Medicus April 2016

F O R T H E R E C O R D

and are cognisant of all management decisions and involvement in the running of the ED and the hospital. Having two HoDs means that we are present in the hospital five days a week (if not more), which makes us more accessible and more aware of what is going on in our working world. Michele: We are two different people and although we went to the same medical school, both grew up in the UK and have both done the Institute for Health Leadership Consultant Development Program, we have slightly different managerial styles. That’s a good thing! We promote the same message but express it in different ways; it reaches more of our team as they have their own individual receptiveness to management styles. Q. Do you have different management styles?

Q. What do you believe are the advantages of job sharing a senior role such as this? Michele: Importantly it gives us some sort of work-life balance, although we suspect our families may dispute this. It enables at least one of us to attend most meetings, as either of us can create space in our calendar. We are both available to all our team and they can approach whichever of us they feel most comfortable chatting to and we hope this is instrumental in helping us all to manage change. We still get to do clinical work, which is our passion, and we really enjoy our shifts on the floor after a couple of days administrating. Matt and I both have different areas we enjoy within the role. Having someone to share the load with is good for our “wellness” and enables us to celebrate and commiserate together – it’s not lonely at the top at SJGMPH’s ED.

Q. What would you say is key to successfully job-sharing?

Q. Are there any challenges?

Michele: Having the same philosophy and working equally hard, sharing the load and celebrating the wins! Matt: We complement each other well as we have strengths in different areas, which really helps. We also get along very well. ■

Matt: We haven’t experienced any open expression of questioning the arrangement. It is similar to having a Deputy Head of Department, except we both accept equal responsibility, can cover for each other in any absence

Dr Stuart Salfinger & Dr Pippa Robertson HORMONE REPLACEMENT THERAPY POST GYNAECOLOGICAL CANCER Continued from page 47

demonstrated in a study by Stillman et al.

Summary Woman who are thrust into premature menopause from cancer treatment often have a more severe experience of menopausal symptoms whilst dealing with the psychological impacts of their disease. HRT post gynaecological cancer remains a challenging issue with some doctors being reluctant to prescribe it due to reservations of stimulating recurrent or new disease and lack of concrete evidence in some cases. As new studies emerge, doctors can be increasingly confident when educating patients about the potential risks and benefits associated with HRT. This in turn will go some way in ensuring that patients can make an informed decision as to whether they commence treatment and have an improved quality of life. ■ References available on request.

In those receiving primary radiotherapy with their uterus in situ, studies have demonstrated that residual endometrial tissue can potentially respond to estrogen therapy. In this situation, combined HRT is advised. Local vaginal estrogen application for radiation side effects have not been found to have a negative outcome in those treated for cervical cancer. Vaginal and Vulval Carcinoma In vaginal and vulval cancer, the most common subtype is that of SCC. Radiotherapy treatment can cause an early menopause yet as described above, it is thought that SCC is not estrogen responsive. Studies have also shown no adverse outcome when treated for HRT post treatment for VIN or SCC.

Dr Stuart Salfinger is on the Executive Board of the Australian Gynaecological Endoscopy and Surgery Society. He is currently completing a Master’s Degree in Surgical Education.

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