Latest / Rad Chat / E222: Dr Georgia Harris - Life as a Consultant Clinical Oncologist
Transcript
- Jo McNamara (00:00) Hi everyone and welcome to Rad Chat. This is part in our leadership series. Today we're going to heading all the way to Australia to chat with the brilliant Dr. Georgia Harris, where we're going to explore Georgia's journey into radiation oncology, where she learned about working across different healthcare systems, the realities of caring for people with advanced cancer and why equitable access to high quality radiotherapy matters on a global scale. So welcome Georgia, how are you? Dr. Georgia Harris (00:25) I'm well, thank you both for having me today. Jo McNamara (00:27) We're really excited to have you and so for any listeners just tell us a little bit about yourself. What do you do? Dr. Georgia Harris (00:34) So I'm a radiation oncologist, which means that I am a cancer specialist who looks after the radiation therapy component of treatment. That means that I work closely with other members of their clearing team. So that's other medical oncologists in Australia, surgeons. I am based in Australia and I work in a big hospital in Sydney. And I mainly look after patients who have breast cancer and lung cancer. But I also treat patients who have tumours of any type, who have advanced disease, looking after their radiation therapy to help with symptoms that their cancer might be causing. Naman (01:15) Why did you want to work for radiation? Dr. Georgia Harris (01:18) Interesting question. I I actually f was lucky I fell into radiation oncology. I actually had no idea what I wanted to do when I was at medical school and through my residency. I dabbled a little bit in dermatology and didn't really enjoy that, no offense to any dermatologist. and then I was living at the time in a share house and one of the girls that moved in was a registrar doing radiation oncology training. And she loved her job. She was a very cool person as well. She seemed to have a really nice energy and enthusiasm for her work. And she invited me to come along with her to sit in some clinics and see what she did. And that's how I found out about radiation oncology. I actually didn't know much about it at medical school. We had about two lectures in our entire curriculum about it and so it was really meeting her. She is still a big mentor for me, so I'm still very close to that person and she's actually a very impressive radiation oncologist. so yeah, so she was my intro to to radiation oncology and sitting in with her and observing her, just seeing the way that I I guess what impressed me about it when I first had some exposure to radiation oncology was seeing how she interacted at that very team based approach which really struck me. with other doctors but also the nursing staff, the radiation therapists and the physicists and I guess just that that very special relationship that you get to have with your patients as well. So it just seemed like something that was very meaningful where you could actually really help people and it seemed like a a a really nice job as well in terms of the way that it's set up, working closely with lots of other people. Jo McNamara (03:02) Tell us a little bit about your career pathway. What do you have to do? How do you specialise? What made you decide specifically to specialise on breast and lung cancer patients? Dr. Georgia Harris (03:14) Yeah. So in Australia there's there two pathways through through medic medicine. I did the postgraduate pathway, which meant I did a undergraduate degree in science. Again, didn't really know what I wanted to do, but but at that time, but then as I went through my science degree, decided that I'd love to do medicine. it's probably heavily influenced by the fact that my mum was a midwife and my my dad was a surgeon. They had a hospital love story, that's how they met. And so that was always a around. Naman (03:46) Grey's Anatomy style or... Dr. Georgia Harris (03:49) Probably not quite so glamorous. And yeah, so so did my medical school, which is four years of postgraduate medicine in Australia, and then we do a compulsory intern of resident year. And beyond that, then you you then have the opportunity to consider specialising. Most specialty training programs in Australia require you to do a unaccredited year where you get exposure to that particular specialty, you get to meet other other people in that specialty, potentially do some research in that specialty, and eventually you can apply to the training program, which is a a competitive process. once you get onto the training program, then it's a five-year training program in Australia. So I was lucky to do to to get onto the the training program after doing an SRMO year, which is like a senior resident, a senior medical resident job, I think is the equivalent maybe in the UK, I'm not sure. and yeah, so it's a five year training program. You rotate through different hospitals in various radiation oncology departments in your training in Australia, which is great because you get to work in metropolitan centres and also regional centres and that is really interesting. Obviously very different demographics, very different patient populations, very different disease entities and different resources as well. So the challenges of working in different healthcare settings. And beyond that you then have the opportunity to do a fellowship year, which is where you get to so so you finish all your exams and your training, and you get the opportunity, if you wish, to do one or sometimes two dedicated years sub-specialising in an area of radiation oncology that you really love. So for me I was really lucky I got to go and spend 12 months at Princess Margaret Cancer