Why it’s hard to get specialist training in the bush

3 minute read

The AMA is coming up with a new plan to tackle the outback’s doctor drought.

The rigid training structures required for accreditation with the Australian Medical Council may be contributing to regional and rural Australia’s doctor shortage, according to the AMA president.

The association convened a rural medical training summit in the nation’s capital attended by representatives from the government, medical colleges, doctors in training and rural doctors.

President Professor Steve Robson told Rheumatology Republic that discussions had led to renewed excitement and interest in changing the status quo when it came to training, specifically non-GP specialist training.

“There was the absolute sense in the room at all levels that the way forward is moving away from college-led, one-size-fits-all training programs to building bespoke programs that are informed by what local communities tell us will work in their communities,” he said.

Professor Robson said there was a general feeling that rural Australia had been failed by metrocentric specialist training models which were keeping registrars in cities for longer.

“At the moment, the colleges – at the behest of the AMC – structure training programs that are very rigid,” he said.

“But I think there was a general sense, reading the room today, that that’s failed.”

While he couldn’t pre-empt the final report from the summit, which will be released in due course, Professor Robson said there had been promising discussion about how remote supervision and bespoke training program design may be of use.

The AMA also used the summit event to launch its new plan to tackle rural and remote access to general practice.

“Investing in the rural general practice workforce requires additional and distinct solutions to overcome unique workforce issues such as professional isolation, uncompetitive remuneration compared to state hospital salaries and locum rates and the viability challenges of running a rural general practice,” the association said.

It went on to lay out a three-point roadmap for success – creating healthy communities, providing local training opportunities and supporting “vibrant” general practices.

The specific proposals under the first two banners will ring familiar to anyone who has been following rural primary care over the last few years – they include things like funding fly-in fly-out GP models, supporting single-employer training models and finishing the rollout of the National Rural Generalist Training Program.

Initiatives listed under the supporting vibrant practices banner depart a little bit more from the well-worn path.

“Rural GPs and RGs tell us that job satisfaction, practice viability and an environment that is attractive to their families are among the key priorities that influence their decisions to work in rural areas,” the AMA said.

Proposed solutions to make it more attractive for doctors to stay out bush include ensuring rural health communities are involved in policy making decisions, identifying “local champions” of rural practice and providing funding support for locum relief to reduce burnout.

It also recommends providing rural emergency and advanced skills incentives, something the government actually followed through on earlier in the week.

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