Optimising Longer-Term Training for General Practitioners in Rural Aboriginal Medical Services.

Abstract

Aims: This commentary explores the evidence and experience of the Remote Vocational Training Scheme (RVTS) to reflect on the long-term training of general practitioners (GPs) and rural generalists (RGs) within rural Aboriginal Medical Services (AMS).

Context: Aboriginal Community Controlled Health Organisations (ACCHOs) and their AMSs provide culturally informed, holistic health services that directly and indirectly address a breadth of primary and preventative healthcare for First Nations communities. However, commonly only short-term and specialised GP/RG training posts are available in these settings, which contrasts with the continuity of care and stable workforce often required in First Nations communities. The Remote Vocational Training Scheme (RVTS) has over 10 years of evidence and experience in implementing a rural AMS training stream, providing 3-4 years of continuous training for GPs/RGs based in the same AMS.

Approach: This paper reflects on the lessons learnt by the RVTS leadership team and the evidence from an independent evaluation to inform longer-term training of GP/RGs in rural AMSs across the sector. At the time of the evaluation in November 2023, the AMS stream had enrolled 71 doctors, 36 of whom had completed training in the same AMS, with 14 participants still in training. The commentary offers valuable insights into the design, delivery and outcomes of the program, providing guidance for broader implementation of longer-term training.

Conclusion: Longer-term rural AMS training provides valuable learning to trainees whilst ensuring continuity of care and medical workforce stability for First Nations communities. It could be enhanced by incorporating selection and training conditions that prioritise holistic, retention-focused support for trainees.