Abstract
Click here to hear an intoduction by the authorsIntroduction: Queensland Health's Rural Generalist Pathway is a supported career pathway for junior doctors to train in rural and remote medicine. The pathway joins evidence with policy to achieve professional recognition, credentialing, and industrial recognition.Methods: This article describes the principles underpinning the notion of rural generalism, the background to the establishment of the Rural Generalist Pathway in Queensland, Australia, how the pathway has been developed to meet the needs of Queensland's rural and remote communities, the implementation of the pathway, and the implications for other jurisdictions.Results: In 2007, 30 trainees commenced on the pathway, with total enrolment now of 182 in 2012. Trainees commence at the start of internship, completing their prevocational training component in postgraduate years 1 to 2. After prevocational certification they undertake advanced specialised training in a range of specialties, and then complete vocational training in a rural location, usually in their 4th to 5th postgraduate years. Trainees complete their general practice training through a Regional Training Provider, and achieve vocational registration by completion of appropriate fellowship assessment requirements. The pathway is managed by a geographically dispersed team of educators, clinicians and managers. The Rural Generalist team provide training and career advice, advocate for trainees and assist with negotiating posts. They map progress of trainees through the Vocational Indicative Planning process and arrange other educational activities including Rural Generalist workshops. Applications are often oversubscribed, with the intake growing to 41 in 2012, located at 10 intern training hospitals. In total 90 trainees have completed advanced specialised training as at the end of 2012.Conclusion: The Rural Generalist Pathway includes a challenging prevocational start to the career, the opportunity to specialise in a procedural skill or skills of interest and obtain general practice vocational training in a rural setting and appears to be proving an attractive choice for medical graduates seeking a challenging and varied career. Early evidence suggests that by recognizing and rewarding the worth of rural and remote practice, this strategy is creating its own supply line. From its initial roll-out in Queensland, rural generalist training continues to generate increased interest and enthusiasm across all Australian states and territories wishing to join this new wave of generalist practice. This new generation of health professionals for a new generation of services has the potential to provide the rural medical workforce the bush needs.Key words: Australia, generalism, pathway, Queensland, rural generalist, rural medical education, vocational training.
Highlights
Queensland Health’s Rural Generalist Pathway is a supported career pathway for junior doctors to train in rural and remote medicine
The agreement arose in response to the failure of supply of Queensland’s rural and remote workforce which was evident early in the 21st century despite substantial strategy and initiatives by Commonwealth and state governments, colleges and education providers over the preceding 15 years
The salaried Senior Medical Officer (SMO) workforce in larger rural centres was in decline, with such dependency on international medical graduates (IMGs) that by the early 2000s rural IMG workforce management dominated Queensland rural medical workforce planning and strategy
Summary
Australia’s rural and remote medical workforce shortages are well documented. Responses have included the growth of rurally oriented medical schools and rural placements, rural scholarships, rural incentives and other retention strategies, and the development of training pathways into rural medicine[1,2,3,4]. Queensland Health’s Rural Generalist Pathway (RGP) provides a supported career pathway for junior doctors to train in rural and remote medicine which joins rural medical educational strategies with rural medical workforce and practice strategies. The Rural Doctors Association of Australia (RDAA) comments: The term 'rural generalist' has been used to emphasise the expansive nature of the professional role required to meet community needs in rural and remote practice. This includes providing care in general practice or primary care AND secondary care such as rural hospitals or other extended settings. Possibly hospital- and community-based public health practice – in remote and Indigenous communities
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