Our training of prevocational doctors is about to change with a new national framework being implemented over the next two years. Part of the focus of the new framework is to incorporate primary care terms into the training of PGY1 and PGY2 doctors, with the eventual goal to have primary care experience as an integral part of prevocational training, just as medical, surgical and ED terms currently are.

We are lucky in our Richmond/Clarence Network to have had the opportunity to get ahead of things by recently having two rural generalist terms accredited for our prevocational trainees to rotate through during their time at Lismore Base Hospital.

Commencing in 2022, and by utilising funding through the John Flynn scheme, our Network has had the pleasure of introducing resident terms at Kyogle Hospital/McKidd Medical Centre and Maclean District Hospital. These terms are usually occupied by second year doctors but are also accredited for first year doctors if the opportunity arose.

‘The feedback has been overwhelmingly positive’.

Rural experience as a junior doctor may trigger some difficult memories for some of us older practitioners. I recall distinctly and somewhat traumatically as a second-year doctor in Queensland 18 years ago being dropped into random, remote communities to survive for a week on my own with virtually no orientation and next-to-nothing in the way of support. 

Thankfully these days are long-gone. The introduction of a resident doctor to rural and primary care medicine in Australia is now a safe, controlled, methodical process with a focus on supervision and gradual exposure to autonomy.

At Kyogle, the resident doctors spend half their day consulting patients in a GP setting and the other half of the day working in the local Emergency Department. They are attached to a supervising GP at all times. In Maclean the residents work in the ED department alongside a rural generalist throughout their shift. 

The feedback from our resident doctors, the supervising GPs and the patients themselves has been overwhelmingly positive. The supervision by our local doctors at these sites has been particularly impressive and our resident doctors have felt supported every step of the way. 

It has also been great to hear the appreciation from our rural GPs and their patients with respect to the positive impact the resident doctors have made during their placement.

Already, after only 18 months, we have had doctors inspired by their time during these rotations to change their career aspirations towards rural generalist or GP training. Hopefully these doctors will be the first of many and by focusing more on primary and rural care in the early years this will help attract more doctors towards pathways in these specialties.

We are currently canvassing other opportunities around the Richmond/Clarence Network to hopefully expand these terms to allow more opportunities for exposure to primary care or rural ED work during the prevocational years of training.

Rik Lane
Director of Prevocational Training, Lismore Base Hospital