Rural generalist training – the right pathway for rural medicine?
Dr Daniel Halliday, RDAQ, Australia*
Rural Generalism is a “Back to the Future” phenomenon. Its development is in response to the poor recruitment and retention of rural medical staff and subsequent de-skilling of the rural medical workforce in Queensland. This had lead to a reduction seen in procedural services provided to rural communities.
Rural Generalism establishes a formal supported training pathway within already established training structures. It identifies the future rural medical workforce at an early stage in their careers (from medical school), and encompasses a vertical integration model of general practice training.
RDAQ and now RDAA have formally registered support for the Rural Generalism movement. It is seen as the potential saviour of rural medicine.
Is this the case? The main issues surrounding the development of the Rural Generalist Training Pathway in Queensland should be considered. RDAA needs to review cases where it is working, where the model is not addressing the needs of rural communities and their medical workforce, and why difficulties are occurring.
In dealing with a national roll-out of Rural Generalism three main issues need to be considered; funding, partnerships and outcomes.
Without appropriate and continued funding from the Federal and State Governments, a Rural Generalism model will not succeed. The Queensland Government has placed a significant amount into the program for five years, and is only just starting to see rewards.
Collaboration and partnerships will need to exist between Federal and State Governments, training colleges (not only general practice), general practice training providers, medico-political bodies such as RDAA and rural communities.
Finally, all involved must consider the outcomes trying to be achieved. The main outcome is better access to, and improved health care for, rural communities. The second, integral to the first, revolves around maintaining and developing a competent, comfortable and content rural medical workforce for the future.
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