Rural GP training | Attracting doctors across the generations

Australian GP training applications now open

Dr Tom Battisson and Dr Allison Hempenstall are the new faces of Rural Medicine…and proof that training for a career as a Rural Generalist doctor is now, more than ever, appealing to more diverse age groups.

Tom, aged 38, fell in love with rural medicine when working as a paramedic in rural Queensland. He is now undertaking GP training in Monto, 200 kilometres west of Bundaberg.

Married with two young children, he balances work at the local general practice and hospital with his study commitments as a GP Registrar.

Allison, aged 29, is undertaking her GP training on Thursday Island, 1000 kilometres north of Cairns. Here, she provides primary and emergency care to a vast population spread across multiple remote islands in the Torres Strait.

She also contributes to a free open access medical education website (http://islanddocs.com.au) with other local doctors.

While she enjoyed living in Melbourne, she quickly found that paddling around Thursday Island in outrigger canoes can be just as much fun.

She has a long-term career goal to move into international public health and plans to work for NGOs such as the World Health Organisation.

Both Tom and Allison are undertaking GP training through the curriculum set by the Australian College of Rural and Remote Medicine (ACRRM). The ACRRM pathway is four years in length, and culminates in the award of Fellowship of ACRRM (a ‘FACRRM’).

It is one of only two general practice qualifications available in Australia.

The ACRRM pathway offers training in a wide range of skills that are in significant demand in rural and remote areas - ranging from procedural skills like Obstetrics and Emergency Medicine through to non-procedural skills like Mental Health, Public Health, and Aboriginal and Torres Strait Islander Health.

They both said making the choice to undertake rurally-based GP training through ACRRM was an easy one.

“Having worked as a paramedic in some of the smaller towns around Mackay, I realised that I would really like the variety of rural medicine” Tom said. “I liked the idea of having GP work, Emergency Medicine work and hospital duties in my role, and providing all these services to a community.

“Undertaking GP training in a rural environment has been great - there’s all the different stuff in both the general practice and Emergency Department (ED), I’m able to make my own diagnostic and treatment decisions, and my GP Supervisor is there for me if I need help.

“It’s much more hands-on training than I think you would experience as a city-based GP Registrar, and the support that’s available is excellent.

“One recent Monday night, we had a very unwell gentleman at our ED. As I have Emergency Medicine as an advanced skill, I was tasked with intubating him. I thought to myself - ‘I doubt many first year GP Registrars are intubating someone in the hospital after a full day in the general practice!’

“But I had excellent support - including my GP Supervisor, a junior doctor and a Retrieval Services Queensland emergency doctor on hand via a video-link.”

Allison said that, with her future career path in mind, training in a remote setting was a ‘no brainer’.

“For me, the GP training pathway offered by ACRRM is the only one I could see that would equip me for working in developing countries.

“There is little utility in training in a metropolitan hospital with an MRI machine, surgeons and an Intensive Care Unit next door, to then go and work overseas where there will likely be none of that.

“In a setting like Thursday Island, with Cairns being the closest referral centre, we have to be able to manage relatively unwell patients until retrieval services arrive.

“With ACRRM training you have your hospital time, and you have time in general practice, but you can also choose a specialist skill - not only procedural skills but also non-procedural skills - so the flexibility is amazing and can take your career in all sorts of different directions.”

Tom said the Monto community has also been a big factor in cementing rural practice as the right career option for him.

“At this stage in our lives, this location is excellent - my kids are set for primary school, my wife has found a great job, and I’ve got two more years left of GP training that I can complete in this town. The local health staff and wider community have been fantastic too - we have been made to feel very welcome.”

Allison said she couldn’t ask for more in terms of support on Thursday Island.

“I’m working with an amazing group of doctors who are not only dedicated to providing healthcare up here but also to training and retaining the next generation of doctors like me.

“They are happy to come in at two o’clock in the morning when I’m on-call to help teach me something, or for me to phone them if I need advice.

“My GP supervisor, Dr Robin Chan, is the most approachable supervisor a trainee could ask for and individualises my learning needs.

“Having worked in metropolitan hospitals as well as rural hospitals, I have definitely felt more supported in my rural settings.

“Additionally, many of the doctors on Thursday Island have small children, and at the end of the day they can go home, have dinner with them, put them to bed and be present in their lives - that’s a wonderful balance to achieve.”

While previous generations of rural doctors saw their vocation (and rural location) as being one for life, where for fifty years they might work 70 hour weeks, the next generation wants rural practice to provide flexible career options as their needs change... and many don’t expect that they will necessarily stay working in one community forever.

“But having a FACRRM means I can work anywhere” Tom said.

When asked what brought her to Thursday Island in the first place, Allison suggested providence had a role to play.

“My first ever job as a junior doctor was in the Swan Hill District Hospital Emergency Department, in rural Victoria. An amazing GP Anaesthetist, Dr John Britten, was also working there. He’d sometimes come into the Emergency Department with a ukulele, and when I asked him about it he told me that he used to work at a place called Thursday Island.

“I thought to myself ‘What an awesome place that sounds like!’ - and four years later, I could have never imagined that I would be here!

“The possibilities are endless, if only you keep an open mind.”

The application period for Australian General Practice Training (2019 intake) is open from 26 March to 30 April 2018. To find out more about undertaking GP training via the ACRRM training pathway visit acrrm.org.au/agpt.

Both Dr Allison Hempenstall and Dr Tom Battisson are undertaking their ACRRM training as part of the Australian General Practice Training (AGPT) program, with training delivered by the Generalist Medical Training program (James Cook University’s training program in the medical specialty of General Practice).

Sidebar / note for media

Becoming a GP in Australia

In Australia, junior doctors undertake a period of additional hospital-based intern training once they have graduated with a Medical degree from university. Thereafter, they can undertake further training to be able to specialise in a particular field of Medicine. To be accredited to work as a General Practitioner (GP) in Australia, doctors must first undertake a significant period of training as a GP Registrar.

This includes working in General Practice under the supervision of a GP Supervisor, while also undertaking formal training via one of two colleges - the Australian College of Rural and Remote Medicine (ACRRM) or Royal Australian College of General Practitioners (RACGP) - whose qualifications for General Practice are accredited by the Australian Medical Council. Training towards the qualification of Fellowship of ACRRM (FACRRM) also entails additional hospital-based training.