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Dr Renan Sandrei de Oliveira

PGY5 Rural Generalist from Brazil with extensive experience in mental health | AMC MCQ

Summary

Now in my 5th year of clinical practice, I work as a community rural health doctor providing a range of first-line acute and chronic care services to patients in my community, including extensive exposure to patients with mental health conditions.

Amongst my many skills in psychiatry I am capable of: turning a risk assessment into a management plan for vulnerable patients including coordinating nursing and psychological care; assessing patients for various mood, anxiety, psychotic, eating and cognitive disorders; performing legal functions under the Mental Health Act; working with local community mental health services and therapeutic residential services.

In terms of my general clinical skills, I am capable of assisting patients with a range of emergent, urgent and chronic problems from young children to the elderly. Having worked as both an Emergency Medical Officer for 1 year and now a Rural Health doctor for 2 years I am comfortable independently managing a range of problems. I have advanced skills in airway management and management of trauma, as well as ophthalmic care, women's health, child health and a range of surgical and minor procedures.

For some time my goal has been to further my understanding of the practice of psychiatry in a country like Australia and I believe that this unaccredited training post will both permit me the opportunity to gain this exposure as well as enable me to advance towards obtaining general registration in Australia under the Standard Pathway.

I am confident that I could make a strong contribution to your team.

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To be successful in this role you will meet the following Selection Criteria: 

  • Hold a medical degree (MBBS or equivalent) and be registrable with the Australian Health Practitioner Regulation Agency (AHPRA)
  • Demonstrated clinical practice as a registered medical practitioner for a minimum of one year with progress towards career goals in Psychiatry
  • Demonstrated clinical competency and an ability to work independently within a supervised complex clinical environment utilising excellent clinical skills, judgment and expertise
  • Demonstrated commitment to quality improvement, patient safety and risk management and evidence of sound working knowledge of legal and ethical obligations governing medical practice**
  • Demonstrated excellent written and verbal communication skills, time management and problem-solving skills in the clinical setting as part of a multidisciplinary team**

Work experience

2019present

Community (Rural) Health Doctor

ESF Bananal do Sul Primary Care Clinic, Primary Health Care Provider | Guaramirim, Santa Catarina, Brazil

I work as a lead doctor providing the first point of care dealing with a diverse, low-income, low-literacy range of patients in a small town in Southern Brazil. The role would be equivalent to a Rural Generalist in Australia and is primarily a mix of general practice, primary care as well as urgent, acute and emergency care.

I perform the full spectrum of the clinical workup for patients, including ordering investigations, diagnosis, developing management plans, prescribing and referring to hospitals and specialist doctors.

I work as a leader in a multi-disciplinary team that includes nurses, dieticians, and therapists [what type of therapists do you mean psychologists??]. 

Key Achievements:

  • Wide experience with emergency presentations including mental health presentations such as suicide attempts, anxiety attacks, and exacerbation of psychosis.
  • Wide experience in medical emergency presentations, including acute myocardial infarctions, arrhythmias, blunt wound traumas, kidney stones and abdominal pains.
  • Extended experience with mental health patients following up on a daily basis for acute presentations ad well as long-term follow-up of chronic conditions [Here I think you should talk a bit more about the cases you see regularly, are you looking after patients under the local mental health care team, depot injections, clozapine etc...]
  • Wide experience with ante-natal care and womens' health appointments, pediatric routine appointments, immunization schedules, chronic infectious and non-infectious diseases appointments.
  • Performed numerous minor procedures including sutures, IUD insertion, pap smear collection, syringe external auditory canal, matrixectomy (nail removal).
  • Providing weekly medical home care to the most disabled and impaired patients, including mental health patients, with dementia, post-discharge from suicide attempts, and puerperal psychosis, among many other conditions.
  • Experience with alcohol and other drug addictions, including opioids, psychostimulants and benzodiazepines. 
  • Experience with electronic medical record systems, both prescriptions, exams results, referral letters, etc…
  • Large experience managing COVID19-positive patients in all aspects in acute and chronic presentation.
                        20212021

                        Emergency Medical Officer

                        Santo Antonio Hospital | Guaramirim, Santa Catarina, Brazil

                        I worked in a medium complexity public hospital with 5 acute beds and daily influx of 100 patients per day. I saw an average of 50 patients per shift, and significantly more during the COVID19 second wave.

                        [Here I would reference any mental health experience you had during this post]

                        20182019

                        Community (Rural) Health Doctor

                        ESF V Primary Care Clinic, Primary Health Care Provider | Schroeder, Santa Catarina, Brazil

                        My first position following internship. I worked as a Rural Generalist similar to my current post, including significant exposure to patients with mental health conditions.

                        20162017

                        Intern

                        Hospital de Clínicas, Federal University of Paraná | Curitiba, Paraná, Brazil

                        The internship is completed as part of the medical degree in Brazil.

