RACGP training model fast-tracked for Tasmania

‘We need to set a target … we need 50% of graduates choosing general practice as their specialty of choice.’
 
That is RACGP President Dr Karen Price discussing GP workforce solutions following latest research showing the number of non-GP specialists is growing annually by 4.5%, compared to 3.5% for GPs.
 
As part of ongoing efforts to attract more graduates to choose general practice, the RACGP launched its new model for general practice training in April this year – RACGP profession-led community-based training – following the 2017 announcement that the Australian General Practice Training (AGPT) Program would transition back to the RACGP.
 
Outlining the college’s operating model to manage and deliver the AGPT Program* and Remote Vocational Training Scheme (RVTS), the model also incentivises junior doctors to undergo their training in rural and remote communities, where the workforce shortage is worsening.
 
Although recognised as a nationwide issue, one state in particular need of GPs is Tasmania, where the ‘dire’ shortage in rural areas is impacting the health of patients and communities, according to RACGP Tasmania Chair Dr Tim Jackson.
 
‘At the moment we’ve got some 50 positions available on the Rural Workforce Agency to be filled in Tassie,’ he told newsGP.
 
‘Part of this college-led, community-based training is getting an opportunity to look at ways in which we can improve the situation and improve the workforce, starting with the training and selection of registrars to go rural and remote.’
 
In a bid to help address GP shortages, the Federal Government announced higher bulk-billing incentives as part of its 2020–21 budget to encourage uptake and retention of doctors to rural and remote areas.
 
Around 10,000 rural doctors are set to receive increased incentives to bulk-bill their patients from 2022, with $65.8 million provided to increase the Rural Bulk-Billing Incentive for doctors working in these areas.
 
While the additional investment in rural GPs is strongly welcomed by the RACGP, the investment needs to be part of a ‘wider, holistic policy response’, the college’s budget overview states.
 
For some Tasmanian GPs in small towns where there is a lack of resources and support, the increased bulk-billing incentives simply ‘won’t cut it’.
 
Other GPs remain uncertain about the future of the workforce in Tasmania, even with the establishment of the General Practice Incentive Fund Tasmania (GPIFT) to attract and retain doctors in the state’s north and north-west by providing a range of incentives for doctors who relocate to the region.
 
Dr Jackson says although the $2 million increased GPIFT is a ‘step in the right direction’ for rural GPs, there needs to be more focus on a connecting healthcare services to ease pressure off GPs.
 
‘It probably isn’t enough to encourage people to move,’ he said.
 
‘It really needs to be partly [about] funding, and partly [about] enabling wraparound services with the allied health providers available in these rural communities, and it needs to be a team approach, rather than just the GP trying to do everything themselves.’
 
Despite the challenges of attracting medical students to specialise as a GP and to live and work in rural and regional communities, there are many benefits and many chose to stay.

‘There are misconceptions about general practice and rural practice as a career, and the benefits of this speciality. It is an exciting and varied career – we will be doing a lot more to promote this to medical students,’ RACGP Rural Chair Dr Michael Clements said.
 
‘The RACGP represents the most rural and regional GPs of any group in Australia and increasing the number of highly trained GPs across the country [through the new training model] is our priority.’
 
Dr Jackson says the college’s new model of training is part of the groundwork in supporting retention of doctors in rural and remote areas.
 
‘Through the training we’re trying to expose what we know, [which is] that if medical students just completing university training and newly Fellowed doctors have a good experience in rural and remote communities, they’re more likely to go back to those communities,’ he said.
 
‘So it’s important that we help give them the best time that they can have when they go out and do some training in the rural remote communities, then support that experience.
 
‘In these communities GPs look after the whole family unit, with the spouse and the children, so that’s also an incentive to enable people to stay.’
 
With rollout of the profession-led, community-based training part of the first steps to improve GP distribution, Dr Jackson said the structure of the funding model is important.
 
‘The problem is the funding model – it has to be a mixed-funding model,’ he said.
 
‘Partially through Medicare, [and] partially through state and community funding councils, that sort of thing. Because to be sustainable, there needs to be more funding, particularly for the rural and remote workforce.
 
‘[Training organisation] General Practice Training Tasmania has done a good job in supporting training within the state and rurally, and with the new college-proposed plan, we’ll be building on the good work.’
 
Dr Jackson and Dr Clements are meeting this week with key health stakeholders in Tasmania, including local GPs and workforce training organisations to examine the workforce solutions.
 
*Applications for the final intake of the 2022 AGPT Program open 30 August 2021. More information is available on the RACGP website.
 
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