Rhea Singh
Dr Rhea Singh
Bachelor of Medical Science (Honours)
It's been great to see the impact that my research has had, whether that be from other researchers or GPs contacting me to get some more information, or from applying my research findings to my own clinical practice as a junior doctor.
Dr Rhea Singh was at the end of her fourth year of medical study when the COVID pandemic struck in 2020, and used it as an opportunity to break from her studies and undertake an Honours year with us. “It was such a disrupted time, and to be fair I was looking for a break from the routine of medical study anyway. Honours seemed like it would deliver that, and give me research skills that I know are becoming increasingly important for medical job prospects.”
She enrolled in a project supervised by Dr Asvini Subasinghe, and co-supervised by Professor Daniella Mazza and Dr Mridula Shankar. Together they mentored her as she worked to better understand general practitioner perspectives on delivering early medical abortions to women from culturally and linguistically diverse (CALD) backgrounds.
Medical abortion is a safe, reliable and non-surgical means of abortion for people who have made an informed decision about their options, and in Victoria it can serve as an alternative to surgical abortion during the early weeks of pregnancy (up to nine weeks). While the non-invasive aspect of the procedure is a big benefit, there are wide accessibility issues for women nationally.
“For women from CALD backgrounds, the lack of accessibility to these services is likely to be compounded by other barriers unique to them,” says Dr Singh. “I wanted to better understand the experiences of GPs who were actually delivering these services, and get their insights.”
She took a three-prong approach to recruiting GPs: blanket-emailing primary practices that listed medical abortion as a service, listing on a special-interest Facebook group for service providers, and snowballing (encouraging participants to spread the word about the study with their eligible colleagues). In the end, she interviewed 18 GPs. Each interview was transcribed, coded and thematically analysed using Braun and Clarke’s reflexive thematic analysis approach.
“I wasn’t keen to be in a lab, or crunching numbers, and I think qualitative research has a really important role to play in truly understanding the consumer perspective to healthcare improvement. It can humanise research, and while it was daunting at first, I got a lot out of it.”
The GPs identified a number of challenges, especially with regards to language barriers and involving interpreters in a time-constrained working environment. Other challenges were cultural, for example relating to the stigma surrounding abortion in some cultures and concerns around reproductive coercion which often made engaging women from CALD backgrounds challenging.
“With women from cultures where husbands tend to lead these sorts of decisions, GPs found it difficult to navigate the consent process in line with our local frameworks, where the woman’s needs and views are prioritised. A number of GPs said they’d really appreciate more training and support in that area.”
Ultimately her research suggested that upskilling GPs in culturally competent care, improving access to multilingual resources and enabling efficient interpreter use could optimise early medical abortion delivery to women from CALD backgrounds.
Dr Singh presented her results at several conferences, including the AAAPC 2022 conference, where she won the 'Most Distinguished Paper' Award. That win provided the chance to fly to Europe in 2023, to present at the SAPC Conference.
“I think the main challenge during the year was getting the right mindset. After four years of medical school, where learning is very structured and presented to you, taking charge of an Honours project and adjusting to independent and self-directed learning can be overwhelming at first. However, it’s an amazing way to learn about time management and organisation – research rarely goes to plan, so you also learn to be very adaptable.
“It’s also taught me to be more critical in my thinking. I don’t necessarily take medical practice or dogma at face value any more – I see the importance in digging below the surface and evaluating the rigour of the supporting evidence.”
Since completion, Rhea's seen the publication of her results in the Australian Journal of General Practice, and has worked with colleagues at CRE-SPHERE on other articles. She's also completed an internship with Alfred Health, and is now part-way through general physician training.
A well-earned year off is allowing her to travel, undertake locum work, and pursue research in her special interest area of endocrinology.
“It's been great to see the impact that my research has had, whether that be from other researchers or GPs contacting me to get some more information, or from applying my research findings to my own clinical practice as a junior doctor.
"Although my Honours research focused on a different topic/area to endocrinology, the foundational skills I developed, such as critical thinking, data analysis, scientific writing and experimental design, have been transferable. This background experience has allowed me to approach new research projects with confidence and has made me eager to take up new opportunities moving forward."