Laying future foundations through training and research

‘We need long-term solutions … looking at how we put firm foundations in so that the discipline and the role of the GP is absolutely secure, prioritised and valued.’
 
That is Professor Jane Gunn, a GP and the Dean of Medicine, Dentistry and Health Sciences (MDHS) at the University of Melbourne, discussing with newsGP the role of training and research in strengthening the future of general practice.
 
As part of her leadership role as Dean, and in addition to various other research such as mental health models in primary care, Professor Gunn is looking at how universities can help build future workforce opportunities within general practice, and boost recruitment and retention of GPs.
 
‘It’s very disappointing that we have such a small proportion of graduates from all our medical schools across the country choosing a career in general practice,’ Professor Gunn said.
 
‘We have to change that – it is absolutely core to a strong healthcare system that we have general practice and primary care right at the centre.
 
‘We need to get the balance right and … bolster and invest in general practice. The investment needs to be in more than the payment system.’
 
The RACGP’s General Practice: Health of the Nation 2022 report showed that only 13.8% of medical students considered general practice as a preferred career path, a decrease from 16.1% the previous year.
 
Meanwhile, the results in this year’s Medical Board of Australia and AHPRA Medical Training Survey point to an even larger problem, with only 11% of respondents intending to pursue a career in general practice and expressing an interest in the RACGP’s specialist training program.
 
To help rectify the situation, Professor Gunn would like to see more investment in development opportunities for GPs such as leadership programs, Fellowships and study leave. Although she recognises that they are not ‘quick wins’, she does believe these types of programs would help to strengthen the workforce and rebuild the reputation of general practice.
 
Reflecting on the fact that while training programs have changed since starting her medical career in 1982, Professor Gunn said they remain ‘absolutely critical’ to securing the future workforce and care of the community.
 
‘Throughout my career, I have experienced and researched the transformation of general practice from a solo practitioner model to a team-based model,’ she said.
 
‘Our training models need to develop to accommodate that change.’
 
In efforts to foster that change, the University of Melbourne is developing a new Centre for Collaborative Practice, to train the MDHS Faculty’s health professional students in a collaborative team-based environment, providing leadership skills and high-level implementation and research into practice.
 
The Centre will examine how to strengthen understanding of the career pathway, and how to expose students to the wide variety of pathways that come from being a GP.
 
‘It’s one pathway out of medical school to become a GP, but even within that practice of being a GP, there are many, many opportunities for a career,’ Professor Gunn said.
 
‘We want to signpost and expose our students and interns, etcetera, to this amazing world of opportunity and fabulous, rewarding careers.’
 
Acknowledging that general practice has shifted markedly from a solo practice career to a ‘group endeavour’, the Centre for Collaborative Practice will also examine how students can train together across healthcare disciplines, throughout their entire training journey.
 
‘This will allow them to form networks and linkages and know how to work in a high-performing team,’ Professor Gunn said.
 
‘It gives a lot of opportunity for reinvigorating and having students excited about working in community-based healthcare in general practice, as part of [that] team.
 
‘If people are going to have fulfilling careers as healthcare professionals and, in particular as GPs, one of the things that is key is working within a very well-supported team.
 
‘That’s [also] part of a potential solution to supporting them to make that choice so that they’re exposed to experiences during the training that make the whole idea of general practice very engaging and rewarding.’


Professor Gunn would like to see more investment in development opportunities for GPs such as leadership programs, Fellowships and study leave.
 
On 1 February, the RACGP officially launched its general practice training program, to help strengthen the GP workforce by delivering profession-led training.
 
The college’s Australian General Practice Training (AGPT) Program is designed as a foundation to deliver ‘world-class training’ to the next generation of GPs.
 
Providing a pathway to encourage students to choose a career in general practice must also be coupled with the right financial environment, as well as the right reward and recognition, according to Professor Gunn.
 
That includes being underpinned by investment in the academic side of general practice.
 
‘That is essential and another really important thing that we have to value,’ she said.
 
‘Even though it’s often called out as an area of concern and priority within all of the schemes, including the Medical Research Future Fund, when I look at the proportion of funding that’s gone into supporting and growing general practice research, the actual level of investment … has been miniscule in comparison to the sizes of the problems that we face.’
 
The RACGP welcomed recommendations for stronger investment in primary care research as part of the Strengthening Medicare Taskforce report.
 
From her experience of ‘coming up through the ranks’ of training as a GP to become a university Dean of Medicine, Professor Gunn has had many opportunities to be involved in medical education.
 
‘That has helped me to realise the importance of having a strong academic basis for our discipline, and … that everybody has to put their shoulder to the wheel to get this back on track, and it’s going to take a lot,’ she said.
 
While she acknowledges the Strengthening Medicare Taskforce is mainly focused on Medicare reform, Professor Gunn hopes the outcomes will somewhat provide a solution to better investment in primary care research as part of the reforms.
 
‘We need to think of the places where this all begins – in the medical schools where people start to train,’ she said.
 
‘How do we bolster that knowledge? But also consider the role of universities not only in training the medical students but also in providing that strong base to the academic discipline of general practice – to which is there for sure, but it’s not heavily invested in.
 
‘It’s struggled to develop … and while we have much world-class research coming out of our academic community in general practice, it’s small and it’s vulnerable.
 
‘So it really is crucial that it’s supported.’
 
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