A Tamworth native has brought specialist training in retinal diseases and uveitis acquired at a world-class UK eye hospital back home where it’s needed most.
Ophthalmologist and mother-of-two Dr Phoebe Moore has been practising in her hometown of Tamworth for the past year, at North West Eyes, a clinic her father Dr David Moore established in 2003. A highly awarded and talented surgeon, her homecoming follows a tumultuous twelve months prior.
Moore graduated first in her undergraduate medical degree at the University of Newcastle in 2011. In addition to graduating with distinction, she was awarded the RANZCOG Women’s Health Award for the highest overall ability and capacity in obstetrics and gynaecology and the Andrew Lojszczyk Prize in Surgery, for the highest overall performance in surgery. She also graduated with the Australian Medical Association (AMA) prize for the student with the highest overall ability and capacity.
She completed her internship through the Hunter New England Health Network while also completing her Master of Medicine in ophthalmic science. She then graduated first in her master’s degree, being awarded both the Anthony Molteno award for optics as well as the Clarence and Mabel Clark Award for the most proficient graduate.
Moore says she always held an interest in medicine, partly owing to growing up with an ophthalmologist father.
“I was interested in studying medicine, or law as my next option. But reflecting back on it, law wouldn’t have suited me. I like science and the practical application of it. I like working with people and pushing myself to be the best I can be. I enjoy expanding my knowledge and skills, and ophthalmology offers opportunity for continual growth and development,” she says.
Moore commenced ophthalmology training in Melbourne through The Royal Victorian Eye and Ear Hospital in 2015. She graduated first across Australia and New Zealand, adding another award to the mantlepiece – the KG Howsam medal for excellence in 2018. All the while, she became a mother of two while completing her training.
Moore, with her husband and two sons, departed for the UK in January 2020 to undertake a Fellowship at Bristol Eye Hospital, sub-specialising in retinal diseases and uveitis, in particular management of immunosuppression for patients with inflammatory diseases of the eye.
Life in Bristol
“We were committed to spending a year in Bristol for my fellowship, and were considering staying a further six to 12 months after that, all going well,” Moore recalls.
“Beyond that, we were tossing up between Tamworth and Newcastle, where my husband is from, as a place to come back to.”
A few months into their planned year in Bristol, the outbreak of COVID disrupted their day-to-day, but not their longer-term plans. Then, a sudden family emergency back in Australia meant Moore and her family had to reassess.
“Dad had a heart attack in May, at the height of lockdown in the UK, and he didn’t work for the following five months. That made the decision to come back to Tamworth obvious,” Moore says.
But they decided not to return immediately, for multiple reasons, Moore says.
“I made a commitment to RANZCO to complete a 12-month fellowship – without it, I wouldn’t get my qualification. I had also signed a contract with the NHS in the UK,” she says.
Despite the many personal challenges, including navigating a pandemic in a foreign country with a young family – her youngest son was 7-months-old at the time – and an unwell parent in Australia, on a professional level, she was learning more than anticipated, with the pandemic heightening the need to triage patient diagnosis and treatment.
Midway through her fellowship and with no signs of the pandemic abating, in September 2020, after Australia introduced a cap on passengers arriving into the country, Moore and her family began looking at flights from London to Sydney.
After witnessing other Australians being “bumped off” flights, they borrowed money for business class tickets with Singapore Airlines to maximise their chances of getting home.
“But in January 2021, the cap was slashed in half again, and our February flight was cancelled, with no alternatives until late March,” Moore says.
Adding to their dilemma, they had given notice on their lease in Bristol, and Moore’s medical registration and visa were due to expire. With few options, she met with Bristol Eye Hospital administration to explore the possibility of staying on, and began applying for an emergency extension of their visas.
Moore’s plight garnered mainstream media attention, with 7News, Sunrise and The Guardian all seeking an interview. Her predicament coincided with news at the time that Australia’s High Commissioner to the UK, Mr George Brandis, had abandoned his post at the peak of the COVID crisis.
