Dr Naomi MacIntyre is training to become a breast physician at Sydney Breast Clinic
Why did you decide to become a breast physician?
I had been away from general practice for 5 years travelling overseas. When I returned to Australia in 2004, I knew the upskilling I would need to re-enter general practice was significant and felt I would rather learn something new. A friend had applied for a job as a breast physician, something I had never heard of. It involved working in the field of breast cancer screening and diagnosis as part of a multidisciplinary team, doing imaging, procedures and coordinating patient care. Training was on the job and part-time, and no after-hours, on-call or weekend work was required. My friend couldn’t take the job so I jumped at the opportunity to work at Sydney Breast Clinic. A year later, she was so impressed by how much fun I was having, she reapplied and we are both still loving it 7 years on.
What do you enjoy about the training?
I enjoy the atmosphere of the multidisciplinary clinic. It’s very busy in a collegial way. I enjoy the procedures and the imaging work. I received excellent supervision from the senior breast physicians and other doctors over the first several years and gradually increased in independence. We have 30–40 patients a day (for three clinicians) and by the end of the day everyone is sorted.
What have been the main obstacles/challenges?
Breaking bad news is always sad, and it is a regular part of the job. Coming from general practice, the imaging component was new to me. It takes a while to develop a sense of what you are looking at. I’m not good with technology, and that is a challenge with the high-level imaging equipment we use. Other challenges are harder to describe — they are to do with boundaries. Breast physicians are not recognised as a subspecialty group. As you are not a surgeon or a radiologist, you need to be careful that your clinical decisions are consistent with what these other groups would do.
What advice do you have for doctors interested in working as a breast physician?
This job is suited to someone with a strong interest in women’s health, who enjoys procedures and feels they could learn to love imaging. You need to be able to balance the opinions of a group of health professionals with the needs of the patient for a result that keeps everyone happy. I find it works well with my family commitments. Many doctors hold a fellowship of the Royal Australian College of General Practitioners before they begin training as a breast physician. It’s probably best to spend time observing in a breast screening or diagnostic clinic to get a sense of whether it’s something you could enjoy. The pay is not great and the job market is small. I earn more than what I earned as a GP registrar but less than what I earned as a qualified GP. Once qualified, I will still earn less than my GP colleagues but there are other breast physician jobs that pay better.
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