For Dr Shivani Shailin (pictured above, along with FACEM Dr Georgina Phillips and FACEM Dr Anne Creaton), her dreams for emergency medicine in Fiji are coming to fruition.

“One of the great things about being here from the beginning of the speciality is that you see the drastic changes that have happened - we are now a force to be reckoned with. I wouldn’t have believed it if someone had told me this five years ago,” Dr Shailin says.

Inaugural recipient

In 2016, Dr Shailin was awarded the inaugural Mika Ah Kuoi Award for Excellence on completion of her Master of Emergency Medicine in Fiji. She was one of the first graduates from the Master’s program in Fiji.

Funded by the ACEM Foundation, the award is presented to the highest performing student in the program and came about after Fiji National University made a request to ACEM for an award. The award is a first for ACEM but other Australian and Australasian speciality colleges do provide similar awards in their fields in Fiji.

Asked about receiving the award, Dr Shailin said the recognition was unexpected. “I was part of a cohort that consisted of some very smart doctors. I was absolutely thrilled when I found out. It’s very rewarding when your hard work gets recognised. The fact that the award was named after one of our late colleagues made it even more meaningful,” Dr Shailin said.

FACEM Dr Anne Creaton requested the award be named after Dr Mika Ah Kuoi from Samoa, who had been enrolled in the Master’s program in Fiji and would have graduated with the first cohort of students, but sadly passed away in 2013. His sudden death devastated the tight knit medical community in Fiji.

The award was named after Dr Mika Ah Kuoi to honour and celebrate the qualities of the emergency physician that he embodied: courage, leadership and a pioneering spirit; innovation, teamwork, sacrifice and persistence despite adversity.

“Receiving an award from ACEM that recognises your success is an honour in itself. Naming the award after Dr Mika makes it even more meaningful because it means that his contribution to this specialty will always be remembered,” Dr Shailin said.

Building on the award

The award included a medal, certificate and $500 towards medical education resources.

Dr Shailin received 2 clinical reference books, one covering clinical procedures in emergency medicine and the other a resource for the practising emergency medicine resident which allows for a case-based interactive approach to studying for the Oral Boards examination, while also providing an introduction to the speciality.

However, it was the two non-clinical books that found favour with Dr Shailin.

Emergency Department Leadership and Management: This has been my go to book this year. It is easy to read and includes a lot of information that is very useful in this new and challenging phase of my career when there is a lot of focus on leadership and administrative duties,” she said.

Being Mortal- Medicine and what matters in the end: A great read that makes you think about the limitations of modern medicine, how a patient is more than a disease/condition and also the importance of autonomy and how it becomes a luxury for some people as they grow old. As a doctor, it makes you look at things from a different perspective.”

Key to exam success

Dr Shailin identified a number of measures – picked up from advice from her consultants as well as things she learnt from personal experience – when asked what was key to exam success.

Continuing to work until a few days before the exam- I learnt the most and consolidated information that I had read during my clinical shifts,” Dr Shailin said.

“Taking breaks when needed is also important. Sometimes I would spend hours reading something and not understand. It’s quality over quantity and if you can’t concentrate, are distracted or tired, it is a good idea to take a break and come back to it.

“Start your revision with a topic or subject that you don’t like or find the hardest – seems counterintuitive when you think that you can revise the easy topics quickly and then get to the difficult ones. However, you are often unable to give these topics the time and attention that is needed if you tackle them last. With the subjects you like, you often know enough to score more than 50% in that question.

“And practice with a time – this includes your written paper and SCE’s (structured clinical exams). Even if you have the knowledge, writing or giving answers in a structured manner is a skill that needs a lot of practice.”

A love for emergency medicine

After graduating from medicine in 2009 and completing her internship and rural/community attachment in the subsequent two years, in early 2012 Dr Shailin joined the Emergency Department (ED) at the Colonial War Memorial Hospital (CWMH).

CWM Hospital is one of the three divisional level hospitals in Fiji and is located in Suva. “At the time I joined ED, it used to be a rest stop before joining other specialties as the emergency medicine specialty did not exist,” Dr Shailin said.

“My initial plan was to join the department of internal medicine but the emergency medicine program started after a couple of months. I realised that I loved the specialty so I stayed back and joined the program the following year and have been working there since then.”

There is also a deep personal connection with emergency medicine. “In 2012 my dad had a cardiac arrest. The emergency medicine program had just started that year and a visiting emergency consultant from the US was present at the time. He led the team (consisting of my colleagues) trying to resuscitate my dad,” Dr Shailin recalls.

“Despite their best efforts, my dad did not survive. I remember the teamwork and compassion demonstrated by everyone and this really helped my family and I cope with our loss.

“I realised that becoming an emergency doctor is how I am going to make the most difference. As   clinicians, we underestimate the impact we have on patients’ lives and the lives of their family and friends.”

As to what the future holds, Dr Shailin hopes emergency medicine in Fiji continues to thrive.

“I hope that in future we can form a society, carry out more research and get published, get more recognition locally and in the international community and most importantly continue to educate doctors across Fiji and the region so that high quality emergency care is accessible to everyone,” she said.

And personally? “At the moment I am focused on obtaining my specialist registration which I will get at the end of this year. There are a lot of things to learn and experience to become a better clinician and leader – educating yourself is a lifelong process. I also want to concentrate a bit more on research.”

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