                        I had rotations in Internal Medicine, General Practice, Obstetrics and Gynaecology, Pediatrics, Surgery across 20 months.

                        20152015

                        Academic Observership

                        San Francisco Veterans Affairs General Hospital, University of California San Francisco | San Francisco, California, United States of America
                        • Supervised observership performed in the Simulation Lab of a major military General Hospital for 8 weeks.
                        • Simulation training with medical interns, registrar and consultants in various procedures including oral and nasal intubation, CPR, central venous access, peripheral venous access, ABG, etc…
                        • All sets were performed with ultra-realistic models and robots for emergency situations in a Silicon Valley medical facility.

                        [This sounds like a medical school elective probably belongs below]

                            Education and Qualifications

                            2021present

                            Australian Medical Council

                            Australian Medical Council

                            Multiple Choice Question Examination passed in 2021

                            20112017

                            Bachelor of Medicine

                            Federal University of Paraná, Curitiba, Paraná, Brazil

                            Including exchange year abroad at Southern Illinois University at Carbondale, Carbondale, Illinois, USA

                            APPENDIX 1

                            *AHPRA asks you for a skills list (I have no idea why). Employers in Australia are rarely interested in a list of basic skills.

                            I have the expected skill level of an Australian PGY2. Competent:

                            General:

                            • Measuring vital signs
                            • Interpretation of pathology, radiology and nuclear medicine results
                            • Venepuncture
                            • Intravenous cannulation
                            • Intravenous fluid, electrolyte and drug administration
                            • Diagnostic blood sugar testing
                            • Wound swab
                            • Oxygen, nebuliser and inhaler therapy
                            • Bag and mask ventilation
                            • LMA and ETT placement
                            • Intramuscular and subcutaneous injections

                            Women’s health:

                            • Copper IUD and Levonorgestrel IUD insertion
                            • Bartholin glands drainage and Word catheter insertion
                            • Palpation of the pregnant abdomen, assessment of fetal positioning and fetal heart sound detection
                            • Gynecological pelvic examination and speculum examination
                            • Endocervical and perineal swab
                            • Pap smear

                            Child health:

                            • Infant respiratory distress assessment
                            • Infant/child dehydration assessment

                            Surgical:

                            • Scrub, gown and glove, assisting in the operating theatre
                            • Injection of local anaesthesia
                            • Simple skin lesion excision
                            • Surgical knots and simple wound suturing
                            • Suture removal
                            • Complex wound suturing
                            • Abscess drainage
                            • Matrixectomy (nail removal)
                            • Skin wart cryotherapy

                            Ear, nose and throat:

                            • Throat swab
                            • Anterior rhinoscopy
                            • Anterior nasal pack insertion
                            • Otoscopy
                            • External auditory canal irrigation

                            Cardiopulmonary:

                            • 12 lead electrocardiogram recording and interpretation
                            • Arterial blood gas sampling and interpretation
                            • Pleural effusion/pneumothorax aspiration

                            Neurological:

                            • Glasgow Coma Scale scoring
                            • Assessment of neck stiffness
                            • Focal neurological sign identification

                            Mental health:

                            • Mini-mental state examination
                            • Psychiatric mental state examination
                            • Suicide risk assessment
                            • Alcohol withdrawal scale use
                            • Application of Mental Health Schedule

                            Ophthalmic:

                            • Visual field assessment
                            • Visual acuity assessment
                            • Direct ophthalmoscopy
                            • Eye drop administration
                            • Eye bandage application
                            • Eye irrigation
                            • Eyelid eversion

                            Urogenital:

                            • Bladder catheterisation in adult males and females
                            • Urine dipstick interpretation
                            • Urethral swab

                            Trauma:

                            • Primary trauma survey
                            • In-line immobilization of cervical spine, cervical collar application
                            • Pressure haemostasis
                            • Volume resuscitation
                            • Peripheral neurovascular assessment
                            • Plaster cast/splint limb immobilization
                            • Joint relocation

                             

                            Observed or assisted with:

                            • Central venous line insertion
                            • Intercostal catheter insertion
                            • Oral intubation

                             

                            Continuing Professional Development

                            Advanced Cardiovascular Life Support ACLS (2018)

                            Referees

                            Dr Vinicius Vialle Ferreira | Resident Medical Officer, Emergency Medicine |The Tweed Hospital, NSW
                            T: 0405434392 | E-mail: dr.viniciusvialle@gmail.com


                            Guaramirim’s Health Secretary  ???
                            Rua Henrique Friedmann, 415, Guaramirim
                            T.: +55 47 33736255
                            E-mail: saude@guaramirim.sc.gov.br

                            Declaration

                            I attest that this is a true and accurate representation as of August 2022

                             Renan Sandrei de Oliveira