by the Medicare Urgent Care Clinic.

I also got to practise a lot of my skills, including seeing patients independently, doing the workup, including cannulation, suturing, MSK management like backslabs, as well as some more serious cases like haemorrhages. I got to practise reporting to consultants, and I also followed doctors of all levels.

The team was so lovely and there were many HMOs from the UK or Ireland who were here temporarily. Maybe up to half of the doctors were from there actually, the greatest percentage I’ve seen so far. All the doctors were very nice, and I felt supported and welcomed in the environment, as a student who didn’t always have a set tasks to do and was sometimes just there.

I feel that this rotation has been the most beneficial so far in terms of learning during placement, due to the hands on nature and the applicable takes. All interns have to do at least one ED rotation as well, with further rotations in the future, so it’s very important to become a good ED doctor. It felt like endless OSCEs in an independent environment, and I have grown much from this rotation.

I don’t think I want to pursue Emergency in the future. The work life balance isn’t as bad as it has been described to me, but the lack of patient continuity and the repetitive nature isn’t very appealing to me. Nevertheless, I have gotten much of this roation.