Regional ED powerhouse: The transformation of Albury Wodonga Health
Three years ago, Albury Wodonga Health (AWH) had just two ACEM trainees in its emergency department (ED). Today it boasts eight trainees, with the regional ED becoming an option of choice for emergency physicians looking for career development opportunities.
FACEM Dr Joanna Manton
AWH FACEM Dr Joanna Manton puts this growth in trainee and FACEM interest down to AWH’s transformation into a regional ED hub offering rewarding career-building experiences comparable with what major metropolitan EDs have to offer.
‘Property prices and rents in big cities are climbing and that has pushed some people to look more closely at regional centres as places that suit their lifestyle – and their budget,’ Dr Manton said.
‘When you combine that with the reality of many major city hospitals not offering the employment opportunities, it’s made regional EDs more attractive in the last few years.’
And the interest is still growing.
‘The area is exceptional to live in – the best of city living with food, wine and arts available located in serene environment. Perfect for those who love the outdoors with plenty of options for skiing, water sports, fishing, mountain biking, and just relaxing,’ Dr Manton said.
Professional opportunities
Lifestyle perks aside, Dr Manton said that ongoing investment in AWH’s ED meant that professional opportunities continued to grow.
‘The demographics in our area are young families and a lot of retirees out of the big cities. As a result, we do see a mixed cohort of patients, giving trainees a wide range of experience, including paediatrics,’ Dr Manton said.
“‘The registrar pool has also expanded, meaning there is less pressure on night shifts and less pressure for sick relief,’ Dr Manton said. ‘Overall, it makes for a safer work environment.’”
Dr Manton highlighted increases in clinical staffing and support levels — ‘three FACEMS are on per shift in Albury, as well as another FACEM situated in Wodonga’ — that she said had resulted in more clinical supervision and support.
‘The registrar pool has also expanded, meaning there is less pressure on night shifts and less pressure for sick relief,’ Dr Manton said. ‘Overall, it makes for a safer work environment.’
In addition, she said the introduction of CNCs and increased specialist-level staffing allowed the department to ‘ensure that there is a strong culture of quality improvement’.
For emergency physicians seeking a diverse range of EM experiences, Dr Manton says ‘the case mix is broad and high acuity. There is plenty of opportunity to be involved and expand skills.’
In addition, AWH’s FEx program and weekly OSCE offers a schedule that matches anything that the tertiary centres offer.
“For emergency physicians seeking a diverse range of EM experiences, Dr Manton says ‘the case mix is broad and high acuity. There is plenty of opportunity to be involved and expand skills.’”
‘We have done a trial OSCE exam in July 2023 and invited other local regional trainees. We had five in total,’ Dr Manton said.
"‘In March 2025 AWH also held an on-site ACEM fellowship written trial exam, free of charge, and invited external trainees to attend. We had six trainees in total all planning to sit the exam in May this year. We have also run a trial exam for the ACEM primary viva.’
Dr Manton said this was a natural next move after participating in the collaborative delivery of a weekly online Primary exam preparation course.
‘We run primary teaching on a weekly basis in conjunction with four other regional sites and rotate which site leads it,’ she said.
With trainees already able to do their critical care rotations at AWH – ‘both anaesthetics and ICU, as well as medicine and paediatrics’ – Dr Manton said they are also ‘open to helping trainees obtain rotations in other specialties too’.
(L-R) FACEMs Dr Matt Killmurray, Dr Gavin Fincher, Dr Michael Davoren, Dr Joanna Manton, Dr Tracy Wylcynski, Dr Zeena Tawfik, Dr Simon Judkins and Dr Lucy Schofield
‘The department is part of the Emergency and Critical Care Division, with a strong relationship with the ICU. Trainees are well supported with Co-DEMTs and mentors, are expected to be involved in quality assurance projects, and are assigned audits with members of the specialist staff,’ Dr Manton said.
Work/life balance
Dr Manton emphasised the lifestyle-friendly benefits she knows are primary considerations motivating people who are considering a regional shift.
“‘As a growing ED, there are a range of non-clinical portfolios to get involved in and new ones that are opening up,’ she said. ‘For those looking to help contribute to the development of a service, there are massive opportunities to leave your mark and help improve patient care for the region. It makes for a rewarding environment when you can help change how things work.’”
‘We are aware that a good work/life balance is essential to wellbeing and career longevity, so our medical workforce is flexible with rostering shifts for trainees,’ she said.
‘The leadership of the department is also very supportive to trainees in difficulty and will create flexible options when needed.’
Dr Manton said staff morale had been boosted measurably since a new department with 50 care points had opened at AWH in March 2024.
‘As a growing ED, there are a range of non-clinical portfolios to get involved in and new ones that are opening up,’ she said. ‘For those looking to help contribute to the development of a service, there are massive opportunities to leave your mark and help improve patient care for the region. It makes for a rewarding environment when you can help change how things work.’
Being a regional town, Dr Manton also likes that her work commute is no more than 10 minutes each way.
‘Before coming to Albury three years ago, I had commuted all my life to get to work, often in excess of 30 minutes each way,’ Dr Manton said.
“‘If you’re looking for a change of pace in life outside of work, the way many regional EDs are evolving means you no longer have to choose between career and lifestyle. That’s an exciting change that will have flow-on benefits for entire communities.’”
When she came to AWH, it was on a permanent contract – something Dr Manton said is unheard of in metropolitan hospitals, which tend to offer new FACEMs a temporary contract for six months at a time.
Importantly, Dr Manton said improved patient experiences have been a significant achievement following this regional ED’s transformation.
‘Changes to our model of care have seen our Cat 2 performance move from 45 per cent in March 2024 to now sitting at 75 per cent,’ she said. ‘We are always looking for the next thing to improve, and pride ourselves on innovation. The innovation is not only in clinical care but in initiatives to support staff and training.’
As the community of FACEMs keen to make AWH their ED home continues to grow, Dr Manton said word-of-mouth has proved a powerful recruitment tool.
‘If you’re looking for a change of pace in life outside of work, the way many regional EDs are evolving means you no longer have to choose between career and lifestyle. That’s an exciting change that will have flow-on benefits for entire communities,’ Dr Manton said.
ACEM recently launched the second iteration of our Rural Health Action Plan (RuHAP), which marks another significant step in our ongoing commitment to regional, rural and remote emergency medicine, as well as our commitment to rural health equity. Read it here.
