Since its inception in 1999, the Overseas Trained Doctors Scheme has accepted 117 doctors to work in rural WA. Provided these 'OTDs' complete a stint in an area of need and sit their FRACGP, they gain early citizenship and an unrestricted Medicare provider number. The ?stint' has recently been reduced from 5 to 3 years. Of the 117 OTDs, 23 have left and 13 have completed their tenure, leaving 81 doctors currently serving. Medical Forum spoke to scheme participants Quairading GP Werner Fleitmann (ex- South Africa) and Geraldton GP Brenda Murrison (ex-UK) about their earlier experiences and why they decided to stay in WA.

Dr Werner Fleitmann and family, without their motor home,

As far as early support goes, Werner apparently had an idyllic initiation.

"Over our first week in Quairading, people (including Shire President, Mick Laycock) would arrive at our door welcoming us with words, fruit, eggs, food, invitations for tea etc. We introduced ourselves to the school principal and our children were accepted and made welcome from the start."

"Support is there in WACRRM, the divisions, colleagues and conferences, but no amount of support will assist an OTD without the right feeling in their heart," Werner said.

Brenda did not find her initial experience quite as fulfilling.

"I had a weeks' orientation in Perth on arrival which included MRSA swabs, HIC, AMA, bank visit and trip to Gin Gin for 1/2 day of rural general practice. There has been no ongoing support since then. I guess I could have had support from WACRRM if I had felt that I needed it," she said.

"Rural Medical Family is a venture sponsored by WACRRM but I was not contacted by anyone from this organisation on arrival or on moving to new locations. WACRRM do organise CME events and I have done a number of these."

Dr Brenda Murrison came to rural WA from the UK. Juggling work and family wasn't easy.

Brenda found the level of responsibility her biggest challenge early on.

"I came to WA immediately after completing my MRCGP, spending one year in my training practice in Ellon, Aberdeenshire. Coming to WA and having to do on call and look after hospital inpatients with minimal specialist support was a shock."

For Werner, the biggest issue was distance.

"The most difficult part for us over the last six years was the fact that we were far from our parents, who were troubled by various health issues. Dorthe lost her father and I had to fly back on several occasions [because of ill health with both his parents]."

For OTDs, a combination of climate, lifestyle, income and opportunity played a part in keeping them in WA. When Werner was asked what cemented their decision to stay, he revealed his mechanical skills.

"I bought an old ex-Transperth Mercedes Bus. Over two years it was transformed into a motor home. This project not only let me get away from work pressures, but I bonded with mates that came over to give a hand with the work."

"The Shire did extensive renovations to our house - now it is a lovely family home. Our son Walter is studying after obtaining his B.Ec at UWA last year. Our daughter Liesel is doing her second year nursing at Notre Dame University and our youngest daughter Sabine is in year 9 at Narrogin Senior High School."

"Dorthe and I are content and happy to stay where we are - Quairading is now our home town."

For Brenda, a new relationship was the critical event behind staying.

"I was very motivated to stay in WA, meeting my future husband only two weeks into my working holiday! If I had not met him and had a swag of exams to sit, I'm quite sure I would not be in WA now. Socially, as a single female GP I would have been quite isolated."

Brenda was asked how important it was to retain OTDs in WA.

"Local graduates still perceive that country life is not for them. GP Registrars in Perth will not be keen to leave the city with jobs in Mandurah and Rockingham classified as rural. If OTDs were not present in Geraldton, the town would lose 8 of its 24 GPs and that figure does not include temporary resident GPs and locums."

Werner, as a member of the Quairading Medical Executive Committee, is also a staunch advocate of retaining OTDs.

"Take away the OTDs and how many communities are left without a doctor? I have heard the comment: 'We should not label doctors as OTDs'. I feel differently - I am proud to be an OTD; I am proud to be part of a fantastic, rural community; I am proud to be part of my local division of general practice and I am proud to be part of WACRRM."

"As a matter of fact, I am in the process of applying for Australian Citizenship - if I'm accepted, I will be a proud Australian, but still proud to be an OTD."