Incentivised training placements reduce registrar shortfall

Rural communities have long been facing GP workforce shortages, with many going without a general practice registrar for years.
 
But this year, the RACGP has revealed it has placed 177 registrars in priority areas of workforce need under its general practice placement incentives, marking a significant success in boosting Australia’s GP shortages.
 
These regions have not had a general practice registrar since 2021, while Mallacoota in Victoria, and Coonabarabran in New South Wales have gone without since 2016.
 
Of the registrars who took a six-month incentivised placement at the start of 2024, 64.6% chose to stay beyond their initial six-month placement to continue training in the same community.
 
RACGP President Dr Nicole Higgins said these are ‘promising results’ for the future general practice workforce.
 
‘The research shows GPs who train in a rural community are far more likely to work there – so this is growing our future rural GP workforce. This backs up what we have told governments – funding gets results,’ she said.
 
‘There was a big increase in the number of GPs training in Victoria after their government offered an incentive of up to $40,000.
‘We are successfully getting more GPs training in rural communities, but there is far more we could do with appropriate government support.’
 
Almost 20% of the RACGP’s general practice training catchments are incentivised in the second half of 2024, including around a quarter of those in Queensland, Western Australia, and Tasmania, and nearly half in the Northern Territory.
 
The RACGP’s placement incentives are valued at up to $45,000 and can be used to cover accommodation, childcare, travel, and other costs associated with taking placements in rural areas of need.
 
The funding provides much-needed relief for relocation costs, which Dr Higgins says can be ‘a big barrier for registrars’, especially those bringing a partner and children.
 
Dr Blake Kelly is one of those registrars, who is now building links to his new rural community while raising a young family.
 
Mossman in Tropical North Queensland is where he relocated this year for an incentivised placement with his partner Dr Annaleice Rose and their young son, Barney, with a second child on the way.
 
‘My wife always wanted to be a GP and grew up in the area, whereas I have fallen into the role in moving here and experiencing it,’ he told newsGP.
 
‘The incentive is a positive but was only something we discovered in retrospect and the decision for us at least was already made.’
 
After completing some of his residency at Cairns Hospital, Dr Kelly was offered ‘unique placements’ in rural hospitals and a stint in Cape York with the Royal Flying Doctor Service, leading him to pursue a career in rural general practice.
 
‘Working up in the Cape and speaking with some of the experienced consultants was where I first was exposed to the idea of rural generalism, as it’s something with only limited exposure opportunities in the big city with the main focus being on hospitalist sub-specialisation,’ he said.
 
Already reaping the rewards of his placement, Dr Kelly says the best part of his part-time training is the work–life balance that allows shared care of his young son with his wife, as well as the unique tropical landscape where his family now lives.
 
‘The flexibility of being able to do the drop offs and pickups, night time books, spend quality time with him and take an active role in him growing up whilst also having a job that meets my professional needs is pretty great,’ he said.
 
‘There aren’t many places in Australia you can have a 1.00 pm walk-in with a jellyfish sting to your clinic because they didn’t think it was serious enough for a hospital.
 
‘Much like everywhere in general practice you get all the usual presentations, but I’m always surprised by the variability and wide scope you get here which is important to me for job satisfaction.’
 
One of the RACGP’s key asks is for the Federal Government to ensure GPs in training receive equal pay and entitlements as their colleagues in other specialisations, through direct incentive and parental leave payments to registrars, which Dr Higgins says could be done ‘efficiently and almost immediately’ through existing systems.
 
‘If the Government is serious about getting GPs into communities, they should ensure GPs in training receive equal pay to their colleagues in other specialisations,’ she said.
 
‘A doctor who starts their specialist GP training loses parental leave and other entitlements they’ve accrued working in hospitals, and may even have lower starting remuneration. This doesn’t happen in hospital-based specialisations.
 
‘Frankly, it’s ridiculous our registrars are expected to take a pay cut when so many communities need more GPs.’
 
State governments have offered differing incentives in efforts to rebuild their GP workforce.
 
In addition to the increase in the number of GPs training in Victoria when the State Government offered $40,000 incentives, the Queensland Government has also committed the same amount to attract up to 500 GPs in training.
 
The Tasmanian Government has said it will cover up to $100,000 of the HECS student debt for up to 40 GPs who work in rural and regional areas.
 
Meanwhile in the Northern Territory, applications for the 2025 RACGP NT Placement Support Grants opened on 19 August, providing up to $15,000 to eligible individuals.
 
Based on his experience so far, Dr Kelly encourages others to follow a similar path by applying for a training placement in an area of need, which offer a unique opportunity.
 
‘We just weren’t told about the opportunities general practice offers, and by the time people are considering it they are already applying to training positions as junior registrars in the hospital or already on programs that don’t suit their evolving lifestyle,’ he said.
 
‘It’s easy to lose sight of the patient in the hospital setting when you have overbooked clinic lists or full emergency waiting rooms.
 
‘In small communities you can do so much for the individual which can keep them out of the hospital and treat the person, not just their issue.
 
‘There really is something within general practice for everyone.’
 
More information about the college’s registrar placement incentives for different regions is available on the RACGP website.
 
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