Health Minister Mark Butler announced more rural medical student places as a win, but not everyone is buying it.
Training more medical students in a rural setting is a good first step but destined to fail without investment in rural specialist training programs, according to the AMA.
Earlier this week, Health Minister Mark Butler announced an additional 80 Commonwealth-supported medical student places would be funded for regional and remote medical schools.
These are not part of the Bonded Medical Program, meaning students are not forced into serving out a rural moratorium at the end of their degree.
The investment, totalling $114.2 million over four years, follows Australian research which found the two biggest indicators that a doctor will go on to practice outside of a major city are a rural background and spending an extended time doing clinical training in a rural area.
Students who grow up rural and then go on to train rural are the most likely to eventually practise in a rural, regional or remote area.
Some studies suggest a dose-dependent relationship of sorts – the longer time spent rurally, the more likely to practise rurally.
It would seem, then, that more rural medical students should be met with enthusiasm from the AMA; the RACGP welcomed the announcement.
But the association’s fear stems from the belief that Australia has a distribution issue, rather than a supply issue; the bulk of postgraduate specialty training programs are only available in metro areas.
“Australia is producing medical graduates at rates well above the OECD average, and yet rural areas are still plagued with crippling medical workforce shortages,” AMA vice president Dr Danielle McMullen said.
“This is because medical students who train in rural Australia are often left with no option but to return to a major city if they are to complete prevocational and specialist training because of a lack of training places in those regional areas.”
Before looking at increasing the number of medical graduates, Dr McMullen argued, there needed to be more investment in medical colleges and expanding rural training programs.
“Doctors who can complete their training in regional hospitals are more likely to remain in practice in a regional location and can offer significant benefits to their regional community,” she said.
“Increasing our capacity to train in regional areas will also require coordination with medical colleges to ensure there are suitable and safe training places available to avoid overcrowded and diluted clinical training environments.”
ACRRM, the only college which exclusively runs rural training, said it supports the decision to introduce new places but called for the government to target the medical schools that will deliver rurally-based, rurally-relevant programs and support rural careers.
“We should be looking at targeting those medical schools which already have a good track record for turning out medical students as doctors into rural and remote areas where there is a significant under servicing of health needs,” ACRRM president Dr Dan Halliday told The Medical Republic.
RACGP rural chair Associate Professor Michael Clements, while broadly welcoming the additional training places, also touched on the need for robust and competitive specialty training programs.
“The next challenge ahead of us is encouraging them to take up a career in general practice,” he said.
“I think if more medical students had greater exposure to general practice and we were able to improve the portability of entitlements through GP training, we could boost the GP workforce.”
Interested universities have to apply for a share of the additional places – Charles Darwin University has already announced that its new Northern Territory-based medical campus will apply for 40 of the 80 places.
The CDU Menzies School of Medicine is the only university headquartered in the top end and does not currently have any Commonwealth supported places as yet – it was only set up at the beginning of last year.