Centre in Toronto I did a fellowship in palliative radiation oncology, which was fantastic for for many reasons, but yes, it was it was just a very special time in my life and I loved it, met some great people, learnt a hell of a lot and then was able to bring that back to to my role in in Australia as a staff specialist. Naman (06:04) There's obviously a lot of skills you need to be in oncology as a radiation oncologist but when it comes to palliative care what advice would you give anyone who's considering it or thinks it's a nice specialty as well? Dr. Georgia Harris (06:15) Well, I feel that we're very lucky to work closely with our palliative care colleagues and I have the utmost respect for for them. I think the what they can provide our patients is is incredibly special and requires a very special skill set and it's funny because during medical school I think there's so much emphasis on treating disease and treating the illness and in fact helping patients live better with terminal illnesses or very advanced cancer and actually helping people to die with dignity and and peacefully is such an important thing to be able to do and I think sometimes we we forget that we're so focused on just looking for a cure and and trying to eradicate the disease that we we forget that actually a big component of caring for somebody is being able to help them die peacefully. And I know palliative care is not just about end of life care but I think it's an important part of what they do. in radiation oncology, I think we recognise the importance of linking patients in early with palliative care not only to help with symptom management but also just some of the social supports that they can provide patients and their families we're quite lucky in the area of Sydney that I work. Jo McNamara (08:24) Georgia, how do you balance the really technical aspects of palliative radiotherapy whilst also ensuring the patient care elements? Dr. Georgia Harris (08:33) Well I think that's one of the things that makes radiation oncology such a great specialty, if I'm being honest, because you do have the amazing technology which is constantly evolving and constantly challenging us, but also potentially opening up, other therapeutic options and improving the side effect profile of the treatments that we can give. I think that's one of the the the really exciting parts of radiation oncology and then being able to marry that with the patient care aspect of of what we do. I think that's one of the things that makes radiation oncology unique as well is that you have this ongoing evolution of technical capabilities and emphasis on evidence-based care it allows it this ability to personalise medicine more and more. so I guess when trying to incorporate some of the technical advance, obviously we try to do it in the right clinical scenarios and most of us, try to be a adaptable and I work in a department that I think is generally excited about the innovation and being able to bring that bring that on board and make sure that we are able to offer our patients, really up to date and modern sophisticated treatment. Naman (09:49) I was just going to ask with your experience of traveling and going to different conferences, how much has practice changed for you? But then also at the same time, how do you keep up with it all? Dr. Georgia Harris (09:59) Good question. Well, for the first part of your question, I think it's changed a lot. So I did my fellowship year got my letters in 2016 and then I did my fellowship year from 2016-2017 and so I've basically been a consultant now for about ten years. and if I think about the the changes that have occurred in that time, they're huge. When I was training, for breast, particularly in breast cancer treatment, we were very much doing 3D conformal radiation therapy. When I started working at Christopher Bryan Lifehouse, which is where I still work as a site specialist, we were doing a lot of hybrid IMRT treatments for our breast patients. We then moved to full IMRT treatments and and now VMAT has replaced that as Our routing practice for for for breast radiation therapy. And so that's just one example. I think some of the treatment paradigms in general oncology have also shifted considerably since I graduated as well. I think particularly in the breast space. Yes, there's been technical improvements in what we're able to achieve dosymetrically with more conformal radiation therapy planning and lower toxicity with that. But I think obviously there's been huge improvements in the drug therapies that are available for our patients, and that has transformed outcomes for cancer patients. I'm thinking specifically of the breast seting, but also I I work in lung cancer as well, many treatment options that were just not available when I ten years ago that that that are now part of routine practice for our patients, which is awesome. And with that we've seen patients doing so much better and just, really seeing improved outcomes. In terms of radiation therapy specifically, I think too with the improvements in diagnostic imaging. The ability to give stereotactic radiation therapy to appropriate patients has been really exciting too in terms of, it's a very sophisticated treatment that's really well tolerated, it's a few visits, it's so easy, and we can do it safely, and there there's evolving data, for for inoperable early lung patients, but also for for bone metastases. and spinal metastases. I think those things have been really exciting developments that that I've seen in the last ten years. I'm sure there'll be many more. Naman (12:21) Do you think with all of that, that there is enough of a focus on quality of life for the patient and the carers? Dr. Georgia Harris (12:26) Good question. I don't know if it's fair for me to say on behalf of my entire specialty, but I do think radiation oncology again, one of the things that's really nice about it is I do feel that it really is centered on on patients and and I think as oncologists, yes, we're always thinking about giving a better a better treatment option where we can and, making that treatment more sophisticated and and less toxic but but really because we want to make we want to try and make patients' lives better and whether that not only be improving their oncological outcome but also minimizing long term side effects of their treatment, I feel like, for our trainees, we place a lot of emphasis too on, taking good histories from patients, taking good social histories from patients, trying to ascertain, what supports patients have, what are the stresses the family might be going through, being mindful of that. I think that's something that's entrenched in our our training as well. Yeah, I I I do think I do think as a specialty gener generally where where we try to be really mindful of thinking about quality of life and the broader impact as well. not just the technical aspect of the treatment that we're delivering. Jo McNamara (13:46) We're definitely seeing more research as well, aren't we? Including the patient voice, which is obviously helping Dr. Georgia Harris (13:51) One hundred percent. Yes, absolutely. And most clinical trials now in radiation oncology do do mandate having consumer input, getting patient getting getting the patient perspective in how those studies are conducted and and it really involving them from the outset and in the conduct of the trial and what outcomes are important to patients. So it's definitely something I think we're getting better at doing. Jo McNamara (14:23) So Georgia, we had the pleasure of teaching together on the leadership course at ESTRO. Dr. Georgia Harris (14:28) Yes. Jo McNamara (14:29) tell me a little bit about leadership in radiation oncology and your experiences. Dr. Georgia Harris (14:36) Well I think I've been very lucky to have worked with some wonderful leaders. and that's been at various stages during my career. I have been lucky to work with with with leaders who I think, have have been approachable, have been calm in stressful times, who have been fairly imp impartial and I feel very fortunate that I've worked with with with with leaders that generally I have really admired and most of those people have ended up in some way being a mentor or having that dynamic in terms of the the way that they've established their their career and their leadership skills, I guess one of the things I like about the FLIRO leadership course is that I feel like there's obviously there's different ways that. That someone can can be a good and effective leader. And I think their personality is your your personality style makes some types of leadership easier than others. and so what I appreciate about that course too is tailoring some of those skills to what feels natural to you, and even if you are an introvert and there are still ways that you can be an effective leader, and so it it doesn't have to look a certain way. It's not always being the loudest person in the room or having the most to say that makes you a good leader. And so I I found that very valuable when I did that the FLIRO course many years ago and it was nice to rejoin the the faculty for Estro this year as well. Naman (16:21) If you could give your younger self any advice on leadership, what would you say? Dr. Georgia Harris (16:25) It's interesting because I would describe myself as an introverted person and if you hadn't picked up on that already and I think Naman (16:33) says you on a podcast in 151 countries. Dr. Georgia Harris (16:37) I think too and again maybe this is a generalisation, but I do think perhaps women in general are not quite as good at putting themselves forward for leadership positions or maybe and again, this is probably a big generalisation but maybe are a little bit hesitant to put themselves forward in general compared to their male colleagues. And that's probably why we see fewer women in leadership positions still, even though we do have a fairly even gender distribution in our specialty, at least in Australia, and I think partly that maybe that we may question our abilities a little bit more sometimes. I think that we're still figuring out that, women, that they have to, balancing family, balancing career is really challenging and I think luckily we're in a time where we're trying to be really mindful of that and where places are trying to be more flexible and I think that there's generally a little bit more equity in terms of some of the runnings of the family and the household. But I think it's still evolving and still challenging and it's certainly something that I still struggle with, if I'm being honest, at this point in my career is how to get the the balance right. and I certainly see other female leaders and admire the the way that they structure things and can see that they're very effective and very impressive leaders. So I definitely think it's possible. in terms of giving advice to my younger self, I don't know because I don't know that I've necessarily fully figured it out yet. Jo McNamara (18:18) Hm. Dr. Georgia Harris (18:19) But yes, I think surrounding yourself with people that you admire, finding someone to mentor you in a way that can be a role model has been helpful for me. And also putting yourself out there a little bit, sometimes going a bit outside your comfort zone, and just trusting the process and the I feel like the more you do that. The more it helps you build the confidence to to do it more regularly. Jo McNamara (18:45) That's really good advice. And I'm sure that's why you said yes when I said, Will you come on Rad Chat? She's like, no. Dr. Georgia Harris (18:48) I didn't want to let you down. Jo McNamara (19:01) Georgia, in terms of you then mentoring and supporting others, because you now are a leader in your organisation and supporting others coming through in radiation oncology, Dr. Georgia Harris (19:11) Move. Jo McNamara (19:12) what what do you do for your mentees? How do you support them? Dr. Georgia Harris (19:17) Well, I actually I I one of the things that I love about my job is obviously the the clinical component, but I do love teaching and that involves teaching medical students, but also our our trainees coming through the training programme and I'm exam an examiner for FRANZCR which is our a professional college. I think that it's a really special job to be involved in teaching and training. I feel like I learn a lot from the trainees and the medical students to be honest. So it's definitely mutual. I think that it's just it's nice to be a part of helping give back because I know that a lot of my mentors invested a lot of time and energy into training me and so I really valued that and so it's nice to be able to pass that on to others. And it's also nice to see them go forward in their career and and flourish. It's very rewarding. And you have this sense too that yes you have your day to day clinical work but even being being able to to be involved in teaching and mentoring junior trainees i there's a ripple effect where you know that you're contributing to improving care for for for patients generally and gives you confidence in the the direction that our specialty is headed, I suppose being a good mentor for them, I guess I try to be approachable. I try to be, someone that they can talk with comfortably about their anxieties and, what their stresses are, I guess, in the job, and also, I like having conversations with them about what their goals are in terms of the next steps in their career planning and things like that. And, if I can do anything to kinda help connect them with someone that else or, help facilitate their, their career progression. That's always really rewarding as well. So I think just being available, listening, making time for them, making them feel important and I think those things are helpful. At at least they were for me. Jo McNamara (21:13) Yeah. I definitely think the point you made about being available and being all your authentic self but also being curious about them and their learning because you do learn so much from other people, but you do come across some leaders who are quite closed off thinking, Well, I've done everything, I know everything and it can be really restrictive because when you're in that mindset, even as a leader in that mindset, you're then like, I'd really like to ask these questions, but I can't because I've already boxed myself off when Dr. Georgia Harris (21:44) It's true. Yes. Jo McNamara (21:46) you can learn so much from people. Dr. Georgia Harris (21:48) Mm, yes, I agree. Jo McNamara (21:56) So Georgia, we're coming towards the end of the podcast episode, although we have loads of other questions we would love to ask you. But for any listeners out there, what take home messages would you like to leave them with or any top tips? Dr. Georgia Harris (22:11) I think this is a nice opportunity to give a shout out to to radiation oncology and to radiation therapy. I think it's so lovely to work in an area of medicine where we have the ability to to make such an important difference to to patients' lives and their outcomes. Modern radiation therapy is so sophisticated, it's so safe, it's such a great treatment option. It's cost effective. I would like to give an opportunity just to really champion it and all the wonderful things that radiation oncology departments around the world are doing for cancer patients and all the research that is focused on improving outcomes for cancer patients. As I said, just reflecting on the things that have developed within the specialty for patients in the last ten years has been pretty awesome. So I really can't wait to see what happens in the next ten years. Jo McNamara (23:05) amazing. And Georgia, have you got any aspirations? Is there anything that you'd love to do with your career going forwards? It's like a work interview. Your PDR. Right, tell us what's next. Dr. Georgia Harris (23:12) Gosh, I haven't really thought about that. To be honest. Yeah, I know. Most of the days I'm just trying to get through each day, managing my little my little kids on two hours' sleep and just but no, Jo McNamara (23:27) Yeah. Dr. Georgia Harris (23:27) I think look, I feel very fortunate to work in a in a job that I absolutely love. I love the people that I work with. I feel like I have so many special opportunities, not only the ability to to work closely with my patients but within a great team of people and we're all focused on the same goal of wanting to do better for our patients. and it's lovely to balance that with with being able to do teaching and and education, just hope to be doing more of that essentially. Jo McNamara (23:58) Amazing. well a huge thank you to our guest Dr. Georgia Harris for talking about her career as a radiation oncologist, palliative care and the role of leadership. Thank you all for listening to Rad Chat. My name is Jo McNamara and Naman Julka-Anderson. Thank you very much. Jo McNamara Rad Chat Host (24:12) So what do you do now? Well you can use this episode as part of our free continual professional development accredited content which offers flexible learning that fits your busy schedule. 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