“I became a spokesperson of sorts for Australians stuck abroad. The online commentary and the tone of discussion on ex-pats living abroad, who were now stranded, was quite negative. I felt ostracised at the time and wanted to raise awareness of the circumstances beyond our control,” she says.
“In the wake of the media coverage, a representative from Singapore Airlines got in touch, and said they’d managed to find space on a flight for us.”
Returning home
Part of the concern Moore raised in the press coverage was the impact her delayed return to Australia would have on the eye health of the Tamworth community.
At the time, Tamworth ophthalmologists – servicing an area comprising 240,000 people who travel from as far as southern Queensland and western New South Wales – faced a workforce shortage that could have been much worse if internationally-trained Dr Kayvan Arashvand wasn’t granted a special extension of his Medicare Provider Number to continue practising in Tamworth. Without this, the region would have been left with 1.5 full-time equivalent ophthalmologists.
Tamworth’s ophthalmology situation has since become a flashpoint in a push for policy change around how the government determines areas of workforce shortage.
In addition to consulting at the Tamworth rooms, ophthalmologists at Moore’s father’s practice, North West Eyes, operate at Tamara Private Hospital and Tamworth Rural Referral Hospital. Outlying clinics are provided in Narrabri and Moree, as well as surgery in Moree.
Knowing she could be part of the solution, Moore was relieved to finally return to Tamworth in 2021. She began her career in earnest and was thankful to have completed her formal training, but faced a significant step-up in responsibility.
“I have more work than I can keep up with. Most new consultants starting out take a while to build up a patient list, but I’ve been busy from the get-go. We cover an area of 250,000 to 300,000 patients, from Moree, to the coast, to Muswellbrook. Dad works two days a week, and we have two other permanent doctors. There have previously been some fly-in fly-out doctors working – all of these have stopped coming to Tamworth due to a variety of personal commitments,” she says.
“It’s a fine balance in knowing there is always more work to do but you are no good to your community if you work into early burn-out.”
Moore says her training in Bristol has been “incredibly beneficial” in treating her Australian patients.
“Cataract is one of the most common conditions I treat, and the cases I see are, generally speaking, more challenging than those in city populations because here, the wait is longer, and cataracts are denser. It pushes you as a surgeon. I don’t have a vitreoretinal surgeon around the corner I can consult with,” she says.
Moore is also the only ophthalmologist in northern NSW practising her subspecialty in retinal disease and uveitis.
“Patients requiring my specialty could go to Sydney or come to see me, but they don’t want to go to Sydney, especially in a pandemic. Treating these patients is stretching my own ability, not just in my specialty, but into other sub-specialties too,” she says.
“Although isolated in the sense we don’t have an entire eye hospital [in Tamworth], the care we provide with the resources available in Tamworth is exceptional. Patients are not disadvantaged, their eyecare is not compromised,” Moore says.
It’s a point Moore wants to make clear.
“In my experience, when liaising with my city counterparts, there is an assumption that rural medicine and rural ophthalmology is sub-standard. It’s rhetoric, a subconscious bias, that I’ve picked up on,” she says.
“In truth, rural ophthalmology is on par with any care given anywhere in the world. At North West Eyes, we do everything out of private practice, apart from operating, and our equipment is as good as anywhere.”
Working in a regional clinic with colleagues who offer a different set of expertise, depending on their speciality, means she encounters various conditions she might not otherwise.
“Tamworth ophthalmologists are a small, collegial community. I’m grateful for my colleagues and their shared experience at North West Eyes, as well as Dr Peter Hinchcliffe from Tamworth Eye Centre,” she says.
“Although the ego in me would like to make a name as an academic in a big city hospital, the reality is long hours, and years spent trying to make a name for yourself. In contrast, working in rural and regional ophthalmology, I have a five-minute commute to the clinic four days a week, and can spend more time with my family including my sons, now aged two and five.”
More reading
Tamworth ophthalmologist granted 2022 extension; work towards permanent solution continues
Stopgap solution for Tamworth’s precarious ophthalmology situation
