A big part of securing the next generation of rural GPs is around ensuring there remains a positive focus on general practice.
Rural practice is challenging which in turn makes it very rewarding, enabling you to develop a breadth of skills to build resilience in addressing need. Providing that insight for future doctors in a supportive way during those early learning years is so vitally important.
Sitting with a registrar recently, I was surprised to learn that he considered himself a rural generalist, and not a rural GP. This is despite the fact that he was training to a curriculum which is general practice: the endpoint in training for a rural generalist is of course a general practice Fellowship.
Let’s be very clear: rural generalists are rural GPs.
General practitioners are generalists by definition. The term ‘rural generalist’ describes a rural general practitioner working to the full scope of their practice with skill sets that are informed by the needs of the community they serve. These skill sets may encompass both advanced procedural and non-procedural skills working across primary and secondary care contexts with an emphasis on emergency medicine.
It’s about ensuring the right skill mix against demand.
The Federal Assistant Minister for Health, Dr David Gillespie MP, certainly knows this requirement well and his own definition is fitting: “A rural generalist is a doctor who’s trained as a general practitioner but has extra skills so that they can operate in a hospital setting as well as a community setting. That involves not just being a jack of all trades, but being a well-qualified doctor who can cope with the extra problems, clinical, public health, and hospital skills that you need to look after a regional town.”
It is the context that matters most and is key to getting health rural workforce policy right. The general (core) and advanced (specific) skills required in addressing patient need depend on the health needs and context of the community.
That is why it is important we align training investment to service need. In developing a rural generalist pathway nationally, this, therefore, must also be broad. We need a national pathway that equips general practitioners with a full range of competencies enabling them to deliver patient care closer to home in the primary and secondary care contexts.
We know that developing skills around the ongoing care considerations are the areas that best serve the community. We also know that dedicated and clear pathways for rural GPs to acquire advanced skills and utilise them in a way that is valued and recognised are important workforce factors.
Supportive strategies like these are vital in attracting and retaining a skilled rural workforce that is responsive to need. Most of all it’s about valuing the contribution to the healthcare system of quality general practice and its essential and enduring role in supporting rural communities.
 Gillespie transcript. 29 March 2017. RDAA Poli Breakfast. Dr David Gillespie MP Federal Assistant Minister for Health. Canberra.
Dr Ayman Shenouda