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  • Joanne Gray: Hello everyone. We'll get started, if everyone's settled. At first, we would just like to acknowledge that we are meeting on the land of the Cadigal people of the Eora nation tonight. We acknowledge them as traditional custodians of knowledge for this place. Indigenous Australians have been on this land as we know for around 60,000 years, and in that time they've developed communities, they've developed languages, a deep culture and a connection to country. They've worked, played, loved and parented. They've built family and they nurtured this land, and they remain deeply connected to country. I acknowledge elders past, present and those emerging in the future, and also any Aboriginal and Torres Strait islander people who happen to be here with us tonight.

    Joanne Gray: Welcome to you all. It's wonderful to see so many enthusiastic faces here with us this evening. You come from a broad background and I think for many of you, you probably haven't decided which discipline you may eventually journey into, whether you are going to take that journey at all. But tonight it's a wonderful opportunity to hear from clinicians as they talk about what they do every day in their work. It's quite unique I think, to have this opportunity because sometimes you think you might know, for example, what a speech pathologist does. I have certainly learned since I've been in the Graduate School of Health a lot more about these disciplines than I thought, and having thought I already knew a little bit, anyhow. I come from a background as a nurse and a midwife. So, I've worked in the hospital setting and I thought, oh yeah, I've got a pretty good idea, but when they start talking about their deep understanding of their discipline and the passion they have, I've really learned a lot more, and I'm sure that'll come out tonight as we listen to each of our clinicians who are here present.

    Joanne Gray: So, my name's Joanne Gray. I'm the head of the Graduate School of Health. I've been in the school now for about nine months and as I said, I come from a background of being a nurse and a midwife from the Faculty of Health. So, this has been a lovely change to work with a different range of disciplines, which has been great. As you know, tonight, the event is being filmed. If later when you ask a question, we will come to you with a microphone and ask, please that you speak in to the microphone. The reason we're filming it, is because there's many people who can't be here tonight. We know this is a unique opportunity. We don't expect our clinicians to come back every week and be so generous in their time. So, we are wanting to film it, and that these videos we put up on the website so that other people who are interested in the programmes we offer here are able to go on and find those films.

    Joanne Gray: The other thing I'm going to do, is ask you, we're going to do what's called slido. You probably all know what it is, but if we can just go to that slide and I will ask you to set this up on your phone now. So, this is where, if you go into your web browser and type in, if you wish to, that web address and key in #UTSGSH. What you can then do, is you can pose questions and then you can vote those questions up. So, one of you might ask a particular question and you think, "I've always wanted to know the answer," but you didn't think of asking it. You can then click on that and you can then decide that you think that's the best question out there, and you can push that up to the top of the queue. That's just another way of us sort of getting an idea of what it is you want to ask. If people don't feel free to always ask questions themselves, but there will be an opportunity just for the old fashioned, put your hand up and you'd like to ask somebody a question.

    Joanne Gray: I will now go through and introduce our speakers. We're very fortunate that they're sitting in front of the banner that belongs to their name due to their profession. I promise you there are no tricks. So, you will hear from Mitch, who's an orthoptist. It's all going to work out like that, but I thought I'd just let you know. But they look very, I think it's very attractive, sort of lucky we've got going here, which is wonderful. And again, thank you so much all of you for coming tonight. So, I'll start first with Helen Benson. Helen is an accredited pharmacist and a practitioner teacher at the UTS Graduate School of Health and Health Destination Pharmacy coach for the Pharmaceutical Society of Australia. Helen has a special interest in the integration of pharmacists in JPs and the expanding role of pharmacists.

    Joanne Gray: Adele Stavropoulos, I nearly got it right, I think. Adele is a Clinical Psychologist and a UTS Alumna. Adele is experienced in the evidence-based assessment and treatment of a range of clinical presentations, including mood disorders, anxiety disorders, trauma and stress related disorders, feeding and eating disorders, grief and loss, adjustment difficulties and personality disorders. Adele also works with children and their families to overcome issues such as behavioural problems, emotion dysregulation, trauma and attachment concerns. Adele works with adults as well as with children of all ages, adolescents and their families. It's a huge scope of practise you can hear from the work that Adele does.

    Joanne Gray: So, Belinda Hill, is the senior speech pathologist and clinical director. Belinda graduated from Sydney University in 1993, with a Bachelor of Speech Pathology, and completed her masters of Applied Linguistics at Macquarie University in 1996. She's worked in private practise as a speech pathologist for the last 26 years, in addition to a range of other contexts including Tafe and juvenile justice sittings. She currently owns and operates a multidisciplinary clinic in western Sydney, and she's Vice President of Communications at Speech Pathology Australia. Maya, is it Maya or?

    Maya: Maya. Good.

