Medical training embedded in regional Australia is often hailed as the best way to keep doctors in the country, but experts say there is more to it.
Doctor shortages in the regions have predated the pandemic, with regional Victorians struggling to get GP appointments and opting to go to emergency for smaller issues.
Monash Rural Health's graduate entry program in Churchill has been running for 10 years.
Over that time, 250 regional-origin students have been a part of the course with the remaining students from metropolitan or international backgrounds.
Out of more than 1,000 graduates, 51 graduates have stayed working in Gippsland.
Sean Atkinson was in the very first cohort of students in the program. For him, the decision to study and practice rurally was always an easy one.
"I've lived 95 per cent of my life in Gippsland and … I felt I was in a good place to be able to hopefully try and bridge the gap in lack of medical care," Dr Atkinson said.
Now Dr Atkinson is a lecturer for the course at Churchill and works as a general practitioner in nearby Trafalgar.
He stressed the importance for metro students to see for themselves the differences in health outcomes rurally and regionally.
"They may not be quite sure exactly what to expect … but once they interact with the educators, [and] with the local clinicians, they actually find that it's a place that they would come back to," Dr Atkinson said.
Lack of specialist training in the regions
Head of Monash Rural Health Shane Bullock said the biggest issue in trying to retain medical students regionally was that many specialist courses were only available in the city.
"We're really trying to increase their opportunities to continue their training in Gippsland in rural, so that's the real challenge," he said.
Professor Bullock said Monash Rural Health had partnered with the federal government to establish training hubs throughout regional Victoria, including Gippsland and north-west Victoria to increase access to specialised training.
Professor Bullock hoped extended medical training in regional areas would help doctors form connections and roots in the community.
A 2018 academic study looking at graduates from Monash's medical program found students who had regional jobs were more likely to gain jobs in a region they studied in for an extended duration or that they were from.
Of a cohort of graduates working in either of Monash's rural training regions, 40 per cent had received either schooling or training in the region they were working in.
Professor Bullock said engaging students to study medicine in the region they grew up in would be an important aspect of boosting doctor retention rates.
"Even at school we need to show Gippsland kids that they can aspire to medicine, that they're as good as other students at getting into medicine," he said.
More government support needed
The Royal Australian College of GPs (RACGP) rural council chair Michael Clements said more government support was needed to keep doctors in the regions.
"We also need to see significant other fixes such as investment and, a pull factor — we need to be rewarding doctors who do make the decision to move regionally," Dr Clements said.
A recent Senate inquiry interim report on GP services in regional Australia said the committee was concerned to hear remuneration, wage structures, and Medicare rebates were not recognising the expertise of GPs.
The committee recommended the federal government investigate a substantial increase for Medicare rebates for all GP consultations and incentive payments for GPs moving to regional areas.
Last year the RACGP provided a submission to the Department of Health for the 10-year primary health care plan, indicating the government needed to create higher Medicare rebates to support GPs to spend more time with their patients.
The Department of Health did not respond to a request for comment on what measures were included in the most recent budget to keep doctors in the regions.
"There's only so much that we can do from the university training perspective," Dr Clements said.
"Having rural training areas within the universities is important, and it's a part of the puzzle, but it needs to be combined with our government, federal and state investment."
