Uni debt incentives help keep GPs working rurally

A Federally funded program designed to attract doctors to practise in rural and remote Australia in exchange for university debt relief has found most GPs stay put once the program ends.
 
However, the review also found that for many GPs, helping to pay off their HECS is not the key driver for them to stay in the bush, but instead family and lifestyle reasons.

Of the 400 GPs that applied for the Rural and Remote Higher Education Loan Debt Reduction Program, known as Med-HELP, 80% chose to remain working in the rural or remote setting, according to a newly published review.
 
While the review was overall favourable, it also identified several areas for improvement, including eligibility criteria, enabling more doctors to apply sooner, and the program’s visibility.
 
RACGP Rural Deputy Chair Dr Rodney Omond added that restricting applications to those in post-graduate year three or beyond often made it too late for many to apply.
 
‘When you’re already in your third year in a hospital, you’ve already probably had a good think about what specialty you want to be in, and you know where that might be,’ he told newsGP.
 
‘So, a lot of decisions are already made before you can even apply for the program. And I think that’s why so few doctors felt that it was influential in their decision to go to the country – most GPs would remain anyway.’
 
Of the GP applicants, 42% said the program was ‘not at all influential’ in them relocating to a rural or remote area, but 77% said they expected to remain there beyond six years.
 
The Med-HELP initiative, which began in 2022, aims to attract and retain doctors and nurse practitioners to rural, regional and remote areas by waiving or reducing their Higher Education Contribution Scheme (HECS) debt.
 
Eligible GPs must work at least 24 hours a week in Modified Monash (MM) areas 3–5 for as long as their degree took, or for half that time in more remote areas.
 
The review identified that this minimum hour requirement also puts many potential female applicants at a disadvantage, a point Dr Omond agrees with.
 
‘It’s not allowed for part-time doctors, which does tend to disadvantage female doctors who tend to be more often part time, often because of childcare obligations,’ he said.
 
‘The GP population and college membership is enormously heavy with female doctors. A lot of female doctors go into primary care medicine, so it’s just not appropriate.’
 
Dr Omond said the program also needs better promotion, with the review finding 31% of GP participants found out about it by word of mouth.
 
‘It’s a little bit better now that the federal government is subsidising GP trainees into rural areas. But before that happened, it was different in different states, so there is a great deal of complexity about what financial incentives or other things are available for GPs to go and train in rural areas,’ he said.
 
‘That lack of visibility about those incentives means that probably people are not making the decision to go rural, because they can’t really afford it, and they don’t know of incentives to help them.’
 
RACGP President Dr Michael Wright said analysis shows there is ‘real value in recognising that being able to clear your HECS debt quickly and early is a strong motivator’.
 
‘This is a really good example of when you put proper incentives for people to work in rural areas, they’re popular, they get taken up,’ he told newsGP.
 
‘When people do get the opportunity to work in rural and regional areas, they’re much more likely to stay there.
 
‘And doing it with incentives is very effective, rather than creating rules and regulations which might force people to go where they don’t want to work.’ 
 
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