#158 Forging a future for rural specialty training pathways
24 April 2020
Had I been asked four years ago when beginning my medical degree whether I thought I would ever live in rural Victoria, the answer would have been no. I had always lived in Melbourne and there was no requirement for me to spend any of my training years in a rural setting. However, at the end of my second year of university, when the time came to preference an area for clinical placement, it seemed fitting to take a plunge, tick the ‘rural’ box and move out of home.
I elected to study my third year in Gippsland and I quickly fell in love with the lifestyle and teaching model. The following year it was an easy decision to tick that ‘rural’ box again. I am currently studying my fourth year of medicine in the same area of Gippsland. The community feel, support from rural staff and magnitude of hands-on learning experiences are just some of the reasons why I have absolutely loved studying rurally. I feel empowered to know that there is a current push to increase specialty training pathways in rural Victoria. Staying in the area is now a real option for me, as I continue to establish roots for my professional and personal life.
Currently, most specialty training programs in Australia are based in our capital cities and trainees spend limited time in rural areas. When they do, they are often forced to work in a rural area away from their partners, families and other support networks that we understand are often vital to a doctor’s mental health. This can create negative associations for junior doctors with rural areas and does not increase the likelihood of the doctors returning to service these rural communities in the future.
Research shows that the major indicators for whether a doctor will practise in a rural area are rural background and undergraduate rural clinical experience. The current lack of speciality training opportunities in rural areas means that even if a junior doctor wishes to stay in a rural area, they may be forced to move to the city to undertake training in their desired specialty. We understand that specialty training often coincides with a crucial time in a junior doctor’s life, where they are establishing both professional and personal ties that, once set-up, cannot easily be relocated back to a rural area. This is particularly important considering the increase of women in medicine and the rise we expect to see of co-parenting and other forms of parenting systems, as we shift away from traditional roles.
Stability and support are important for both doctors and their families. Hence, it is the goal of Larissa Attard, Coordinator of the Gippsland Regional Training Hub, to work with medical students and junior doctors and enable them to complete their training in a rural area if they desire. I spoke to Ms Attard to gain a greater understanding of the current and future aspirations of the Regional Training Hubs across Victoria and Australia.
“At present, the government funds university-level rural clinical schools and the Hubs are the next logical step in developing rural post-graduate training pathways,” Ms Attard explained. Hubs from Monash University, Deakin University, the University of Melbourne, University of Tasmania and UNSW (Sydney) are collaborating as the Southern Regional Training Hubs Alliance. The Hubs from across Australia and the Federation of Rural Australian Medical Educators (FRAME) meet throughout the year to discuss the future of rural training programs across Australia.
“The Southern Regional Training Hubs Alliance is looking to develop a website that will contain information about specialty training pathways, links to college requirements and a map highlighting where training positions are currently available in rural areas. They hope to enable students and junior doctors the freedom to access information to plan the direction of their careers”.
At present, junior doctors can complete parts of certain specialty training programs in Gippsland and other rural areas, with more information available via this link.
Ms Attard works with Associate Professor Michael Nowotny, a paediatrician in Gippsland who is working with the Royal Australasian College of Physicians and the Victorian Department of Health and Human Services to develop a regional training stream for paediatrics. This will mean that junior doctors will have the opportunity to apply for the paediatrics training program through a dedicated rural stream in Victoria, rather than vying for the increasingly competitive spots based in Melbourne.
“The program will prioritise junior doctors with genuine future rural intent and thus increase the access our rural communities have to paediatric services longer-term,” Ms Attard said. “A/Prof Nowotny is forging the way of the future for specialty training in Australia. The Southern Regional Training Hubs Alliance and FRAME hope to see other Australian specialist medical colleges fostering these opportunities for their future fellows and rural Australian communities.”
For me, having access to a rural speciality training program may be the difference between setting up my life in rural Victoria and returning to the city. The idea that the future of post-graduate medical training may enable junior doctors to have the freedom to foster their professional and personal aspirations is nothing short of exciting.
AMA Victoria Women in Medicine Committee
References available from the Editor on request.
For more information on the regional training hubs across Australia click here
For more information on the Gippsland and North West Victorian Regional Training Hubs: click here