Joining the dots to create rural careers

4 Dec 2018

Dr Chris Wilson, Deputy Co-Chair of the AMA Council of Doctors in Training (AMACDT), says the formation of the National Rural Generalist Taskforce (NRGT) has brought with it a renewed focus on the challenges of rural and remote medical workforce staffing in the latest Doctors in Training column in Australian Medicine.

The Chair of AMACDT, Dr Tessa Kennedy, sits on the NRGT. Professor Worley and the NRGT are joining the dots between students and independent, competent rural generalists, to develop a training pathway that we hope will acknowledge the need to look beyond graduating more students and the trickle-down approach to solve workforce distribution issues.

In the late 1990s, workforce figures released by the federal Department of Health identified a growing disparity in the number of GPs per head of population in rural and remote Australia compared to metropolitan centres. The response at the time was a rapid up-titration of medical school positions without much thought for downstream training or how people would actually move from a city start point to a country end point.

Since then we’ve seen a number of further initiatives trying to tackle the same problem, all with varying and at best limited success. On the more successful side, the Rural Clinical School has given early career exposure to people interested in rural medicine, with an associated increase in the number of people working rurally down the track. This approach has been shown to increase the likelihood of working rurally for both students from regional and urban backgrounds.

Other programs aimed at getting doctors out of the city and into the regions have been far from a success. The Bonded Medical Placement and Medical Rural Bonded Scholarship schemes have not driven a generation of docs to practice in the bush.  Conversely, the schemes have created resentment at the way young people entering medicine were tied to draconian contracts without full knowledge of what they were signing. The AMA is currently in the process of working with the Department of Health to reform the program and find a model that works for both the participants and the communities they were intended to serve.

Read Dr Wilson’s article in the Doctors in Training column in Australian Medicine.