Unis join forces to address rural doctor shortage

04 September, 2013

Deakin and Monash Universities have joined forces to address the shortage of doctors in rural and regional Victoria.

The universities' joint initiative will establish a network of regional medical training centres offering postgraduate programs in general practice and other key medical specialties and will provide guaranteed places in medicine for talented regional school leavers.

The universities maintain that the significant increase in the number of medical students trained in rural and regional Victoria in recent years has not translated into the required increase in the number of doctors actually practising in regional parts of the state.

Pro-vice chancellor of health at Deakin, Professor Brendan Crotty, said the primary problem was not the number of places in regional medical schools in Victoria, it was the shortage of clinical training places for regional medical school graduates.

Professor Crotty said that many regional medical graduates were successfully completing internships and the second year of postgraduate training in regional hospitals and general practices but were not able to stay on to complete the remaining years of postgraduate training because of a lack of training positions.

Training programs to become a general practitioner or other type of medical specialist (surgeon, heart specialist, paediatrician, psychiatrist etc) take between four and seven years, usually commencing in the second or third year after graduation.

Although some general practice training for graduates is available in regional areas, graduates who wish to train in other specialties are forced to return to large teaching hospitals in capital cities.

"Most of our graduates are in their late 20s when they return to a capital city for up to seven years of specialist training and during this period it is very likely they will marry, buy a house, begin a family and arrange childcare. Once they have put down roots in a capital city, it is difficult for them to return to practise in rural Victoria," Professor Crotty said.

"The training they receive in a highly specialised metropolitan teaching hospital is another problem.

"Regional specialists need generalist skills within their specialty so they can participate in a general surgery and general medicine admitting rosters. To do this, trainees must maintain general surgery or general medicine skills during their specialty training and this is increasingly difficult in highly specialised metropolitan training hospitals. The best place to get this type of training is in regional Australia."

Professor Ben Canny, Deputy Dean of the Faculty of Medicine Nursing and Health Sciences at Monash, said the Deakin-Monash program would keep medical graduates in the regions for most of their postgraduate training.

"We will create regional health and medical education centres — in Geelong and Bendigo — leveraging existing university facilities.

"These will be hubs for a network of training centres in Warrnambool, Hamilton, Ballarat, Horsham, Colac, Mildura, Castlemaine, Traralgon and Bairnsdale.

"The centres will support delivery of telemedicine and online education and be used for undergraduate and postgraduate education of other health professionals in short supply in regional Victoria, including nurses, physiotherapists and occupational therapists. They will also be centres for both universities' research into the rural workforce."

The Deakin-Monash proposal will offer guaranteed graduate-entry places in a medical course for talented rural Year 12 students after they have completed an undergraduate qualification.

A total of 40 additional places will be reserved across Deakin's and Monash's graduate-entry programs, including 15 places specifically reserved for Year 12 students from the Bendigo-Loddon region who successfully complete an undergraduate program at a regional university. This is on top of 115 places already reserved for regional graduates at the two universities — a total of 155 guaranteed medical places for regional students in the two graduate entry medical courses.

Deakin and Monash are calling on the next government to provide a $15 million capital investment and an ongoing annual commitment of less than $2 million for the program.

"The Deakin-Monash proposal offers a long-term, sustainable and cost-effective solution to Victoria's rural medical workforce shortage," Professor Canny said.

"We encourage an incoming federal government to work with the Victorian government to ensure that our graduates are able to provide the high quality healthcare so badly needed by the people of rural and regional Victoria."