Training for the bush, positive and far reaching
THE core principles behind the national rollout of an advanced training program for rural and remote practice will have far-reaching and positive consequences for the health of those living in the bush.
Recently released by RDAA, the principles have been developed by a technical working group comprising representatives from RDAA, the RACGP and its National Rural Faculty, ACRRM, GPRA, AMA and GPET, as part of a detailed and constructive consultation process.
Modelled on the successful Queensland Rural Generalist Pathway, but reflective of practice circumstances in other states, they focus strongly on the need for country communities to have doctors with the relevant training for rural practice.
This includes doctors having the skills, qualifications and confidence to practise a continuum of care from rural general practice and primary care to extended settings including hospital-based care.
The principles recognise the importance of advanced rural curricula developed by the RACGP and ACRRM and the need to quarantine training posts for doctors committed to rural and remote practice.
The endpoint for training will be the FRACGP/Fellowship of Advanced Rural General Practice (FARGP) or the FACRRM, although it is recognised that many advanced trainees will opt to complete both qualifications.
Trainees will still enrol in the Australian General Practice Training program (AGPT), the Remote Vocational Training Scheme or ACRRM’s independent pathway to achieve the required training endpoint.
The advanced skills training available to participants will cover a broad range of areas, including procedural areas such as anaesthetics, obstetrics and advanced accident and emergency, but also complex non-procedural areas like acute mental health, Indigenous health and advanced paediatrics.
While early entry should be encouraged, the principles note the need for flexibility in selection for the program so that doctors committed to rural practice are not excluded at any stage.
The principles also recognise the need for appropriate professional and industrial acknowledgement and incentives for doctors completing the training, achieving advanced qualifications and meeting the continuum of workforce needs in rural and remote areas.
There is no doubt a key concern for trainees considering rural practice is whether they can maintain an interesting professional career without being trapped, burnt out or caught out of their professional depth without adequate support.
Living and working in small communities has many lifestyle and professional advantages. The right balance can be achieved if there are enough doctors to support adequate time off while meeting community needs for a continuum of care.
Advanced training goes a long way to meeting training and professional concerns.
Experience with the Queensland Rural Generalist Pathway shows that doctors will join a program with a view to rural and remote practice if the training, professional, personal and industrial needs are met.
RDAA will now approach the federal government for its support in promoting the principles to the states through the Australian Health Ministers’ Conference.
We also want the government to implement incentives for practice that adequately reflects the isolation, costs, complexity and responsibility undertaken by doctors practising comprehensive rural practice in general practice and extended settings.
A number of additional states are already having discussions with stakeholder groups around the implementation of advanced training programs for their particular jurisdictions. The core principles will inform these discussions and ensure that these programs meet the needs both of trainees and rural communities.
The document, Core principles for a National Advanced Rural Training Program, can be found at www.rdaa.com.au (go to Policies).
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