What is Rural Generalist Medicine?

Rural Generalist Medicine is the provision of a broad scope of medical care by a doctor in the rural context that encompasses the following:

  • Comprehensive primary care for individuals, families and communities
  • Hospital in-patient care and/or related secondary medical care in the institutional, home or ambulatory setting
  • Emergency care
  • Extended and evolving service in one or more areas of focused cognitive and/or procedural practice as required to sustain needed health services locally among a network of colleagues
  • A population health approach that is relevant to the community

Working as part of a multi-professional and multi-disciplinary team of colleagues, both local and distant, to provide services within a ‘system of care’ that is aligned and responsive to community needs.

(From the Cairns Consensus, International Statement on Rural Generalist Medicine, 2014).

Primary Care Wheel

What is a Rural Generalist Medical Practitioner?

A Rural Generalist medical practitioner is a General Practitioner who has specific expertise in providing medical care for rural and remote or isolated communities. A Rural Generalist medical practitioner understands and responds to the diverse needs of rural communities: this includes applying a population approach, providing safe primary, secondary and emergency care, culturally engaged Aboriginal and Torres Strait Islander peoples’ health care as required, and providing specialised medical care in at least one additional discipline. 

Learn more about the College’s Rural Generalist Medicine Position Statement.

Plane

Training & Support

Learn more about the training and support programs that are available to facilitate your journey to becoming a Rural Generalist.

Dr Rebecca Devitt_Member Story

Member Stories

Meet our Rural Generalists who are dedicated to providing exceptional healthcare for rural and remote communities across Australia.

RG specialist recognition

The Medical Board of Australia is currently assessing a joint application by ACRRM and RACGP seeking recognition of Rural Generalist Medicine as a new field of specialty within General Practice. This effort is being driven by The Rural Generalist Recognition Taskforce chaired by the former National Rural Health Commissioner, Adjunct Prof Ruth Stewart.

The Australian Medical Council (AMC) is currently undertaking the second stage of assessment for the Medical Board of Australia. Public consultation has now closed, which was the last critical milestone in the process. The AMC will now collate a report and in turn make a recommendation to the MBA.

Want to know more about what recognition will mean for you and your community? Watch one of our webinar recordings below

RG Recognition Webinars

To find out more about RG Recognition and the consultation process and what it might mean for you, we invite you to watch the recordings of our recent webinars below. These webinars were co-hosted by: Remote Australians Matter, the National Rural Health Commissioner Adjunct Prof Ruth Stewart, the RACGP and ACRRM, and explain: 

  • What a Rural Generalist is  
  • How Rural Generalists support rural, remote and First Nations communities  
  • What Rural Generalist recognition means    
  • How to submit your response to the consultation.   

Download the presentation slides here.

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Practitioner Webinar

The National Rural Generalist Taskforce hosted a webinar on the recognition process for practitioners. Watch the recording via the link below using the passcode: NiSUV@u5

Community

Community Webinar

The National Rural Generalist Taskforce and Rural Australians Matter hosted a webinar for the wider community on the recognition process and the opportunities to participate in the public consultation. Watch the recording via the link below using the passcode: qXU?K3R+

Next steps

  • Step 1
    AMC establishes review panel for stage 2 assessment
  • Step 2
    AMC public consultation (Open 17 Oct - 12 Dec 2023)
  • Step 3
    AMC panel draft advice paper
  • Step 4
    MBA provides recommendation to the Council of Health Ministers
  • Step 5
    If successful, RG recognised as a specialist field within general practice an Fellowship programs are approved through AMC processes.

Timeline

  • 2023
    AMC assessment panel formed
  • 2022
    Stage 2 joint application for RG Specialist Recognition submitted to MBA
  • 2021
    Second round of advice submitted to the MBA.
  • 2021
    National RG Strategic Council of which ACRRM is a member formed to progress the broader National Rural Generalist Pathway agenda.
  • 2020
    RG Recognition Taskforce conducts further national consultation.
  • 2020
    MBA requests further actions and information.
  • 2019
    Joint-application for RG Specialist Recognition submitted to MBA.
  • 2019
    RG Recognition Taskforce formed (ACRRM, RACGP, National Rural Health Commissioner) to progress joint-application
  • 2019
    NRGP Advice tabled with Parliament
  • 2018
    National RG Taskforce (NRGT) Advice on implementing a National Rural Generalist Pathway developed following national consultation. Recommendations include seeking RG specialist recognition

National Rural Generalist Pathway

In 2014 the Government announced its commitment to implementing a National Rural Generalist Pathway and appointed the National Rural Health Commissioner to progress this.

