Now that rural generalism has gained specialty status, the Rural Doctors Association of Australia is calling for a new set of item numbers.
Rural generalism may have been formally recognised as a specialty by the Australian Medical Council, but the journey to embedding it into the Australian healthcare system is not nearly over, say the Rural Doctors Association of Australia.
The association’s 2026 pre-budget submission calls for specialty recognition to be reflected in “foundational funding mechanisms” – i.e., new MBS and PBS items.
Following a multi-year process, the health minister tick of approval for rural generalism to become a specialty field within general practice officially came through in September 2025.
The next step is for the Australian Medical Council to define the role of an RG and to endorse the programs of study offered by ACRRM and the RACGP.
It’s likely that it will still be several years before doctors can officially put “rural generalist” after their name.
In preparation for that time, the RDAA argued, it would behove the Department of Health, Disability and Ageing to introduce a suite of rural generalist-specific items geographically limited to MM3 to 7 locations.
A detailed proposal provided by the RDAA, National Rural Health Commissioner, ACRRM, RACGP, AMA and Australian Indigenous Doctors Association is already with DoHDA, and contains items which would support non-procedural advanced skills like mental health and paediatrics.
It is projected to cost $50 million over four years.
The biggest-ticket item on the pre-budget submission, however, is $100 million in infrastructure grants over four years to help local governments in rural areas increase housing and childcare options for healthcare staff.
“We’re running out of room,” RDAA president Dr Sarah Chalmers told The Medical Republic.
“Small rural practices will have to choose between taking a medical student, taking a pre-vocational doctor or taking a registrar.
“How do we help them to take all three and to build their multidisciplinary workforce as well? Clinics aren’t big enough.
“… Student and registrar housing in rural places is tough, and in really remote places it’s pretty much impossible.”
Rural generalism has grown in popularity among junior doctors over recent years, with ACRRM now oversubscribed for places on its program for the third year running.
Thus far, the government has allowed the colleges to utilise underspends from elsewhere in the Australian GP Training program to support the additional places on a year-to-year basis.
The RDAA’s submission pointed out that this was an unsustainable model.
“… It is important to permanently support this growth of Rural Generalist training, provide certainty, and increase confidence in the longevity of the program,” the submission said.
“RDAA proposes funding an additional 200 Rural Generalist training positions, which will build the rural and remote medical workforce in sufficient numbers to meet the health care needs of these communities.
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“Based on the level of interest, and the workforce data for general practice projections, it is critical this investment is made to increase training numbers for rural generalist training now, so that there are Fellows available within the next 5-10 years to address the retiring rural medical workforce (based on aged demographics), support the transition of existing rural doctors to other locations due to personal or family circumstances, and have sufficient head count of doctors to provide the services across the primary and secondary settings to meet the needs of rural and remote Australian communities.”
An additional 200 training positions, by the RDAA’s math, works out to about $10 million per year.
For a modest $30 million per annum, the RDAA also called on government to broaden existing prevocational primary care training programs by another 125 places.
On the other side of training, however, sit the supervisors.
“We’re talking about how to get more students and junior doctors and registrars into practices – who’s going to be looking after them? It’s the supervisors,” Dr Chalmers said.
“One of the things about supervisor payments is that there’s bits and pieces all over the place, and it would be good to consolidate all of the different ways that you can be paid as a supervisor, to make it easier for supervisors to claim the incentives, rather than having to make multiple applications.”
Consolidating the supervisor payments, the RDAA estimated, would be a cost-neutral exercise.
The rural association also recommended extending existing supports for rural generalist training and services like the state-based Rural Generalist Coordination Units and the Workforce Incentive Program – Rural Advanced Skills, both of which will sunset in the next 18 months.
