At RMA25, the concept of ‘geographical narcissism’ was raised as cause for inequitable training funding.
Funding inequality for rural and regional areas has long been a shared gripe, but in instances where metropolitan areas are disproportionately funded compared to rural and regional medical districts, ‘geographical narcissism’ may be a key factor.
Associate Professor Riitta Partanen argued at the Rural Medicine Australia conference on Friday that this factor has gone largely under-recognised and thus has continued to contribute to issues in rural health.
Chronic healthcare workforce shortages and inequitable access have been linked to geographical narcissism, with emerging evidence highlighting where current health policies fail to account for the issue.
“I’ll refer to it as the often unconscious devaluation of non-urban knowledge and expertise, expertise due to the belief that urban knowledge and expertise is the norm, or even superior,” Professor Riitta Partanen said.
“Geographic narcissism is like any bias, whether it’s racism, sexism, ageism; all of those things when somebody doesn’t recognise their urban privilege and their urban centricity.
“I didn’t coin the term – Malin Fors, a Swedish born but Norwegian psychologist wrote a paper back in 2018 … on the concept of geographical narcissism, or GN.
“It really resonated with those of us who are rural GPs or working in rural areas, that this is what we’ve been experiencing all of these years.”
Further research from Professor Partanen has suggested that GN is subconsciously embedded into medical education and training and thus carries into career advice and models of healthcare.
“The cycle of inequality will persist for rural populations, including poorer health outcomes and the rural medical workforce shortfall will continue – in part due to GN,” one of Professor Partanen’s studies stated.
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“Ignoring the potential damage and consequences of GN perpetuates the established metrocentric models of medical education, training, workplace culture, healthcare service provision and investment.”
Education has been touted as effectively ground-zero for this issue with students stated as the most susceptible to carrying GN into their careers.
“It’s important to understand which medical students, pre-vocational doctors are likely to be influenced by GN to a greater or lesser extent,” Professor Partanen said.
“This insight then can inform more targeted and effective educational and policy interventions to minimise or mitigate the negative influence of GN when it comes to workplace decisions.
“For medical learners with metropolitan background and limited rural medical experience, teaching rural medicine with a deficit lens and exposing them to repeated criticisms of rural medicine from trusted sources was likely to reinforce their limited rural self-efficacy and maintain their reduced interest, or decrease their interest in rural medical practice.
“This highlights the role of rural experiences self efficacy and fostering interest in rural medical practice.”
“There are a lot of ways that we could address geographical narcissism, I think we need to bring it directly into our medical schools and medical programmes, raising the awareness that it exists.”
RMA25, which is hosted by both ACRRM and the Rural Doctors Association of Australia, was held at Crown Perth between 23 and 26 October 2025.