In 2019 a commitment of $62m was made toward the Pathway to support dedicated Rural Generalist training, including at the junior doctor stages and an application for professional recognition of Rural Generalism.

ACRRM began in 1997 in the hope that rural doctors could secure a national system to preserve their (Rural Generalist) model of practice and the College has fought ever since to achieve this. After 23 years, ACRRM is elated to see its programs are to be supported by a dedicated, national framework and continues to lead work to implement the pathway in a cooperation with key stakeholders.

The plan will operationalise the National Rural Generalist Taskforce Report recommendations presented by the National Rural Health Commissioner, Prof Paul Worley.

ACRRM co-led the Taskforce and its recommendations are closely aligned with ACRRM’s curriculum, standards and Position Statement and vision for the NRGP implementation.

The implementation of the NRGP is now overseen by the NRGP Strategic Council, which is chaired by the National Rural Health Commissioner, Professor Jenny May and includes representation from key peak bodies including ACRRM and commonwealth, state and Territory health services.

Dr Daniel Halliday and Mark Butler

RG Reports & Research

FAQs

A Rural Generalist is a medical practitioner who is trained to meet the specific current and future healthcare needs of Australian rural and remote communities, in a sustainable and cost-effective way, by providing both comprehensive General Practice and emergency care and required components of other medical specialty care in hospital and community settings as part of a rural healthcare team.

Rural Generalist Medicine is a specific approach to General Practice that is particularly relevant to rural and remote communities. The Rural Generalist Medicine body of skills incorporates the skillset of General Practice and is specifically shaped to optimise medical service capacity in rural and remote clinical contexts.

As rural and remote settings are characterised by their restricted access to the range of services, staff and resources available in urban centres, Rural Generalists are skilled to perform a broad range of medical services, including some skills, ordinarily within the province of other specialties. They are trained to apply these services effectively in a low resource environment, including working in local healthcare teams and providing local medical leadership in managing patient support from health care specialists in urban centres.

Rural Generalist practitioners are thus a key component of the multi-professional teams that together can deliver the highest quality care in rural and remote communities, Rural Health Multidisciplinary Teams are described in the Ngayubah Gadan Consensus Statement which may include other rural GPs, other medical specialists, nurses, Indigenous health workers and allied health practitioners. 

The successful application to have Rural Generalist Medicine recognised as a specialised field within General Practice would result in doctors with appropriate Rural Generalist qualifications, having these indicated in their Ahpra registration within the discipline of General Practice. It is hoped this national formalisation of their qualification status will:
  • enable health services’ quality and safety and employment systems to consistently recognise and understand these doctors’ capacity and appropriately utilize their skills
  • enable rural patients to better understand the training and capacity of their doctors
  • simplify the processes for training, employment, and hospital credentialing for Rural Generalists (which are currently complex and onerous due to lack of coordination)
  • provide a mechanism for Rural Generalists to be counted in rural workforce and resource planning
  • focus academic effort to building the evidence-base for best practice Rural Generalist care
  • make it easier to promote rural careers as RGs to the next generation.

An initial application for national recognition of Rural Generalist Medicine as a specialist field within the specialty of General Practice must is submitted to the Medical Board of Australia (MBA).

Stage 1 Initial assessment of application: The Stage 1 application describes the objectives of the proposal in broad terms. The MBA delegates to the Australian Medical Council (AMC) for assessment and advice and, following from this advice, determines whether a sufficient case has been made to demonstrate that the proposal is eligible to proceed to a Stage 2 assessment.