    Joanne Gray: Maya is an Associate Genetic Counsellor with extensive health practitioner experience. Maya completed undergraduate studies in medical imaging, diagnostic radiography and ultrasound before embarking on a career change through the study of the master of genetic counselling at the University of Sydney. Since then, Maya has worked in a number of settings, including cancer genetics in a public hospital, oncology department and in the private sector, an assistant reproductive technology in prenatal care. Maya currently works with specialist obstetric ultrasound practises providing preconception and prenatal genetic counselling, about the chance of having a baby with a genetic syndrome or chromosomal abnormality.

    Joanne Gray: Mitchell Bagley, an orthoptist who graduated in 2011, and has worked throughout Sydney maintaing strong interest in eye turns, orthoptic therapy and laser eye surgery. He's previously conducted and presented clinical research into surgical procedures and new diagnostic technology. In 2014, Mitchell volunteered at a hospital in Burma, collaborating with an international team to treat severe and rare diseases. More recently, Mitchell has co-authored a children's book called, Amazing Amber and her Lazy Laser Eye. That's a great title for a book. Which promotes successful eye patching therapy. Currently, Mitchell is the Head Orthoptist and eye specialist and in this role, participates in international clinical trials.

    Joanne Gray: Georgia Fischer here is our physiotherapist. She's an accredited physiotherapist currently working in the South Eastern Sydney Health District as a rehabilitation physiotherapist. Georgia is also a PhD candidate at the Graduate School of Health with a research focus on physiotherapy, neurology and allied health science and focuses on unilateral neglect in stroke patients. So, it's an amazing array of work that these clinicians do. Just reading out all of those bits and pieces, you can see that the work of an allied health professional just covers a whole range of areas and certainly across the life span.

    Joanne Gray: So, there are a few questions that I've got, that I'm going to put to the clinicians and just to a variety of them. Remembering of course, if there's anything you want to particularly ask, there will be the opportunities. I'm just going to start off, and if you think of anything else you want to ask, maybe jot it down or of course you can put it up on slido. So, I'm probably going to just go fairly orderly to start with and we'll see how that works out. So firstly, Belinda, what does someone in your profession do, and what are your main job tasks, and where do you work?

    Belinda: Okay. I can talk from my own clinical perspective, and then I might just talk about broadly how the profession is situated. So, I work in private practice. Our private practice works with people across the lifespan. So, from young babies who might have difficulty feeding, all the way through to someone in an aged care facility who may have some difficulties with communication or with some meal time management. So, as a profession, we work with people in all stages of their lives. As I mentioned, from babies right through to aged care. We often assume that we focus purely on speech or stuttering or voice, but speech pathology actually covers communication, which is reading, writing, speaking and listening from infants right through to aged. Those settings can vary from working in the clinic, working in preschools, in hospitals, where the focus is more on rehabilitation. 

    Belinda: So, I might be working with someone who's rehabilitating from cancer treatment. We might work with people who have had a laryngectomy or who have had some recovery from a traumatic brain injury. So, in terms of where you might be working, it could have a medical focus, educational focus if you're working in a school, or working in private practice. So, there's opportunities to kind of follow whichever pathway, someone's preference.

    Joanne Gray: Yeah. It's a lot of choices, certainly. Thank so much. So, Mitch I'll put the same question to you then.

    Mitchell Bagley: Yeah. I work at private practice in Western Sydney. I've kind of worked all over Sydney in different roles, and really as an orthoptist kind of part of our, profession is very much in terms of diagnostics and ophthalmic disease. So, we do lots of imaging using very niche pieces of equipment to look at different aspects of the eye, vision and perception, which is really interesting in itself. That kind of goes hand in hand with those patients who are pre and postoperative eye surgery. So, we do a lot with assessing for people, for laser eye surgery. But then also, we've got a strong therapy focus of course, where we do a lot to do with, people with eye turns. Whether they're born with those, they develop from neurological disease processes, or trauma and injury. We do a lot in terms of correcting double vision, realigning peoples' eyes, eye patching and that goes right down from children to the elderly. So, it's really quite diverse, and interesting.

    Joanne Gray: Yes. Great. Thank you.

    Maya: Okay. So genetic counsellors, we work along with side medical specialists. Common settings for genetic counsellors to work alongside oncologists, cardiologists in my case, obstetrician, gynaecologists, geneticists, and we work in a variety of settings. So, paediatrics, neurology. I'm in prenatal at the moment, assisted reproductive technology and what we really do is, our goal is to translate the science, which is often complex and ambiguous into language that our patients or clients can understand, to make that knowledge and information accessible. So, that they can make values based decisions on information they understand.

    Maya: So, an example would be that, in my current role I work in, a private practice setting where we have patients who come in for scans during their pregnancy. If we see an abnormality on that ultrasound, I need to speak to that couple about that abnormality and what it's likely, chromosomal or genetic basis is. We then organise the relevant testing and depending on what the test reveals, we support that couple through the decision process, in terms of, whether they want to continue that pregnancy. So, it's quite a journey. Then we walk alongside our patients in that journey. It's extremely rewarding to see people work through to reach a decision that works best for them.

