The move will require specialist medical colleges to prioritise candidates with rural backgrounds and experience.
New guidelines are taking an unprecedented approach to fixing the rural doctor shortage.
The Council of Presidents of Medical Colleges and the National Rural Health Commissioner have released their latest plan to address the shortage of specialist doctors in rural and remote areas: force medical colleges to prioritise applicants with rural backgrounds and/or experience when selecting new trainees.
“Too many rural Australians are waiting too long for specialist care or having to travel hundreds of kilometres to access it,” said Associate Professor Sanjay Jeganathan, chair of the CPMC.
“We know that doctors who come from rural areas or have trained in rural settings are far more likely to return and practice in these communities.
“This is about ensuring every Australian, regardless of their postcode, can access high-quality specialist medical care in their own community.”
Specialist training applicants with previous rural experience with be recognised and rewarded under the new framework, with the guidelines focusing on candidates “who spent significant childhood years in rural areas, medical students who completed ≥12 months of rural placements and junior doctors who gained experience in rural hospitals”.
The guidelines note that colleges “will need to consider these points and how the information can be captured and integrated into their selection criteria such as weighted in scoring rubrics or used as a contextual consideration alongside other diversity factors”.
Dr Sue Velovski, a specialist general surgeon working in the Northern Rivers of NSW, said the move was a step in the right direction.
“We’ve always recognised that forcing people to go bush doesn’t help. But if people are keen and incentivised, we need to support them,” she told Allergy & Respiratory Republic.
“I’ve always thought that we should invest money where we know it’s going to work. A positive rural experience as a medical student, resident or registrar may actually influence people to choose a rural career.”
A key point for colleges to consider when implementing the guidelines is adopting a standard definition of “significant childhood years”, with the document preferring the Rural Health Multidisciplinary Training program’s definition: “residency for at least 10 years cumulatively or any five years consecutively in a Modified Monash Model (MMM) 2 to 7 area”.
The coordinated approach from the country’s specialist medical colleges “goes beyond good intentions [and towards] systemic change”, according to Professor Jeganathan.
“Every college will now use consistent definitions and transparent processes that recognise the value of rural medical experience.”
The consistent approach across medical colleges was much needed and overdue, according to Rural Doctors Association of Australia CEO Peta Rutherford.
“The announcement will ensure that the connection to rural communities will be considered in a consistent manner. And I think that will be really important, so that medical students and doctors know that one college won’t give more weighting to that experience than another college,” she told ARR.
Providing quality training experiences to successful applicants is another important part of the process, said Ms Rutherford.
“There’s a huge amount of willingness by many consultant specialists working in these communities to share their knowledge and insights, and participate in training,” she said
National Rural Health Commissioner Professor Jenny May was similarly positive about the new guidelines.
“The initiative from the Colleges to apply practical strategies to improve medical workforce distribution to rural and remote communities by recognising the predictors of rural practice in selection processes – being rural origin and positive rural experience prior to training – is welcome,” she said in a statement.
The release of the guidelines follows a workshop run by the CPMC and the Office of the National Rural Health Commissioner earlier this year, where medical college leaders, researchers and rural training experts came together to “consider practical ways to improve rural workforce outcomes distribution through trainee selection”.
“The workshop highlighted strong momentum across the Colleges to support government strategies and national workforce priorities by embedding rural equity into specialist training pathways,” the introductions to the guidelines read.
“It also affirmed the vital leadership role that specialist medical Colleges can and do play in addressing the challenges of rural health access in rural and remote communities through education and selection.”
Ms Rutherford also highlighted the importance of conducting the selection process in an accessible way to attract high-quality rural candidates.
“That’s often one of the challenges in these processes – when people are required to capital cities of information sessions, workshops or orientation sessions,” she said.
