Interview with Neil Strathmore

Associate Professor Neil Strathmore trained at the University of Melbourne, Royal Melbourne Hospital and the Massachusetts General Hospital. He has been a member of the RMH Cardiology Department since 1991. He has a wide interest in Cardiology and in training junior doctors. He is particularly interested in arrhythmias, especially the management of Atrial Fibrillation and Bradycardias.

 

 

Tell us a little bit about yourself

I was born in Sydney but have lived in Melbourne since I was 6. I went to school here, and then went to the University of Melbourne. I started out in Science majoring in Physics and Maths, but in my Honours year, I decided I wanted to change to Medicine. It took me several years to get in because there wasn’t a direct pathway for graduate entry, so I went to the Department of Physiology, where I did an Honours degree, and research in neuroscience before  finally getting into Medicine.

After graduating I was an Intern, Resident and Registrar at Royal Melbourne Hospital. I did rotations to Wangaratta and Ballarat, and then Cardiology training at RMH under Dr David Hunt. My wife and I went to the US in 1989, where I spent 2 years in Boston as a Cardiology Fellow at the Massachusetts General Hospital, specialising in pacemakers. I came back to RMH doing Cardiology and General Medicine. I really enjoyed General Medicine where the patients can have multiple diagnoses, and I worked with some great Physicians, including Professor Richard Larkins,  but eventually I concentrated on Cardiology.  

So now I work in the RMH Cardiology Department, where Dr Leeanne Grigg is the Director. I have a private practice, where my main office is at Epworth Camberwell and I also work at Melbourne Private Hospital and Epworth Richmond.  I have a special interest in cardiac pacemakers and defibrillators, which I implant and follow-up. I also remove infected or malfunctioning pacemakers. I was the only person doing pacemaker “lead extraction” for many years but I trained my colleague, Dr Gareth Wynn and now we work together as a team. In the RMH and in my private practice, I look after patients with a variety of cardiac problems, not just pacemakers. Many patients have chronic cardiac disease, so I have known them for many years. At RMH I do ward rounds, supervise clinics and teach residents and medical students. 

What is it about RMH that has kept you here?

I came to this area as a student and have been studying or working at the corner of Grattan Street and Royal Parade for 50 years, so I’m not sure I could go anywhere else. I am very lucky that I work with a great team in my Department. It is a high-quality unit, which strives to give the best care to our patients. It’s an exciting place to work with new developments every year.  The people in the unit are great – doctors, nurses, technicians, allied health, administrative. Many of the consultants started as trainees with us and it is a wonderful feeling to work closely with people whom you have seen develop from juniors to experts. I really enjoy working with our residents and registrars, who are training.

You touched on doing your fellowship in the US before coming back to specialise, is that a necessary component of medical education?

It used to be, and it depends on what you want to do. Some people want to do a major research project with a PhD, some go away and train, perhaps in a new procedure, and some decide to go straight to clinical practice. I certainly wanted to work overseas, because I wanted to have the experience of living and working in another country and medical system.  We had a great time, met wonderful people and learned a lot.

It has actually become very hard to practice in the US these days. It used to be that to get a license to work in a hospital in the US, you have to pass a MCQ exam. Now, you have to pass USMLE, a 3 stage exam which includes clinical and oral, and you have to go to America to sit part of the exam. So there are fewer people doing that now and instead, people go to Canada or Europe. Several of my colleagues in recent years have been to Toronto, Vancouver, London, Edinburgh and Copenhagen. A major reason to work overseas is to learn a new skill or procedure that is not available at home. But the experience also broadens your outlook.  You see how other health systems work and how other institutions deal with various problems.  You make new friends – many of whom you stay in touch with for the rest of your career.

We know a lot about you as a consultant and your role at the hospital, what do you do on the weekends and how do you relax?

My wife is a Paediatrician who was a medical student at the University of Melbourne, then trained at Royal Melbourne and the Royal Children’s Hospitals. She now works at Monash Medical Centre. We have 3 sons. The oldest is Alex who graduated from medicine in 2018. He is a resident at Royal Melbourne Hospital. My second son is a musician and digital media consultant in Los Angeles. My third son lives at home and is doing a commerce degree at Melbourne University.

On the weekends, we often have people over for dinner or we might go out. We have a garden, so we spend a lot of time there. We try to do quite a bit of exercise – particularly in the gym or out walking or cycling. I also enjoy reading and doing crosswords.

I usually do some work on the weekends, because that is when the lectures are written.  

What got you into teaching at Melb Uni?

I lived in Queens College as a Science student, and that is when I started doing some teaching. When I was doing my Honours year in physiology, I started teaching physiology to medical students. Then I became a medical student myself, but my teaching continued when I was a junior resident and registrar.  I continued to be involved in teaching at RMH when I was a consultant and that has been on-going to now – both at the bedside and in the classroom or lecture theatre.  Recently I’ve been given lectures and tutorials via Zoom which has been interesting.

At the end of 1990s there was major revision of the medical course, including the introduction of Problem-Based Learning (PBL) and the division of the preclinical years by organ systems rather than by subject.  The Dean of Medicine, Professor Larkins, invited me to be involved in the planning of the Cardiovascular component of the new course. That was when I started giving lectures in the preclinical years.

 

Interview by Sanlin and Erene

Stay tuned for part 2