    Joanne Gray: Great. Thank you. Helen. 

    Helen: I think everybody knows what pharmacists do, but in my career, I've probably worked in about 10 different settings. So, I started off as a hospital intern pharmacist, and then I worked as a military pharmacist for five years. I then worked in the UK as a medication review pharmacist. I came back to Australia and purchased a community pharmacy and worked as a community pharmacy owner. I developed a specialty practice in medication review. So, going into little old ladies houses and helping them with their tablets, and helping their doctors understand the best medications for them to be on. And recently, I've been working with pharmacists who are integrated in general practice. So, when you go into say the GP, there's not just a nurse or a physio, there's also a pharmacist there. I think... There are a few areas I haven't worked in. So, there's obviously industrial pharmacy as well. You could work for a pharmaceutical company. A lot of our graduates do that, but I'd it's a really good career, so, definitely recommend it.

    Adele: As a clinical psychologist, what we work with is the treatment of mental disorders. So, we work with clients and assist their concerns. We might make a diagnosis if that's warranted. We formulate their concerns. So, we find out what are the factors that are maintaining their symptoms, and then we provide psychological treatment. That can range in lots of ways. So, it's evidence-based treatment. It can range from very short term skills-focused treatments like cognitive behaviour therapy to longer term treatment options that can last for over a year or so. Things like schema therapy and psychodynamic therapy.

    Adele: Clinical psychologists work in a range of different areas. It's very diverse. So, you can work in private practice, community, public health settings, hospitals, private and public hospitals. Non-government organisations, consultancy, universities, research. There's lots of different possibilities. So, for me personally working in private practice, I'm sort of seeing, anyone really who comes in, who wants to see a psychologist and we can work with people who, across the lifespan who have, clinical disorder like, anxiety or depression, or who are sort of on in the normal healthy range and just wanting some emotional support with something, or wanting to talk about anything. So, it's very diverse.

    Joanne Gray: Yeah. It's lovely. Thank you. And Georgia.

    Georgia: So most people, when they think of a physio, you think of the classic sports physio, but that's actually the one area that I've never worked in. I've dabbled in every other area, which I started out in acute care in the hospitals. So, people who are post-surgery. We'd have a lot of work to do with people who are post orthopaedic or post cardiac surgery, and getting them back on their feet again, and then move to a rehabilitation clinic for people post big injuries or illnesses. So, people who've had a stroke or a car accident or perhaps have become really de conditioned, and they need help getting home. Then did some work in dementia care for a couple of months, which was really interesting, because a lot of those patients have a lot of fear around movement and they tend to decline in their mobility. So, our role in that space is to keep them active, and it's actually one of the most rewarding areas to work in, even though it's quite difficult, and it's not some place that people usually think that physios would work in. But we can have quite a big difference in that area.

    Georgia: Then went to acute neuro surgery. So, people who've had spinal surgeries and are requiring help to start moving after they've had their spine fused or cut up a little bit, which is very interesting. I currently work with the NDIS. I serve as their community for people who have a really wide range of intellectual and physical, and neurological disabilities. So, I work with people who have things like Parkinson's and multiple sclerosis. I also work with people who have autism and Asperger’s, who have movement difficulties, or difficulties accessing exercise, and other clients with other forms of intellectual disability with the aim of keeping them active and functional for as long as possible. My probably main message would be the sports physio is definitely an aspect of it, but there's this whole other gamut of possibilities with the profession.

    Joanne Gray: That's great. Thank you. I'm going to ask the panel another set of questions, but before I do, is there anybody got a burning question they just want to get out there now? Would happy to keep listening. Okay, great. The question I'm going to put you now is about, when you think about your everyday work, what are two of the skills or abilities, that you think are absolutely key to you being successful in your profession?

    Belinda: I think communication will always be number one for speech pathology, but absolutely being an empathetic person, being able to understand somebody's situation and being able to look at that objectively and to utilise all the clinical knowledge that you've learned and apply that. And I think when you're dealing with complex families and people with complex histories and complex lives, it's really important to be an empathetic person.

    Mitchell Bagley: I think just being really dynamic with eye and vision problems, they very rarely come isolated. If someone is losing vision or is vision impaired, they're not going to just have the eye disease that they've got. They're going to have mobility issues, lifestyle issues, where you might also need to do low vision therapy with those people while they are also receiving treatment. So, that's really important. And obviously, we always work as part of a team, so, communication's got to be up there as well.

    Maya: I second the empathetic nature. Not many people see a genetic counsellor because I particularly want to, it's generally because something pretty awful has happened to make them sit in front of you. For example, a family member might have passed away. And then, the rest of the family wants to understand the implications of the risk to them and their children. So, empathy always. The other aspect is, with genetic counselling, it's really cutting edge. The science is out of date in six months at the moment. So, the science is moving so incredibly fast in genetics that, to stay up to date means really being on top of things, and not just going to work and leaving. You need to read, you need to understand and you need to ask questions. So, I think that genuine enthusiasm and interest in the science is really helpful.

