A new funding stream would help rural hospitals become training hubs and employers of choice for specialist doctors, says the AMA.
Many have tried their hand at fixing rural health. So far, that has mainly meant there have been many failures to fix rural health.
In a new position statement released on Wednesday, the AMA argued that this consistent inconsistency was a major reason for the persistent recruitment and retention difficulties in the bush.
“Rural workforce challenges are not new, and they will not be solved by piecemeal programs that come and go with funding cycles,” AMA vice president Associate Professor Julian Rait said.
More specifically, the position statement called for state and federal governments to develop a coordinated national rural health and workforce strategy which would align investment and training.
This would be underpinned by transparent supply and demand monitoring, as well as a new funding stream for rural hospitals.
“We now have a better understanding of what it takes to develop the rural workforce, and obviously that means having students from rural backgrounds and people having positive rural training experiences, so they’re more likely to go into rural practice,” Professor Rait told The Medical Republic.
“But the missing piece of the puzzle is providing more resources for rural and regional hospitals to become core training hubs for generalist and specialist pathways.”
To build out the pipeline, the AMA said it supported increasing intake of medical students from rural backgrounds to account for one third of all enrolments and ensuring that at least one third of medical students did a minimum of one year in a rural setting.
For junior doctors, the association recommended distributing training positions across Modified Monash Model areas based on population need and service demand.
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It also called for specialist training programs to appropriately value rural and regional training experience in potential registrars and also to enable advanced training to be undertaken in regional centres rather than requiring registrars to relocate to a city.
These initiatives would all require cooperation from the medical colleges, the state-funded public hospital systems, and the federal government.
“If we were to support some of these rural and regional hospitals to be better resourced to provide specialist generalist training, I think it would it would mean that we could actually have more people decide that they want to work in the bush,” Professor Rait said.
“So generally, of course, we need to expand specialist training programs everywhere to accommodate the future needs of the community.
“But I think if we can at least remember that, if we do that in the bush, we’ll probably be able to improve the workforce there long term.”
ACRRM president Dr Rod Martin told TMR that the rural college supported the AMA’s call for a single national rural workforce plan.
“It’s great to have 2100 people in general practice training – we keep on saying, of course, that we need at least 500 this year in rural generalist training – but it’s not being directed or driven by any particular workforce plan,” Dr Martin said.
“In lots of different settings … there is no real understanding of what workforce requirements are going to be. We’re still going to be continuing to import doctors, often from countries that can’t afford to lose their doctors, to fit them into holes.
“We can’t continue to be reactive about this.”
There should be a reasonable degree of predictability, the rural generalist said, in knowing how many doctors we need to have working in rural Australia.
Given the baseline level of predictability in estimating population needs, Dr Martin questioned why the government had not already produced a comprehensive workforce plan.
“Maybe it’s easier to not define a problem so that there’s not a problem to see,” he said.
