Internal Medicine is very much like putting together pieces of a puzzle based on history and clinical findings. I can often have a pretty good idea what may be going on with my patient from a thorough history, and diagnostics are often to help me prove my suspicions. That is particularly true in gastroenterology, which is my primary clinical focus and caseload, where a really detailed GI and diet history is paramount. Of course sometimes a case is more tricky and requires a lot of testing to figure out what may be going on. I joke to my interns I’m basically just good at educated guesses. To be a good internist, it often also means need to be a good enough clinician in other specialties to at least recognise conditions we may not manage commonly as internists, which is a challenge at times as it’s impossible to know everything, but can be rewarding when I do get it right in a complex case.

I guess I’ve always enjoyed teaching. While I can only help the cases I see, if I can teach others how to be better clinicians and share new knowledge, they can go on and help the cases they see and perhaps also teach others what they know. That seems much more impactful. My love for teaching definitely influenced my career decision as I opted for working at a teaching hospital after my residency. I used to be terrified of public speaking, but now that I’m much more comfortable with it, I actually enjoy lecturing, which is probably a good thing since I do lecture fairly often.

Not sure there was a pivotal experience per se. I guess I was always more interested in internal medicine, particularly feline medicine during vet school, and I was lucky to have attended vet school at Edinburgh since they were known for feline medicine. When I was in primary/general practice in Hong Kong for a brief period of time, I remember always spending more time working up complicated internal medicine cases. My boss at the time and one of the more senior vets each had an Australian certification in feline medicine and internal medicine, respectively, and they encouraged me to do an internship and pursue an internal medicine residency. Along the way I’ve been lucky to have been mentored by some great internists. During one of my specialty internships, I realised I was increasingly interested in gastroenterology, and then I was really lucky to end up doing my residency under the mentorship of some renowned internists in gastroenterology/hepatology. So I owe my mentors for being the internist I am today.

Favourite: Gastroenterology, Nutrition, Feline medicine

Least: Nasal Aspergillosis debridement

Misconception: Metronidazole for diarrhea (my soapbox)

I almost considered pursuing:

- Cardiology

- Neurology

- Oncology

Purina fecal score chart

Work-life balance is important for my mental health. My interns will often contact me by text messages regarding my cases while I’m off clinics if it’s sometimes they can’t figure out or can’t wait till I get back. However, I try not to check work emails when I’m off. I work hard and play hard, and dedicate time to training and pursuing my outdoor pursuits which gives me joy…..and injuries, but who’s counting?

Murphy was a cute little Cockapoo with megaesophagus, LES achalasia-like syndrome, gastroesophageal reflux, and chronic inflammatory enteropathy I had managed for a few years. He ultimately succumbed to a severe bout of aspiration pneumonia. His owners were a prominent human surgeon and a nurse and probably the best owners possible given the complexity of his case. The internal medicine intern and I were both off clinics the day he needed to be euthanised, and we both went in because we couldn’t imagine having someone else do it. He was a special little boy.

Being able to have a predominantly gastroenterology caseload, and continue to participate in clinical research as well as lecture locally and internationally.