    Joanne Gray: Okay. Thank you.

    Helen: I've forgotten what the question was.

    Joanne Gray: Two of the key skills and abilities, you think, make a good pharmacist.

    Helen: So, I think, really people skills is the number one. Being able to understand, the level of understanding somebody comes in with, because when we're talking to people about their medications, we can do it on a range of different levels. The main thing is making sure that your communication is heard and understood. So, that the person goes away after a conversation with you, with more skills than they came to the conversation with. I think also being open to anything. I still work in community pharmacy every second Sunday, and sometimes I'll be removing ticks from people's backs. Sometimes I'll be giving them flu vaccinations, and sometimes I'll be explaining to them how to take their blood pressure medication. So I think it's, just being open to whatever comes in the door, is always a good thing.

    Joanne Gray: That's great. Thank you.

    Adele: I would probably say, the ability to be self-reflective, and look inwards, because as a clinical psychologist, you are dealing with emotional topics and clients who have a variety of personalities, and life experiences that might be very different to your own. So, that might trigger some things in yourself and you have to be able to be aware of that and how that's influencing your work, and work through that. I'd also say, just being approachable, so, you can have all the technical knowledge, that's possible, but you have to be able to make people feel open, comfortable enough to share their vulnerabilities with you, after not knowing you for very long. So, you're just being very warm and approachable, and sort of nonjudgmental, and all of those types of qualities as well.

    Joanne Gray: Great. Thank you. Georgia.

    Georgia: I would second Adele, because as physios particularly in the hospital or the disability sector, we're dealing with very vulnerable people, who are quite slow to trust for very good reasons. So, you need to have excellent people skills to gain that therapeutic relationship because then you'll get the best outcome. So, it's the whole gamut of people skills that come along with that. But I also think you need to be really flexible to be a good physio, because you're dealing with the human at the end of the day, and you can have all the theory in the world, and it just won't apply to that person. So, you need to be able to change it up and think on your feet. So, that will be mine too. 

    Joanne Gray: Thank you. I think probably all of you, your things you have identified probably shared across each of you really. Yeah. Which is great. I'm now going to ask you a question. This is more of future-focused. So, you often hear, and I suppose you hear as well, is that, that the job we have today is going to look entirely different in five years’ time. I think that's one of the challenges that we're aware of here at the Graduate School of Health. How do we prepare you, not only for when you graduate and become a health professional, but how do we also prepare you with the skills that you will need in 5 or 10 years’ time, where you're having to adapt to somewhere, workplace, is entirely different from the one we have now.

    Joanne Gray: I certainly again reflect on that. When I think about, when I first started nursing, and I, it was sometime ago, that when I think about that now, and I actually did my nursing back at, in a rural hospital. I think about that hospital now, often when I go home, and I look at it, and I remember my days there, being a student nurse and I reflect now on how different it is in hospital. I go in and visit people and when I was practicing as a midwife. Things have changed so rapidly and part of the skill you have to have as a health professional. And really that was identified by Maya as well. It's about the reading and staying on top of it, but there's more to it than that. So, I'm going to ask each of you, when you think about your profession now and in 5, maybe 10 years’ time, what do you think the key things are going to happen? What are the big picture things that are going to happen within your area? I'll go the other way just to give you a bit of change around. So, Georgia.

    Georgia: I'm biased to a narrow perspective, and in terms of the treatment that we currently have for stroke, which is my specialty, it's just advancing at a really rapid rate. So, they've got this really cool tech at the moment, where they can put a tiny wire into the brain, grab the clot, and take it out. And the person is so much better on the end of it, which means that we're dealing with a completely different patient when we go to rehabilitate them. We are having to expand our concept of rehabilitation. So, I think that's really exciting for the next 5 to 10 years, because the whole paradigm is going to change in how we think about stroke rehab. But in terms of a more general sense, the ageing population in Australia is going to need to stay mobile for as long as possible. I think we're going to play a huge role in that. Some people think, "oh, aged care, that's boring," but from personal experience is one of the most rewarding, and fun jobs to have, because the possibilities are endless, and these people are just so grateful to have your help with doing things they want to keep doing. So, I think that's a big role that we're going to play in the next 5 to 10 years as well. Yeah.

    Joanne Gray: Thank you.

    Adele: I would say definitely, in psychology, because of a range of factors, probably mostly technology is that, we're moving to more of a stepped care model. So, clients with sort of, more general concerns can be serviced through apps and online therapies, and then the more complex presentations are coming to the clinicians. So, that's really exciting. Particularly for therapy, because clinical psychologists would be the professionals who are seeing those on more of the complex, and of presentation. So, we're getting to sort of use our skills the way that they were designed to, rather than sort of just seeing more of the general kind of everyday presentations. I'd also say, there's a lot of changes at the moment going on with, the way Medicare is structured, and the training pathways for psychologists.

