Understanding need and improved support for rural registrars | AMA (WA)

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AMA (WA) | Rural Registrars

Understanding need and improved support for rural registrars

Monday December 23, 2019

Adj/Professor Janice Bell, CEO, WAGPET

This year Western Australian General Practice Education and Training (WAGPET) focused its efforts on understanding community need and better supporting our registrars to provide safe, quality care to those living in more remote places across WA.

Our community-driven efforts were directed towards providing additional assistance for registrars willing to fulfil the full scope of practice required, especially within the context of Aboriginal health, and those locations that have struggled to recruit and retain registrars.

This work has paid off. For 2020, almost every GP training placement in rural WA is taken and we’ve opened new opportunities for registrars to stretch their skills in settings that didn’t previously exist as accredited training places.

We have been able to resource this by streamlining other aspects of the program where there isn’t the need for such dedicated service.

WAGPET was greatly assisted in providing additional assistance for rural registrars, through the work of the National Rural Health Commissioner, Professor Paul Worley, and his broadly accepted report on the development of a rural generalist training pathway with a recognised end point.

WAGPET joined the Country Medical Workforce Interagency Committee, which funded the HealthFix report on rural workforce, and subsequently launched the WA Rural Generalist program, known as WARG.

WARG delivers on our Australian GP Training (AGPT) contract to train up to 30 additional rural generalists each year, bringing our total cohort to well over 100 registrars who have devoted their expertise, experience, and passion to our most vulnerable communities.

These doctors receive excellent support, mentoring, and skill development, directly relevant to the communities in which they work. The principles that underlie WARG carry across the whole rural practice pathway. The program relies on the interagency collaboration that’s needed to enthuse and support students, interns, and prevocational doctors otherwise immersed in a metropolitan education.

WAGPET also partnered with the Australian Medical Association (WA) and the Postgraduate Medical Council of Western Australia (PMCWA) in what has been a first ever in talking with over 500 doctors in training about their career journey. Too often researchers have led previous conversations by using pre-prepared questions. In our work, the questions came from the audience, and these were then used to understand how career decisions are being made.

The reasons many gave for choosing General Practice were less about the meaning of this profession and more about lifestyle. We need to attract the best candidates for one of the most challenging and rewarding of all medical careers and take a collaborative and experiential approach to achieving this end.

The place of a supported rural prevocational program, one that replaces the Prevocational General Practice Placements Program (PGPPP) and the Community Residency Program (CRP), cannot be understated and came up as a positive factor in choosing a career in General Practice through this research.

The GP Project, co-designed with WAGPET and WA Department of Health this year, will support such a GP experience, as it provides GP relevant prevocational rotations that are pivotal to increasing interest, confidence, and competence, as well as better targeting those most suitable for the role.

WAGPET has had tremendous support, not only from its WA partners this year but also from our funders, the government, and our accreditors and leaders. We have valued the renewed interest and increased involvement in our work and the respect we have been shown for delivering, on behalf of the colleges and the government, a program that trains and supports GPs to work where they’re needed most.