WHEN Marg Garde first came to Portland to practice medicine in 1984 she loved the place, but there was one key thing missing – and her efforts to fix that have seen her win a prestigious national award.

Dr Garde was on Sunday night in Melbourne presented with the Brian Williams Award from the Royal Australian College of General Practitioners for her significant contribution to rural medical education and her service to the Portland and Heywood communities.

It is the most prestigious rural award the College presents and a fitting one for a GP who has done so much for the region.

That has ramped up even more in recent years with the establishment of Active Health Portland in 2012 – Dr Garde was one of the driving forces behind the ‘super clinic’ and is its clinical director.

Much of her time has been involved with providing training opportunities for medical students, often as part of her own consultations, and as an aside to convince as many of them as possible to make Portland their permanent home in an effort to give the region the medical staff it needs.

A modest Dr Garde said while she was thrilled, and humbled, to win the award, it was not a solo effort – fellow GPs, medical educators that she had worked with and other staff, as well as her family, deserved to take credit.

“I just want to say how grateful I am to the community that has supported me in what I am doing but more to support the students, registrars and interns,” she said.

“One of the things that I appreciate about the Portland community is that they’ve embraced our students and our registrars and our interns and been happy to see me with a student or intern and not baulked at it at all.

“They also support you in so many ways outside your work and support other things you might do as a hobby or an interest.

“The rich thing about working in a rural community is they understand that work’s work and outside is different, and they support you.

“I was born in East Melbourne but this community has made me feel so welcome and included right from the get-go.”

Dr Garde came to the city in 1984 after meeting her partner Rob Hunt and initially practiced out of the Otway Medical Group building on the corner of Otway and Palmer Sts (now undergoing redevelopment to become the new home for mental health organisation headspace).

The birth of her sone Sam in 1987 saw her work at the Portland Aluminium smelter for a while before deciding to practice from home following the arrival of daughter Georgia (both children are now doctors).

She then moved the practice to Gawler St (where Brophy Family Services is now) and the Woolpress building at the western end of Henty St which she owns, coupled with a part-time stint with Dhauwurd-Wurrung Elderly and Community Health from 2002-09.

That was coupled with teaching two days a week, and that continued after Active Health was started in 2012.

For much of her early years here, she was a lone voice – literally.

Times have changed somewhat, with two new female GPs to start at Active Health next year, meaning the practice will have five women and four male GPs.

“There weren’t any other female GPs then,” Dr Garde said.

“Women didn’t have much of a voice on how things should be run.

“When I first moved here everyone was good to me and I made lots of friends and felt really welcomed but from a professional perspective I felt really isolated.

“I felt I was five hours from anywhere and I thought ‘I’m going to go mad or I’m going to shrivel up and die from a (professional) perspective if I don’t do something, and that’s when I started doing something.”

Back then and until just a few years ago, the Garde/Hunt household was also a second home for many medical students staying temporarily in the region on rotation for rural GP training or holders of a John Flynn scholarship that paid for their rural training/work experience.

In 2002 GP training moved from the College to regional training providers and Dr Garde became more involved.

“At that point I was working from the Woolpress and we trained our first registrar,” she said.

“We’ve had registrars ever since.”

Even more so at Active Health.

“One of the main dot point outcomes for GP super clinics is related to the workforce,” Dr Garde said.

“Training students, registrars and now interns is almost all I do, working with the hospital until recently and Deakin University which has been really good.

“One of the things we’re trying to encourage in this practice is as many doctors as possible have a sense of commitment to supporting our learners.

“This practice should be a learning community.”

Dr Garde and former Portland District Health chief executive Christine Giles have been longstanding advocates for the region “growing” its own medical professionals and the pair, along with Ms Giles, along with Deakin University rural medical education and rural community clinical school director (and former PDH board member) Lara Fuller demonstrated their efforts when giving one of the keynote speeches at the National Rural Health Conference in Brisbane in August.

It’s something Dr Garde remains passionate about and it promises to ramp even further with a new Deakin initiative that should make medicine more appealing to local students.

It aims to make it less of a strain to enter medical school, including not necessarily having to sit the expensive Graduate Medical School Admissions Test (GAMSAT) among other things.

“In 2024 they’ll be almost able to live in Portland and do their studies and do a lot of it remotely with some outreach in Warrnambool and Ararat,” Dr Garde said.

“Going from my kids, who had to go away, find a place to live and work at uni to virtually staying at home and doing your degree at home is just brilliant.

“It is hard for young people to leave home at age 18 and do all that.

“Then we want them to immerse themselves in this practice and the hospital and do their intern year here.

“Hopefully then they’ll have fallen in love like I did and want to stay and build a house and a life here.

“The other thing that’s blown me away is the (federal) government is going to reimburse all university fees to medical students who go and work in the country (in selected regions) – in Portland they’ll definitely get them back.”

So what has been holding local young people back from considering medicine as a career? Dr Garde said she believed there were two reasons.

“One is there might be a preconceived idea that as a rural student studying in a rural school that you will not make the grade,” she said.

“That thinking has to stop.

“All of these strategies that Deakin has put into place are to break that down. They (students) have to put their mind to it but you don’t have to be some genius.

“You have to study hard and you’ll get there. Once you get in everyone’s invested in getting you through.

“Deakin is not lowering the bar but changing the bar so it’s easier.

“The second thing in moving away from home is the cost.

“There is a cost involved and there’s a financial barrier as well and in Portland if you’ve got more than one kid going to uni you almost need three jobs.”

And then there was the bonus of learning even more once in the health system in rural areas.

“They get a much better hands-on one-on-one patient experience here,” Dr Garde said.

“I think that the longer you keep a young person in a rural area and the earlier you have influence the less influential the bright lights and the pizazz (of the city) becomes.

“This community’s a very safe place to live and learn and I think safety’s really important when you hear about the bullying and stuff that goes on in the larger (city) institutions.”

But medical education isn’t confined to young people, with Dr Garde learning more all the time.

“Medicine’s become a lot more complicated than it was when I first started here,” she said.

“Consultations take longer and there’s so many more medicines than we ever had before.

“General Practice has become a lot more challenging as a field of medicine and I think that’s great and I have learned a lot also from the teaching that I do.

“Every single day there’s something new to learn.

“As GPs we can learn skills that can help people make lifestyle changes that make it all worthwhile – that’s also one of the good things about this practice, we can work closely with allied health to help people make those changes.

“Care plans are a great platform too for people to get an understanding of whatever chronic condition they might be experiencing and the hospital provides very, very affordable allied health to outpatients.

“My vision for Active Health would be not just to train doctors but also to help train allied health professionals.”

 Dr Garde also thanked Active Health staff (now about 25) and her family for helping her dedicate herself to those goals.

“The family’s obviously really supportive – Rob also had a job where he didn’t get home until late and he had demands on him through the night as well,” she said.

“Until 2005 I was on call and being pulled out of bed at all hours of the night.”

RACGP rural chairman Michael Clements said the awards showed the importance of GPs working with their communities and the rewarding nature of general practice in rural and remote areas.

“Dr Margaret Garde’s award comes as recognition for many years’ excellent service to her community and the profession, particularly through medical education,” he said.

“Dr Garde has provided mentorship and supervision to more than a generation of medical students and general practice registrars and has been instrumental in developing pathways for rural medical practice in her region and beyond.

“With her leadership, a supportive medical community has developed in Portland that has been transformative for the rural training experience students’ decisions to train and work in the region.”