Stage 2 detailed assessment of application: A second application is submitted providing a more comprehensive overview of the proposal. The AMC assesses the detailed case for recognition of a new field of specialty practice on behalf of the MBA. This stage involves rigorous assessment of the case that includes a public consultation process and results in a recommendation being made to the Australian Health Ministers Committee for final approval. 

Recognition of a specialist field of practice means that the Australian Health Ministers Meeting has determined that under the National Law a new or amended field of specialty practice is to be recognised and the list of titles of specialties, fields of specialty practice and titles for the profession is to be amended to reflect this. Only a medical practitioner with registration in the specialist field can call themselves a medical specialist in that field and use the protected title associated with their recognised specialist field.

The new or amended specialist field becomes an approved specialist field under the National Law and will be added to the approved List of specialties, fields of specialty practice and related specialist titles. The Medical Board of Australia (MBA) will then decide on the approved qualification/s in the new or amended specialty for the purposes of specialist registration. Medical Colleges with programs of study in that field can apply to have these programs accredited with the Australian Medical Council (AMC) as a qualification in the specialist field.

The programs will be assessed against the approved accreditation standards for specialist medical training programs. If the AMC accredits a program of study in the new or amended specialist field, it provides a report to the MBA that will determine whether to approve the program as providing a qualification in the new or amended specialist field for the purposes of specialist registration. 

If the new or amended specialist field is recognised under the National Law, medical practitioners awarded an approved qualification in the recognised specialist field can apply for specialist registration. If a medical practitioner is granted specialist registration in the new or amended specialist field, it will be recorded in the Register of Medical Practitioners and the practitioner can use the protected title associated with the specialty.

As Rural Generalist Medicine is a specialist field within General Practice. It is expected that doctors with a nationally accredited qualification in this field would be both registered as specialist General Practitioners and specialists in Rural Generalist Medicine.

The public can search their doctor’s specialist registration details on the national Register of Practitioners. The public register provides assurance that medical practitioners with specialist registration are qualified in the recognised specialty. It also confirms that they have professional indemnity insurance and are complying with continuing professional development and recency of practice requirements.

The process of recognition of the specialist field is separate to other processes for Commonwealth benefit programs including the Medicare Benefits Schedule (MBS) or the Pharmaceutical Benefits Schedule (PBS). Eligibility for such benefits is established under separate Commonwealth Government application and assessment processes.

The general practice colleges have different models for delivering rural generalist training.

  • The ACRRM Fellowship qualification (FACRRM) is AMC accredited as a general practice qualification and is designed to reflect attainment of the requisite professional standards for the practice of Rural Generalist Medicine.
  • RACGP has introduced a FRACGP-RG Fellowship qualification which is a general practice qualification designed to reflect the standards for Rural Generalist Medicine.

The two general practice colleges, ACRRM and RACGP, currently provide the training, continuing Professional Development and Fellowship qualifications which the Medical Board of Australia recognises for Vocational Registration purposes for specialist general practitioners. As Rural Generalist Medicine if recognised would be a specialist field within general practice, these existing arrangements would be extended to also apply to the new field.

This is the name the Commonwealth Department of Health have given to their commitment to constructing a national framework to support doctors to train, qualify and practice as rural generalist practitioners in a way that is structured and consistent and which enables portability across health services and jurisdictions.

Ultimate determinations will rest with the national committee of health ministers with advice from the Medical Board of Australia (Board).

If Rural Generalist Medicine is recognised as a new specialist field within general practice under the National Law, then doctors awarded an approved qualification in Rural Generalist Medicine will be able to apply for specialist registration in that field.

ACRRM RG Fellowship Program will be assessed through the AMC processes, and it is expected that it will be accredited and FACRRM will become an approved qualification in the new specialist field of Rural Generalist Medicine.  Currently, the ACRRM Fellowship Program is AMC accredited, and the FACRRM is an approved qualification, in general practice.

It is anticipated that as a FACRRM you would then be able to apply through Ahpra for registration as a specialist Rural Generalist and this would be held in addition to your registration as a specialist general practitioner.  Specialist registration in the new field of Rural Generalist Medicine, would be recorded in the Register of Medical Practitioners and would entitle you to use the protected title associated with the specialty.