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Recruit local to relieve rural doctor shortage

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The AMA has intensified its calls for the Federal Government to boost its investment in rural GP education amid mounting evidence that doctors who grow up and train in the bush are far more likely to practice there.

A study published in the latest edition of the Medical Journal of Australia found there is up to a 90 per cent chance that doctors who have a rural background and train in a rural area will still be practising in the bush five years later.

The result lends weight to AMA proposals for increased training opportunities for aspiring GPs and other specialists interested in practising in the country.

AMA President Dr Michael Gannon said the findings showed that the right investments by Government could make a real difference to access to care for rural communities.

“This study provides some important lessons for policy makers looking at how we can ensure that Australians living in rural areas have access to medical care,” Dr Gannon said.

While there has been an explosion in the number of medical school graduates in the past decade, relatively few are opting to train and practice in the bush, which remains chronically under-served.

Governments continue to recruit doctors from overseas to help fill the gap – the Herald Sun has revealed they sponsored 2268 health professionals to enter the country on 457 visas last year, including 1692 GPs and registered medical officers, 228 registered nurses, 35 specialists, 38 psychiatrists,28 surgeons and 19 anaesthetists.

Dr Gannon said proposals to build more medical schools were misguided.

“The problem isn’t a shortage of medical graduates. With medical school intakes now at record levels, we don’t need more medical students or any new medical schools.

“What we need are more and better opportunities for doctors, particularly those who come from the bush, to live and train in rural areas. The evidence shows that they are the most likely to stay on and serve their rural community once that qualify.”

The MJA study, Vocational training of general practitioners in rural locations is critical for the Australian rural medical workforce, found “a strong association between rural training pathways and subsequent rural practice”.

“[The] findings suggest that the periods leading up to and immediately following the vocational training are critically important windows of opportunity for ensuring that appropriate policies optimise recruitment of GPs for rural practice and their subsequent retention,” the study’s authors said.

Dr Gannon said these conclusions backed a number of policy proposals developed by the AMA to boost access to care in rural areas, including:

•    for the targeted intake of medical students from rural areas to be increased from a quarter to a third of all new enrolments;

•    the establishment of a Community Residency Program to give prevocational doctors, particularly those in rural areas, with access to three-month general practice placements;

•    an increase in the GP training program intake to 1700 places by 2018;

•    an expansion of the Specialist Training Program to 1400 places by 2018, with priority given to rural settings, under-supplied specialties and generalist roles; and

•    access to regional training networks to support doctors to train and remain in rural areas.

“The Federal Government has a wonderful opportunity to make a real and lasting difference by adopting these sensible, effective, evidence-based measures,” Dr Gannon said.

The Government has promised to appoint a Rural Health Commissioner to champion rural health issues, including developing a National Rural Generalist Pathway to help address the shortage of rural medical practitioners.

Adrian Rollins