Rural health
Regional and Rural Workforce Planning
Solving the regional and rural workforce problem requires different policies for different career stages.
Prevocational years
The prevocational years present a unique opportunity to invest in the development of doctors-in-training that want to work in regional and rural Victoria.
The Victorian Government is responsible through the Postgraduate Medical Council of Victoria and public hospitals for the appropriate training and funding of prevocational positions.
The challenge is to grow sufficient prevocational positions in rural and regional centres to meet workforce demand. Prevocational doctors-in-training in regional and rural Victoria need well-rounded, quality and supported training pathways in the fields of paediatrics, obstetrics, geriatrics, anaesthetics, emergency medicine, mental health and general practice that can be completed within their geographic region of choice
Pre-vocational pathways into general practice lack clarity, principally because this pathway requires a mixed training experience including training ‘on premises’ in a GP’s consulting rooms.
New training pathways need to be underpinned by an investment in novel training places, including in under-served areas and smaller GP led rural hospitals. In addition, these new training places will require support from primary care for both facility and teaching infrastructure.
AMA Victoria calls on the Victorian State Government to:
- Ensure there is a clear pathway for pre-vocational doctors from medical school to commencement of speciality or GP training;
- Expand the second year position in regional centres by funding more positions in smaller GP-led hospitals. Pre-vocational doctors could work across wards but also in general practice, essentially covering both primary practice and the hospital setting; and
- Provide funding for more regional and rural pre-vocational hospital medical officer positions.
Registrars
The Federal Government has funded regional training hubs to create regional training pathways. These hubs promote the development of regional, not metropolitan-based training programs. Better co-ordination is now needed between the Federal and state governments to turn this into a practical reality and develop training networks in the specialities and geographic areas needed in rural and regional Victoria. This will require what has been called “a reversing of the training polarity” or “metropolitan in-reach training” - the provision of rotational training positions by metropolitan centres for registrars who are regionally based. Achieving this is critical for the successful development of the regional and rural medical workforce by allowing doctors committed to regional practice to keep their regional and rural base.
AMA Victoria calls on the Victorian State Government to:
- Direct funds to explore workforce models that support registrars to study and continue working in country Victoria and to visit metropolitan Melbourne on secondment for highly specialised experience for a period of six months, rather than the other way around.
Independent Practitioners (GPs and consultants)
AMA Victoria calls on the Victorian State Government to:
- Provide funding to improve information technology services and infrastructure to facilitate information sharing and create pathways for better clinical support for rural consultants; and
- Provide budget flexibility for regional health services to match remuneration in metropolitan areas that often pay above the EBA entitlements for senior consultant medical staff.
