The ultimate goal of this policy is for there to be sufficient numbers of
skilled doctors located in rural and remote areas to meet the health service
needs of the people they serve. Although the primary focus of the policy is on
education and training for rural practice, this should be seen in the wider
context of recruitment to and retention of doctors in rural practice. There is
a need to establish an integrated career pathway of education and training for
rural practice, beginning at the pre-undergraduate level and continuing through
undergraduate medical education to specific rural practice vocational training
followed by appropriate continuing and university graduate education, practice
structures and family supports.
Ultimately, recruitment to rural practice will only increase when students and
new medical graduates see rural practice as a positive career option. The
series of strategies outlined in this document are intended to bring this about
through sensitising students to rural medicine early on and providing
appropriate clinical teaching in the latter part of the undergraduate course
and in the immediate postgraduate period.
Retention in rural practice is likely to be improved through tailored
continuing education and professional development programs, and the opportunity
to pursue university higher education while remaining in rural practice.
In addition to education and training issues, there are a number of other
factors which require attention in any program to improve recruitment and
retention to rural practice. Reasonable working conditions, including a balance
between workload, on call and free time, are essential. Reliable cross
coverage or locum relief is a fundamental issue. Also there needs to be
appropriate financial reward for the complexity of the services provided and
degree of clinical responsibility taken by the doctor. Other financial aspects
include additional costs of living in rural communities with the need for
transportation to larger centres for continuing education and professional
development. Providing a good education for the doctor's children can be
difficult and costly.
Also, retention of rural doctors depends greatly on the satisfaction of the
physicians spouse and family. Often the reasons for rural practitioners
returning to the city relate to spouse and family concerns. Consequently,
these are given specific attention in this policy document.