Doctors with ACRRM or RACGP rural fellowship are one step closer to being legally recognised rural generalists. Financial recognition is the next goal.
One more hurdle on rural generalism’s long and arduous journey to specialtyhood has been leapt, with the Medical Board of Australia giving the official nod to ACRRM and RACGP training programs.
On a practical level, it means that fellows of either college’s rural generalist training program will soon be able to add ‘rural generalist’ as a subspecialty on their registration.
Astute readers may note that this was seemingly already announced, and almost one year ago at that.
In September of 2025, the health ministers officially recognised rural generalism as a specialty field within general practice.
This created a title, but not a pathway to obtain that title.
Today’s announcement confirms what exact qualifications make someone eligible for the rural generalist subspecialist title.
As expected, those qualifications are ACRRM fellowship or RACGP rural fellowship.
“There may be a little bit of announcement fatigue on RG recognition because we keep dripping out, ‘[this has been] approved’, ‘[that has been] approved’, because there has just been so many layers to this recognition throughout the years,” RACGP rural chair Associate Professor Michael Clements told The Medical Republic.
“The joint audit committee had a meeting recently, and we tried to remember how long it’s actually been going on for. I think it’s eight years or nine years since it first started.”
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The next step, he said, would be for both colleges to develop resources instructing fellows on how to go about adding the rural generalism subspecialty to their AHPRA registration.
“Now we’re just in the mechanics of how we actually get people’s recognition on the document,” Professor Clements said.
The administrative difficulty of this task will likely vary according to how long ago a doctor trained up as a rural generalist, said ACRRM president Dr Rod Martin.
“Some of the trickier work [was] in terms of making sure that … we’ve got very clear lines of sight for what people’s advanced skill … is, and that they’re current with all of the things that they’re [meant to be] current with,” he told TMR.
“It could potentially be a really onerous and laborious process, but it’ll be relatively easy for people that have clearly demonstrated they’ve got ongoing accreditation to perform anaesthetics or mental health or [whatever is relevant] in those particular areas.
“That’s the first part, moving everyone across to the register. That’s [set] to be not terribly challenging. We just have to make sure that the right [advanced skills] are recognised clearly.”
Another key change which will come from having approved pathways of study is title protection.
From 2027, doctors who are not either an ACRRM or an RACGP rural fellow will no longer be able to call themselves a rural generalist.
Rural Doctors Association of Australia CEO Peta Rutherford told TMR that while today’s milestone marks the end of the journey to getting regulatory recognition of rural generalism, it also marks the start of a new journey.
“We have been in discussions with the Department of Health, Disability and Ageing in relation to Medicare access for rural generalists,” she said.
“… What we’ve put forward is to have a unique set of Medicare item numbers for rural generalists when they’re working in their area of advanced skills or in emergency care; and for when they’re doing their GP primary care work, they would use GP item numbers.
“… We’ve always understood that that was never going to happen until such time as the recognition piece was finished. Now that that has been done, we have a better opportunity because through medical registration these people would be identifiable.”
Outside of the MBS, the long-time CEO said, the training accreditation and official subspecialist recognition puts RGs in a better position for professional recognition within state health enterprise bargaining agreements and medical certified agreements.
Dr Martin also reiterated the importance of states and territories moving to properly recognise rural generalism.
“What we see or we have seen is, if you’ve got a system that recognises a rural generalist emergency doctor, a rural generalist anaesthetist, or a rural generalist obstetrician, that’s a really strong factor [for workforce],” he said.
“If there’s a system for [RGs] to go and work in, one that clearly recognises the specialist-level skills that they need to bring to work each day, then it’s in those states’ favour.
“People will vote with their feet. They don’t go and do this training because it’s interesting, they do it because they want to do it for a living for a chunk of their lives.”
Queensland has long been recognised as a fore-runner in rural generalist recognition, whereas states like Tasmania have trailed behind.
“I said to one of the Tasmanian government officials at the Rural Doctors Association of Tasmania conference last year, ‘Look, thanks from the rest of the states. Thanks for doing a really good job of training rural generalists down here’,” Dr Martin said.
“’But sadly, because there’s no jobs for them to do here, they just they pack up their cars and they go and put the car on the Spirit of Tasmania’ – the Spirit of Tasmania was just across the river as I was saying this – ‘they go back to the mainland, and you never see them again’.”