    Adele: If anyone is interested in psychology, there used to be sort of, ability to go through as a general psychologist, and they are now removing one of those, the four plus two pathway. So, it's becoming, and also with the changes to Medicare rebates, it's becoming increasingly important to have the clinical specialty. So, if you do have the opportunity to do that, I think that would be very important for the future in this field.

    Joanne Gray: Great. Thank you. Helen.

    Helen: So, for pharmacy, I think there's been a big increase in interesting qualities of medicines, and reducing medication misadventure. So, pharmacists are being seen as key players in team-based care a lot more. I think, having pharmacists as medication experts is really, the way the profession is going in the future.

    Maya: Has anyone seen the movie Gattica or am I too old for this audience? So, I think we are kind of heading there, but I want to take the negative away from that and say that we're hopefully heading into a more, if you want to do genetic counselling, watch Gaticca because it's almost compulsory. We are heading towards the preventative model where we're moving away from waiting until something devastating happens genetically and then assessing the family to hopefully identifying the incident in advance to avoid the devastation that can surround that event. So, the good thing about genetics and the optimistic thing about genetics is, if we know there's a risk, we can sometimes mitigate the risk through management strategies. For example, the best example is in cancer where, if we identify a faulty cancer gene in a person, we can improve the prognosis for their family because we know what risks need to be managed.

    Mitchell Bagley: I've just gotten back actually from Taiwan where they're launching a trial into a new medication to prevent macular degeneration. Those sort of, clinical trials and developments in medical therapy, are just always coming out. I've got another staff member going to Chicago next week. So, it's just constantly moving forward. I mean, that's in terms of R&D, which is a huge burden on the Australian society and ageing population. If you were to go get laser eye surgery today, we would recommend a different procedure that you would have had gotten two years ago. The advances in cataract surgery and lenses. The great thing about being an orthoptist is, we are the people that do all the diagnostics, and all the imaging, and all the assessment of these diseases, and these processes. So, we're really in the thick of the progress that's happening in the industry. So yeah, I think that, there'll be completely different treatments in, a few years’ time.

    Joanne Gray: Thank you. Incredible.

    Belinda: There's probably a few drivers of change. So, technology being one. So, things like using [inaudible 00:27:15] we are less focused on our own neighbourhood, and looking more at providing rural services, global services, using robotics for children with autism or augmented reality. So, some of that technology is driving areas of change. With the changes to the NDIS, which is funding a lot of how our services are provided. We're moving more to functional type services, where we're out in the community with clients, less of that traditional sitting at the table with picture cards doing therapy. So, while we still do a lot of that early intervention work, the way we practise is changing and some of that is driven by the funding bodies, where we are sourcing our funds from.

    Belinda: I guess the other, there's a quite a few other areas that are emerging in practice. So, working, speech pathologists, working as intermediaries in the court system, working in juvenile justice, and adult justice settings, because there's a huge proportion of at least 50% who have a communication impairment. So, there are quite a number of areas that are emerging for practice. And probably by the time you have finished your master's degree, if it's in speech pathology that haven't even been identified yet. So, I think some of the government changes are also leading to new opportunities for ways to work as a speech pathologist.

    Joanne Gray: Yeah, that's great. Thank you. I'll ask you now, if you've got any questions you want to put to any of the clinicians, you can put a general question or can choose your discipline of choice. Yes. Sorry, there is a microphone for you. Sorry. Thank you. Speaker 9: Oh. Hello. So, how does NDIS change the field? Is it because there's more access?

    Belinda: Well, I think it's given access. So, looking at the clients who were able to access those services. So, say for example, adults with disabilities previously were funded by government services. I guess, there's a whole group of people who weren't really receiving lots of services who now have choice and control as to how their services are provided. So, those clients previously would have been serviced by a government organisation. Now they're coming into the private sector and they have direct control over how their services are delivered, and we're looking at more functional. So, going with clients into the community to provide their services rather than working in a purely clinical setting. It's like, looking at more functional therapy.

    Georgia: I would say physio echoes that sentiment that, we've got this whole population of people that we really didn't have access to because the government services were a little bit limited for us, particularly when discharging from hospital, and now they are in, exactly as you said, in control of the services that they want and they know what their goals are, and you can work in any context to help them achieve the goals. So, a client I had last week, he really wanted to be able to use the gym, and he was a bit scared about it cause he has a mental illness, and he was worried about the environment and I basically go to the gym with him every Saturday and work on just becoming familiar with basic equipment. I would never have had that opportunity, I think, before the NDIS came into work.

    Mitchell Bagley: Can I just add to that? It's really revolutionised orthoptics from the low vision perspective. So, one of the largest employers of orthoptists are Vision Australia, and guide dogs as well. And they go out into the community and provide that therapy and visual aids and visual assistance to patients in their homes and in their communities. Helping them to work out, which bus they're trying to catch when they can't see. That's been a major injection for orthoptics on that strain.

