High-paying locum work is stopping young doctors from settling at clinics, according to a Mount Gambier GP.
Hawkins Medical Clinic part owner Dr Scott Milan said locums were not a silver bullet for bolstering the regional medical workforce.
He said the locum route was "attractive" to younger doctors with significant HECS debts from years of study.
"If you want to get your debts paid off, you look for something that can be easy work to get," Dr Milan said.
"You are making these big amounts [of money] over a short period of time and walking away without having the ongoing responsibility of looking after people long-term."
He said locum work was a "low commitment, high yield-type attractive proposition".
"Unfortunately, that's dragging a lot of people away that would otherwise settle into a more stable practice environment," Dr Milan said.
No end in sight for shortage
Dr Milan said an ongoing GP shortage was "only going to get worse".
"You need about 50 per cent of graduates to train as GPs to replace the existing workforce over time, and only about 15 per cent of graduates have an intention of doing general practice," he said.
"Within the next five years or so there's going to be a big drop off with an ageing workforce.
"It's going to get bad before things start to change."
Dr Milan said encouraging undergraduates to study and work in the regions was a good way to boost the workforce.
"[There is published evidence] that shows that people who train rurally are more likely to work rurally in the future," he said.
"It takes away a lot of the fear that people in the city have that if they moved to a regional area, they might be unsupported, or working crazy hours, compared to if they just stayed in the city."
A 20-year anniversary
Dr Milan was involved in a medical training program with Flinders University, where students spend 12 months working in a regional GP practice.
The program is celebrating 20 years on the Limestone Coast.
Dean of Rural and Remote Health at the College of Medicine and Public Health Professor Robyn Aitken said the university had learnt plenty about the regional medical workforce over the past two decades.
"Two of the things that, over time, we found is that if a student comes from a rural background, they're much more likely to return as a doctor," she said.
"Secondly, if they spend time in a rural area during their course, they're more likely to come back as a rural doctor."
Professor Aitken said the program had led to great outcomes for the regional workforce.
"More than one-third of our graduates [who were involved in the program] are working in a non-metropolitan area," she said.
"Over half of the graduates report that they're working in general practice, so it's one step further to supporting rural people."
Dr Milan said the program offered a "full immersion type experience for students", who started consulting from day one.
"By the time we get to the end of the year, and they've seen hundreds and hundreds of people, they've had a really broad experience of what's out there in the community," he said.
"It's not something you can learn from a textbook."
A 'wicked' problem
More than 160 students have taken part in Flinder's 12-month program over 20 years.
Professor Aitken said at least eight students were involved each year, and the university was hoping to expand that capacity — but there were some barriers.
"GP practices are also delivering a service — they're seeing patients — so you have to have enough GPs in the practice to be able to both supervise students and see patients at the same time," she said.
"It's one of those wicked problems.
"You need more general practitioners in the country, to get more general practitioners.
"A really good way of doing that is having more students, but having more students puts more pressure on the general practitioners who are there."
