Improving rural opportunities

REGIONAL TRAINING hubs are a component of the Integrated Rural Training Pipeline for Medicine (IRTP) implemented through the Rural Health Multidisciplinary Training (RHMT) program at existing RHMT program training sites.

The RHMT program is a long-standing Australian Government initiative which funds the delivery of rural clinical training to medical, nursing, midwifery and allied health students. It supports a network of rural clinical schools, university departments of rural health and dental faculties supporting extended rural placements.

In NSW, six universities have been funded to deliver the program in eight regional areas. Regional training hubs are expected to build on the rural training network established through the RHMT program and create new opportunities for medical graduates to complete their prevocational and vocational training in rural areas. The objectives of the program are to:

• Improve the coordination of the stages of medical training to enable students intending to practise rurally to complete as much of their medical training as possible within regional and rural areas;
• Identify students with an interest in practising rurally and facilitate access to networked rural training opportunities at an early stage in their careers;
• Develop regional training capacity by supporting current supervisors of clinical training, assisting health services in obtaining accreditation for new training positions, and supporting local medical practitioners to become clinical supervisors;
• Strengthen existing, and develop new, connections with key stakeholders to improve the continuity of training for medical students/trainees within their region; and
• Identify regional medical workforce needs and use this information to prioritise activity.

The ANU Rural Clinical School (RCS) is one of the funded sites, and their hub, which is positioned in south east NSW, recently established an Advisory Committee of all regional parties involved in managing, leading and supporting junior doctors.

For their inaugural meeting on 27 September 2017, the current pathway from medical student to intern to resident to registrar was articulated, with discussion focusing on how the existing model could be improved to allow this training to occur regionally.

The ANU RCS is an established program of the ANU Medical School (ANUMS). A small team is based at ANUMS in Canberra, with academic and professional staff positioned at six training nodes in South-East New South Wales. With an annual intake of around 102 to 120 medical students, 27% are chosen from rural origin. Subsequent to this, a minimum of 25% of students enter the Rural Clinical School (RCS) as Rural Streamers. Students are recruited into the program at the end of Year 1, and in Year 2 spend 50% of their clinical skills training at Queanbeyan Hospital. In Year 3, Rural Streamers spend the entire year at a rural node positioned in Eurobodalla, Bega, Goulburn, Cooma, Young or Cowra. Through the hub, the RCS hopes to build on this successful model, and create new training opportunities for ANU graduates.

In southeast NSW, this will include developing internships in regional hospitals, supporting GP registrars and new rurally-based specialist training posts. Alongside funding for the hubs, the Federal government announced funding for 100 IRTP Specialist Training Positions (STP). Sixty-six percent of the training must occur in a rural setting and in the South East, three applications have been submitted in this funding round.

In addition, the Rural Junior Doctor Training Innovation Fund (RJDTIF) supports the development of rural primary care rotations for rurally-based first year interns. At least 60 full-time equivalents are funded annually and in southeast NSW, two positions have been funded in Cowra and Bega, with the hub hoping to increase this number via the next funding round, expected to open in October.

Through the hub, the ANU RCS hopes to increase the number of doctors choosing a rural career and help retain graduates rurally, by better coordinating the different stages of training regionally.