    Joanne Gray: Okay. That's great. Other questions? Yes sir, there. Thank you. Speaker 10: What's the difference between clinical psychology and other types of psychology?

    Adele: So, psychology is a very broad term. So, it sort of, looking at generally the scientific study of brain and behaviour, and clinical psychology is a specialty if that, which looks at the treatment of mental disorders. There's also a general psychologist who has done the undergrad degree, and then done an internship, and become just a general psychologist. So, the difference between, what they would do practically to a clinical psychologist is, a clinical psychologist has, is more specialised. They've done an additional post grad training in psychopathology, and evidence-based treatment. So, it's practically, it can sort of overlap a little bit, but it's becoming more of a requirement in most, sort of, fields to have the additional specialty now.

    Joanne Gray: Okay. Thank you. Other questions? Yes. At the front. Speaker 11: Hey, I've got a question for Adele. You said that you followed the people that you see through their journey while you're having them move their diagnosis, I was wondering at what point you travelled with them on that journey, and if you pass over to another type of psychologist?

    Adele: Yeah. I guess that's case. The role is knowing what your limitations are as a practitioner and knowing when the person needs more support than you're able to provide. So, an example of a typical journey that a patient will take with me is that, I'll see them in about 10 weeks time to do a newly available DNA-based test for chromosome abnormalities. I'll deliver that result in about a week following that. So, I'll call them and let them know if there's an increased chance that, that baby's affected with a chromosomal disorder. I will then bring them in, and have a lengthy chat with the couple about what that means for them and potentially the child. I'll also do some risky sort of calculations in terms of what the predictive value of the test is, and the likelihood that the baby is truly affected. So, there is kind of, a scientific and a mathematical component to all of that.

    Adele: I will follow that patient up until about, until they finish their testing. Until about 16 or 17 weeks down, like pregnancy. So, it's sometimes about a month of ongoing checking in, phone calls. If I identify that that person has a history of mental illness or that, I mean pregnancy can make everyone a bit on edge, but if somebody has an identified risk factor, or I can say that they're not coping, I will then refer on to a psychologist, in that scenario. Otherwise, if I feel that, we have some questionnaires that we can use to assess that, but otherwise I will be in contact with them often. I'll be in contact with them potentially for many years to come, as they come back for future pregnancies, or they bring a child in. We have a really nice relationship. That's what makes the job extremely rewarding. Yeah.

    Joanne Gray: Other questions and stuff. Yes. Yeah. Speaker 12: This is for you Maya.

    Maya: Thanks. Yeah. Speaker 12: When I talk about genetic counselling, a lot of people don't know what that is and I explain it. So, how do you get referred to? How do you get referred by patients? You know what I mean?

    Maya: So, the referral pathway for me as a genetic counsellor, it's an emerging profession. It's very new. I didn't know what it was myself until I read a newspaper article about this fabulous new profession in the Sydney Morning Herald one Sunday. I read and I said, that's exactly what I want to do with my life. So, it's very you, it's very exciting. But explaining it to people's a nightmare. I spent half the time at social functions with my family, explaining what I do and no one understands it, still. So, what I do say is that, we get referrals from GPs, obstetricians, and other health professionals because for them, genetics is not a comfort, for many of them, they're not comfortable with it. So, we are very specialised in a very small area of medicine, and health, and we get referrals from other health practitioners to organise that facet of the patient journey.

    Maya: It's becoming, genetic counselling is becoming, very heavily embedded in medicine now. So, particularly in oncology, obstetrics or prenatal paediatrics, we're kind of everywhere. So, we're sort of forcing our way in and people are starting to learn who we are. I explain it as, the science meets the human side, because you get to do, for me, it's just the dream job, because it's the best of both worlds. 

    Joanne Gray: Okay, great. Thank you. There's a question at the top of the list. Because it's Maya as well. Thank you. My eyes can't see that far. Thank you Kristy. Because it's for Maya, is it okay we go again?

    Maya: Okay. I can go with that. I can absolutely. I work very closely with clinical geneticists. Clinical geneticists are doctors who've gone, and done a medical degree and have gone and then done a specialisation as a geneticist. So, they will take, the full extent of a medical degree and done it. And then they've done a specialisation in genetics, and then they'll usually specialise in the field of genetics. So, I'll work alongside geneticists, but in my current role, I don't work on a daily basis with a geneticist. I handle what I can handle as a genetic counsellor, and when it gets to something that's very, requires a specialist in that particular area, like maybe neurology, or something like that, then it will go, we will refer onto a clinical geneticist.

    Joanne Gray: Okay, great. Thank you. There was a question here, at the job prospects. I think that's a really good one in terms of, what the future is looking like for you and you can hear from what the panel have already said about the range of opportunities there are within each of those professions. But I'm going to put the question to each of them and just if you could tell us please. What do you think the job prospects are for your career? Do you have a sense that there are jobs out there, that it's changing, what the availability would be?

