Misadventures in the Northern Territory: Upside down Down Under

toby_shipwayRetrieval registrar was never one of my professional aims throughout medical school. A natural pause in the UK training scheme motivated me into seeking an opportunity to break the NHS bond, temporarily, and head away to experience far away places and different health issues. Retrieving patients in Australia’s Northern Territory was not the obvious choice, but the desire to become more self reliant professionally in preparation for seniority, the offer of spectacular scenery, and the need for a breath of fresh air all pushed me to Darwin. I arrived in late October 2014 into 35°C temperatures and 100% humidity.

Getting started

Although the term flying doctor is forever linked with the swagger of an 80s’ television show, I found the realities of the job hard to imagine from the confines of hospital practice in the UK. On arrival we were handed an induction timetable that highlighted lectures in a variety of areas: equipment, cardiorespiratory issues, burns, psychiatric sedation, envenomation, natural disasters. It became clear that not only were the medical topics vast, but they were only the tip of the iceberg.

There was an emphasis on logistics, environment, people management, and timing—”movement is treatment.” We were taught the importance of appreciating our own limitations, medically and physically—otherwise we could turn into a liability and a hindrance in remote and difficult terrain. It also incorporated the safety features and basic functionality of the various aircraft we would be flying in with the job. The training was augmented with simulated scenarios, which highlighted my environmental naivety. The necessary practicality and innovation in the situations was a novelty. I simply had not realised how much I took for granted in UK hospitals: the access to and layout of equipment, the number of staff and their automatic role allocation in time critical situations, a planned hospital infrastructure. It all added up to an eye-opening shot of knowledge, which was mixed with the eye watering HUET experience. We were warned early on about the HUET course.


HUET stands for Helicopter Underwater Escape Training—a collection of words I always hoped would be avoided in a single sentence. The aviation industry makes it a compulsory training component if flying regularly on helicopters, as there are on average 515 helicopter crashes each year with many preventable deaths. With this ringing in our ears, a small group of us were loaded and strapped into a helicopter shell and repeatedly lowered into a large pool of water. When submerged we were then allowed to unbuckle and attempt escape through the nearest possible aperture. When the instructors were satisfied with this they then repeated the situation, but turned the whole contraption upside down. For the majority it was a daunting but ultimately enjoyable experience. For a few, the malfunction of the seat belt release led to serious panic. Although it was a controlled situation with rescue divers present, it underlined what a foreign and potentially dangerous working environment we had signed up to.

Toby Shipway is working as a retrieval registrar for Careflight based out of Darwin. He has taken a brief interlude from his anaesthetic training in the NHS to experience diverse pathology, a markedly different medical system and some fantastic scenery along Australia’s Top End.

Competing interests: None declared.