Doctors get ready to go rural

An increased number of GP Registrars on the rural pathway will begin training in 2021, from February onwards, where they will make up a substantial proportion of the GPs available.

Chief executive officer of rural medical training specialists GPEx Stephanie Clota said there had been a 14 per cent increase in the number of GP pathway registrars for 2020-21, with the bulk of that in the rural generalist field.

"GPs are the largest of all specialties and we do need more GPs in rural and remote SA," she said.

She said these registrars were especially important, as they primarily made up about 20pc of the GP workforce in regional SA.

Ms Clota said there had been a lot of research done into ensuring people considered the rural generalist field, but also that they stayed once they finished their registrar years.

She said graduates tended to stay and work in the remote area code where they had completed their training, which reinforced that managing placements was critical.

"Through the data, we know that having a rural background or a link to the community is important," she said.

But that was not the only factor that kept doctors in regional areas, with Ms Clota saying 30pc of graduates who chose to work rurally did not have a rural background.

"For people who don't have that (rural link), an early quality experience and exposure is important," she said.

"For every 10 weeks in training in a rural location, a doctor is 35pc more likely to stay put in the area where they did their training."

Ms Clota said they tried to encourage this by matching registrars to locations by community connections or interests, such as obstetrics or mental health.

She said the research had also helped tailor support packages to meet the needs of those in training.

Ms Clota said in recent years they had also tried to encourage more people to consider regional medicine by offering it as a six-month option to registrars on the conventional GP pathway.

"For doctors who may not have chosen rural, they may still choose to stay (on that path)," she said.

"We're excited by the take-up of people who would not normally consider a rural pathway - we've found evidence that some will like it, who hadn't had (rural medicine) as part of their plan.

"We hope to see that retention."

The Rural Doctors Workforce Agency is advertising 30 GP positions in regional SA - down from a high of 62 midway through 2019 - with the areas of highest vacancies on Eyre Peninsula and in the Far North.

Appointments have been made in recent weeks of advisers and rural generalist leads in key fields, such as obstetrics, emergency medicine and anaesthetics, as the state government works to roll out its Rural Generalist Program in 2021, as part of the Rural Health Workforce Strategy.

Ms Clota said it was great to have an established system that could help bring together all of the partners in rural health, including universities, training organisations, industry and government.

The chance to try out rural medicine has helped break some of the myths and misconceptions held by GP registrar Wissam Ghamrawi, who is proof of how varied the career can be.

Last year, he was working as a GP registrar in Berri, where he said between the GP clinic and the hospital's emergency rooms and in-patient work, he developed a range of skills.

He said the idea that rural medicine could be slow was "one of the big myths that I personally had" when working in a metropolitan hospital, while the reality showed how busy and varied the job could be.

But he said there was also a number of strategies in place to avoid rural GPs becoming too overwhelmed.

This year he has changed it up and become a roving registrar, working in Aboriginal health across a range of locations.

Dr Ghamrawi is in a different location almost every week, travelling to either Yalata, Port Lincoln or Whyalla, as well as Adelaide.

He said the chance to work in a range of different locations had its appeal.

"Even though it's the same state, they're very different towns and different communities," he said.

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He said even the medical equipment available in each location differed, so there was often a fair bit of problem solving to get things done.

He is also taking a different approach to his training by doing an academic registration, where he teaches at the rural school at Flinders University alongside studying Indigenous health.

"I'm a curious person and I like to learn more about different things and I didn't want to get stuck into a routine where I see the same thing every day," he said.

There are also good signs coming through among the medical student cohort, including this year's President's Prize winners.

The national award, given by the Australian College of Rural and Remote Medicine, recognises a medical student's commitment to continuing a career in rural generalism, with both of this year's winners hailing from regional SA.

Mikaela Borgas, Booleroo Centre, wants to equip herself with the skills needed to handle acute emergency situations.

"Being able to stabilise a patient and keep them alive while awaiting a retrieval is a very real prospect in rural and remote locations, and it's important to have the advanced skills required," she said.

"I am also very passionate about advocating for the importance of our rural healthcare services and can see myself getting involved with teaching and advocacy in the future."

Jasmyn Lloyd, who grew up in the Riverland, says Rural Generalists "learn to use what they have and get around the lack of resources".

She says it is critical that women in regional Australia have access to women's health and female doctors.

"Not needing to travel far to see a female doctor, particularly for obstetrics and gynaecology care, can have a profound difference to healthcare outcomes," she said.

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