    Belinda: Well, I think with the NDIS there's been a huge, kind of influx in terms of, speech pathologists looking for work. I'd say usually, every day at least five new positions advertised online. I think that we probably have a bit of a skills' shortage. So, depending on where you want to work, there's probably more limited jobs in terms of working in the hospital setting. So, if you wanted to work in acute care with adults, there probably are more limited roles. But in terms of working in paediatrics, or in the area of disability, there's a huge range of choices. And probably, if you're willing to look at rural positions, then there's a lot more range of options in the rural settings.

    Joanne Gray: That's great. Thank you.

    Mitchell Bagley: Well orthoptics definitely, has a skills' shortage. There're heaps of jobs really all over Australia. Those who want to get a job in Sydney usually have jobs lined up before they even graduate. But also, Australia is a main orthoptics teaching hub for the whole Asia Pacific region. So, I've got a number of friends who are working in Malaysia, Indonesia. I've got one friend who went over to Sweden for a while, so we definitely, kind of export our orthoptic skills if you're interested in doing some work overseas. But yeah, you shouldn't have no problems getting a job in Australia.

    Joanne Gray: That's great. Thank you. Maya. 

    Maya: Yeah, the job prospects are excellent. There's a shortage of genetic counsellors. My last jobs in genetic counselling have not been advertised. I've been approached. There're jobs that are advertised that get no applicants at the moment. So, that's the level of the shortage that we're talking about. It's an international issue. I've been approached for jobs in Singapore, and various other countries because they are similarly short of genetic counsellors. So, excellent. Yeah.

    Joanne Gray: Great. Okay.

    Helen: Pharmacy, I think, it really depends where you want to work. So, if you want to work in industry or in hospital, it's harder to get those jobs. But our graduates have been really successful in getting those positions. If you want to work in community pharmacy, they're everywhere. Everyone, I'm sure you know, in most towns is two or three community pharmacies. So, I think there's 24,000 pharmacists, working in community pharmacy across Australia. So, if you want to work in, I work on Sundays, five minutes from my house and I do home medicines reviews for people who live in the same street as me. So, it is definitely a job where if you want to work close to home, you can, and if you want to travel anywhere in the country, you can get a job.

    Joanne Gray: Great.

    Adele: Also, very good for clinical psychology. I mean, there's a range of different, like we've said, you can work in a range of different roles. And also, I've got friends who have started to work for themselves only a few years after graduating from the programme, and start their own businesses. So, there's that option as well. There's a lot of variety and flexibility to make your own hours. As there's more awareness about mental health and there's reduced stigma, more people are open to seeing a clinical psychologists. So, there are much more job prospects than previously.

    Joanne Gray: Great. Thank you.

    Georgia: I will say that physio mimics the speech side of things in that the hospital jobs are harder to come by. But that being said, we've moved to a merit based system of new grad positions. So, if you do well enough in your university course and you interview well, then you will get a new graduate position at a major metro Sydney hospital. Once you've got the foot in the door in that manner, it's easier to climb the hospital level. But in every other aspect, physio is expanding rapidly, and particularly as we've already said with the NDIS, and other funding opportunities. There's just such a broad range of areas in which you can work. From working from someone else, to opening your own practice, to working overseas. So yeah, I would say physio is also excellent for jobs.

    Joanne Gray: And many opportunities to actually open your own practice as you were just saying, Georgia. So, I think each of you could do something where you could actually, use it to run your own business in many ways. In some ways. Okay. Thank you. Any more questions from the floor? One more question, I think it'd be great. Oh, down the back. Yes. Thank you. Microphone. Thank you. Speaker 13: Hey, this is for Adele. So with the Medicare restructure and getting rid of the four plus two pathway, is there anything that education providers will do to kind of compensate for that lack of training in specialised training?

    Adele: Oh, what do you mean, sorry, by education providers? Speaker 13: Like UTS and Master's programmes. Because if Medicare is going to be restructured, then general psychologists will be redundant in the future?

    Adele: I don't think they'll be redundant. I think that they're just slowly changing the training pathways to encourage more people to do the prescribed qualification. So, there are a lot more post grads spots than there used to be. A lot more programmes like UTS now offering clinical psychology. It's just becoming more in line with what it is internationally that, you need that postgraduate qualification. Speaker 13: Thank you.

    Joanne Gray: Other questions? Okay. I'm going to put one more just to finish up. I think, on a positive note, even though it's a difficult question, but obviously the work you do is with people, and so part of that of course is managing, as you say, being empathetic, communicating well. But there are emotional impacts of the work you do. So, can you please tell us, again, we start with Georgia down leaning towards, one way that you might do with some of the emotional impacts of the work that you want to take.

    Georgia: It was hard to learn because it was a big shock when I first started working. It took me about six months to settle in. But just having friends who are in the same field as you, particularly if you are working in a hospital because the things that you see in a hospital are, people at the worst end of sicknesses, and someone who understands exactly what you've seen at work today, is really helpful to have, and being able to talk through that of an evening. I would really recommend you make sure you've got that structure around you, if you're going to go into that line of work.

