AMA submission to Linked Dual-Trained Physician Care in Rural Communities

The AMA welcomed the opportunity to comment on the Royal Australasian College of Physicians (RACP) discussion paper Linked Dual-Trained Physician Care in Rural Communities.

The proposed model for dual trained physicians demonstrates that the RACP is keen to improve access to health care in regional and rural areas. While this measure alone will not fix the current regional and rural health workforce issues, the idea certainly has merit and is worth developing further.

The AMA believes such a model will only work if there is close cooperation with other medical practitioners working in the area, and in particular, with local GPs.

The AMA submission raised a number of issues including:

• how the pathway will be fully supported – professionally, academically and personally - and tailored to the needs of individuals;
• the governance structures for the pathway and effective processes including how the pathway should be integrated into existing training structures and credentialing;
• how the mechanisms for monitoring and accountability for the pathway will be built into the program from the start, including reviewing the retention of pathway trainees and graduates in regional and rural areas;
• how dual-trained physician completing the training should be recognised and valued in terms of professional status;
• how will the training for dual-trained physicians in regional and rural areas differ from current dual trained physicians and will the qualifications differ;
• how will the training pathways incorporate tertiary and non-tertiary experience for all trainees and the length of training for dual-trainees;
• specific training requirements for General Medicine/General Paediatrics qualifications for sub-specialist trainees versus streamlined training pathways combining General Medicine and sub-specialty training in one program;
• cost of training for dual-trainees and how this will be funded through the State and Federal funding arrangements and other support programs;
• how the necessary specialist equipment and maintenance of the equipment will be funded. Most specialty areas require access to expensive medical equipment that relies on adequate throughput to achieve cost-effectiveness and skill maintenance. Such costs can be considerable and prohibitive for many medical practitioners who may otherwise want to go down the dual-trained physician path.
• the value of a dual qualification for trainees, particularly as it compares to a single qualification