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Continuous, flexible medical training in the bush

By Rural Health West

Continuous, flexible medical training in the bush

The rollout of the National Rural Generalist Pathway is moving apace with the establishment of jurisdictional coordination units across the country to support junior doctors navigating the training pipeline.

In WA, the Rural Generalist Pathway Coordination Unit forms part of the WA Country Health Service (WACHS) Medical Education Unit, led by Director of Clinical Training and experienced rural GP, Dr Karen Pitman.

“The coordination unit will assist rural generalist trainees navigate clinical and training components from internship through to fellowship and enable them to transition between the various training requirements for rural generalism,” Karen said.

The unit complements programs already in place to enhance rural training options.

“The significance of WACHS having carriage of the rural generalist program is that as an employing health service we can give junior doctors greater certainty about their journey and we are potentially in a position to fund the creation of new jobs where we see the need and opportunity.”

Karen said a major aim for the unit is to create roles that are attractive for medical students and junior doctors currently making their way through medical training.

“It is critical that we create interesting and exciting training opportunities. Roles need to offer adequate supervision from experienced and enthusiastic supervisors, and they need to provide trainees with adequate case-loads with varied presentations and
variable complexity.

“So that is our focus; looking across the WACHS network to identify and map opportunities where someone interested in rural generalism can get the exposure they need to develop competence and confidence as an independent rural clinician.

“It could be a position that is a stepping stone into rural generalism, or supporting someone pursuing advanced skills training, or anything along that continuum.

“Medical training is competitive, and certain rotations and terms are in very high demand from junior doctors pursuing a variety of different specialties. Emergency,
obstetrics, anaesthetics and surgical terms are all important exposures for aspiring rural generalists, so if we’ve identified someone with rural intent, we can support them to be prioritised for those rotations or for certain pre-requisite courses.”

Karen said an important factor to consider in developing training pathways is that people’s training journeys are rarely a straight line.

“Medical training is a long journey and it rarely runs from A-Z in a single, unbroken line. Any rural training system needs to have some degree of stretch and flexibility, as we know there are points in a training journey where someone may not be keen to work
rurally, or where they do not want to travel regularly.

“That’s no small feat to achieve, but it is necessary to ensure we remove the barriers to rural generalism. That is why engagement with other players in rural health is vital. Our stakeholder reference group has members from 13 different organisations and we really appreciate the advice, support and cross-pollination of ideas that occurs within that forum.”

One of the challenges of rural training is the concern junior doctors may not have comparable exposure as their city peers; it is a perception that Karen is keen to dispel.

“In an ideal world, every junior doctor would do a rural term; that would quickly eliminate some of the myths about rural medicine.

“Our larger regional centres have the capacity and volume of patient presentations to support training and meet college guidelines; and junior doctors may actually have more opportunity to manage patients and get involved in procedures.

“While I don’t expect a rural term will inspire everyone to work in the country; it would give all junior doctors a greater appreciation for the challenges their rural
colleagues experience.”

Karen said her own decision to ‘go rural’ was inspired after hearing a rural generalist talking about being a country doctor.

“Choosing rural generalism advanced my career in many ways, well beyond my expectations. I was able to practice a much broader, richer scope of medicine than I had imagined.”

“What I am really keen to achieve is a system where junior doctors will have a great rural training experience, they will have fulfilling and challenging roles while training, and there will be a professional fulfilling job at the end of their training available in
the community of their choice.”

For more information about the Rural Generalist Pathway Coordination Unit, contact
ruralgeneralist@health.wa.gov.au 
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