    Adele: I would say having very good support around you, particularly a lot of, the majority of our cohort went into private practice, and that's notoriously not as good for support as some of the others sort of, public settings. I’ve got a peer supervision group with some of my colleagues set up, and that's been invaluable. Being able to talk about cases and just events and share your experiences, and have that commonality, and know that you're not alone. Because when you first graduate, you doubt yourself so much and you think you're really incompetent and everything's a challenge. So, it's really helpful to have a piece of supervision group. Having really good boundaries as well and not working, not taking on too much, and having very good self-care, and just knowing what the early warning signs are that you might be a little bit burnt out, or you might have a bit of vicarious trauma and getting support for that yourself as well.

    Joanne Gray: Thank you.

    Helen: I think as a pharmacist, you're very rarely working alone. When I do medication review, I do go out to patients' homes by myself, but you're usually part of a team. I think that's... Definitely in community pharmacy, we quite often have a chuckle after people leave, but obviously not while anyone else's in the shop. It is interesting to see what walks in the door sometimes. I think you do get really to see the full gamut of life, and people's experiences. It's very eye opening when you're a junior pharmacist and you're getting, but now I don't think there's too much that could phase me. I think I've been held up at least four times. I've managed to perform CPR. I've had someone have a heart attack in the pharmacy. I've had amazing things happen. I think over 20 years you kind of, get all these experiences and then there's not much that can phase me these days. Usually it's, water off a duck's back.

    Maya: It's difficult at times to disengage. But I'd second what Adele said about, selfcare and talking with colleagues. As genetic counsellors, have our supervision meetings with the people so that we can discuss what's going on. So, you don't feel like you're alone. We reflect a lot on how we've done things, and not just to beat up on ourselves, but just for learning, for future reference, and to learn how to do things better.

    Joanne Gray: Yeah. Thank you.

    Mitchell Bagley: Yeah, I think it is difficult. Often because we are very much involved in diagnostics and very involved with children. We are often the first people to pick some of the severe stuff up. I think the best thing is just working as a team and having, not working in isolation, journeying with the patient as they go through the process, and you present them with the news, and following up on that patient, and just making sure you've got a healthy workplace with good colleagues by your side. I think following the patient through also makes a big difference, and just journeying with them, and seeing the progress. We're very lucky, not thermology that, the vast majority of our treatments are very effective.

    Joanne Gray: Yeah. So, that's great.

    Belinda: Well I think it's okay to be emotionally invested in your clients because that's really what drives you to want better outcomes. It's not, there's not a lecturer there, that's checking your academic performance, but having, when you're really emotionally invested in your clients, you're driven to find out what the  new research is, look for better outcomes and it's okay to be human. I think that's what makes you a good health professional, that you relate to somebody and you can see them, where they are at any given time when they come in. We do spend a lot of time doing social stuff in our clinic as well as having clinical case conferencing.

    Belinda: Sometimes we'll have, social events where staff have a chance to talk to each other, and support each other outside the clinical setting. I think it's okay to recognise that, everybody deals with things in different ways. So, understanding your reflective style. Some people might need to talk about something straight away, other people like to reflect on it for a little while. I recognise that, sometimes when I carry everyone else's burden, that I also need to look after myself. I have avenues for being able to talk through some of the challenges, and having supports at many different levels, whether it's from academic input or having some professional emotional support. I think that's really important.

    Joanne Gray: Great. Thank you. Key message isn't it? It's about, communication as a health professional but also ensuring that you can then communicate with others afterwards and to share your experiences. And it's a great, some great lessons there. I'd like to thank very much our wonderful clinicians for coming along this evening. They've done a marvellous job. Thank you. I do have a small gift to give to them, but before I do that, just a couple of key things to finish off with. You'll see here a list of dates of the upcoming information sessions. So, there's one there to disciplinary you're particularly interested in. The postcards on your seat. We'll give you the URL so you can log on and enrol in those sessions. When you come along to those sessions, you can then, if you've made the decision to apply for UTS, you can apply on the night as well. So, that just makes it, you know, one stop, one stop shop almost.

    Joanne Gray: When you come along, you'll hear not only about what you will learn in your disciplines as you've heard tonight, but also how you learn. So, UTS has a model of learning where we engage very much on a personal level with our students, and we show you all have the ability to be able to go out and to practice as a health professional with the best skills you possibly can. You also have clinical placements throughout the time of your qualification, through your degree. You get to meet and talk with academics and also with students. It's a wonderful chance, I think, to really drill down a little bit more than you're able to tonight. But again, thank you so much to our clinicians. We really appreciate you coming along this evening, wet and cold, and giving us your time. It's been really interesting to hear about what each of you do and for you to share your personal experiences with us. So, thank you very much, and thank you all for coming along tonight. I really appreciate your attendance and best wishes. Thank you.

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