Abstract
The critical importance of primary health care in maintaining a healthy population is well established internationally. Nevertheless, general practitioner care is not always easily accessible for some patients in Australia, particularly in rural regions. This is partly due to an insufficient number of medical graduates entering and being retained in the rural general practitioner workforce. Key elements of international and national programs designed to address this shortfall are discussed and include the use of entry requirements that preferentially select for applicants from a rural residence background, and immersion of medical students for a large share, or entire duration, of their training in rural communities. In addition, other factors that can influence decisions to enter and stay in rural practice are discussed.
Highlights
To address a number of the factors associated with the medical workforce shortage in rural areas, the Australian Medical
Association has proposed a set of solutions for the government to implement which are based on five key priority areas49: 1. encourage students from rural areas to enroll in medical school and provide medical students with opportunities for positive and continuing exposure to regional/rural medical training; 2. provide a dedicated and quality training pathway with the right skill mix to ensure doctors are adequately trained to work in rural areas; 3. provide a rewarding and sustainable work environment with adequate facilities, professional support and education, personal comfort, and flexible work arrangements, including locum relief; 4. provide family support that includes spousal opportunities/employment, educational opportunities for children’s education, subsidy for housing/relocation and/or tax relief; and
Adoption of these measures is key to strengthening the rural health system and improving health outcomes, but it will require substantial investment coupled with ongoing evaluation and enhancement of rural and remote training programs
Summary
A study of 733 University of Otago medical graduates reported that students who underwent its Rural Medical Immersion Programme (RMIP) in year 5 exhibited a more than two-fold higher propensity (OR=2.5; 95%CI: 1.4–4.5) to practise outside of a major urban centre in New Zealand compared to graduates with no rural training[22].
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