The road has been long and winding, and the pace has been described as glacial, but the end appears in sight for Rural Generalist (RG) recognition.
In 2018, the inaugural National Rural Health Commissioner Prof Paul Worley tabled a report, the culmination of the year’s consultations by the National Rural Generalist Taskforce. It included Recommendation 6, the two General Practice Colleges support the national recognition, as a protected title, of a Rural Generalist as a Specialised Field within the Specialty of General Practice.
This was preceded by decades of developments in Australia and globally around describing, training, certifying, and preserving the scope of practice that has come to be known as Rural Generalist Medicine. The Roma Agreement in 2005 coined the term “Rural Generalist” and a series of international Rural Generalist Summits served to familiarise like-minded medical groups in other countries with this name to describe their common practice model.
Five years later, the Rural Generalist Recognition Taskforce comprising the second Rural Health Commissioner Adjunct Professor Ruth Stewart, and the CEOs and leading members of RACGP and ACRRM continue to meet regularly to progress their bid for formal recognition.
The joint-application of ACRRM and RACGP for Specialist Recognition was made to the Medical Board of Australia (MBA) in 2019. The Australian Medical Council (AMC) was delegated authority to assess the application. Upon request, a second consultation was conducted, and a supplementary joint-application was submitted and assessed.
In 2020, the MBA advised that the application had been deemed suitable to progress to a more detailed Stage 2 assessment. An assessment was undertaken to determine if the application would need to be subject to a Regulatory Impact Study and found this would not be required. A Stage 2 Application was submitted in December 2021 and is currently under assessment.
Following the assessment, advice will be developed which will be considered through the AMC governance structure. The AMC will provide advice to the MBA that will in turn provide advice to the national Committee of Health Ministers that will make a final determination hopefully in the first half of 2024.
If the application is successful, the national register will be adjusted to include Rural Generalist Medicine as a specialist field within the broader field of General Practice. Thus, qualified doctors will be registered as specialist General Practitioners and specialist Rural Generalists. The two colleges will undertake a process to have their Fellowship awards recognised under the new specialist field.
National recognition of the training and professional standards of care that RGs provide will give confidence to rural communities in the care they receive. It will provide the current workforce with the status commensurate with their actual training and scope, and that can provide an aspirational career path for future rural doctors.
Importantly, formal recognition will bring structural change by enabling credentialing, employment, and workforce planning to fully incorporate Rural Generalists, and to build resources and models of care that make the best possible use of their service capabilities.
Rural Generalists do not work in isolation but are a key part of the local healthcare team, all members of which are of utmost importance to rural and remote communities. Recognition will however lead to more Rural Generalists being available in rural communities, and to rural services receiving the best possible benefits from their training.
The pace may be slow, but it is sure. Sooner or later, glaciers transform landscapes.