With the national trend of declining applications into the AGPT (Australian General Practice Training) Program, especially the rural pathway, strengthening the rural workforce and attracting doctors into general practice (GP) has never been more important.
To address the challenges facing South Australian medical workforce planning, a partnership between GPEx, the University of Adelaide, and the SA Health Rural Support Service undertook research to understand when, how and why doctors are choosing their speciality and location of future practice, and why applications to the rural and general pathway are declining.
The Medical Speciality Decision-Making (MSDM) research project, funded by SA Health, focused on better understanding the perceptions of rural GP and GP in comparison to other specialities, and the factors that influence career decision-making for medical students, junior doctors and specialists-in-training.
Findings from the research were released in 2020 and revealed that, while rural general practice is perceived as offering challenging, flexible and diverse work opportunities with a good quality training program, there are a number of misperceptions and negative perceptions about the speciality. The importance of positive exposure to general practice, reconsidering traditional rural GP placement models, and delivering messaging about GP that dispels the myths highlighted in the study, were emphasised as important recommendations for future workforce strategies. In particular, the role of quality experience within GP, and exposure to positive, clear and inspirational messaging about GP role models, was identified as critical in positively influencing perceptions and informing decision-making.
Late last year, GPEx coordinated a stakeholder forum to discuss this research, identify strategies to address the shortage of rural GPs, and create opportunities to find solutions through collaboration. This forum was attended by medical and rural clinical schools; student, GP supervisor and GP registrar associations; SA Health and hospital representatives; and other stakeholders within the GP sector.
With the long-term objective of increasing the number of graduates who choose to work in rural GP, a series of objectives which align with the barriers identified through the MSDM research and forum have been identified. These objectives include:
- increasing positive exposure to, and messaging about, GP across the pipeline
- providing an increased number of positive, quality experiences in GP across the pipeline
- piloting and promoting innovative models for GP placements to potential GP applicants
- developing a coordinated support pathway for those interested in GP to maintain their interest and ability to successfully apply for GP.
A small group of stakeholders (including representatives from GP supervisors, medical educators, The University of Adelaide, Flinders University, South Australian Medical Education and Training, the Rural Support Service and local health networks) met with GPEx for a working group early in 2021 to identify priority projects and solutions for collaborative action from the MSDM research. These priority projects include:
- longitudinal placements in medical school
- GPs as teachers in medical schools
- reducing the burden on practices supporting placements at multiple levels
- GP career-based mentoring
- increasing placements for pre-vocational doctors
- increasing GP visibility in hospitals.
The MSDM research has been important in contributing to GPEx’s future planning strategy, and the SA Rural Health Workforce Strategy.
The GP workforce challenge requires stakeholders to work together, with effective engagement and collaboration essential to the success of these projects. GPEx continues to work with stakeholders to progress these recommendations and attract more doctors into GP training in SA and the rural pathway.