Training doctors in regional Australia increases chances they will work there, study finds

Jessica Traves was a city kid, born and bred in the northern suburbs of Brisbane. 

Key points:

• A new study shows the more time a medical student spends training in regional Australia, the more likely they are to work there
• A medical student says the training is better and she loves the lifestyle in a smaller town
• The number of doctors in the most remote parts of the country is falling

But a two-week placement during her first year of medical school in Boonah in the Scenic Rim, south-west of Brisbane, changed the way she viewed her future career as a doctor.  

“I just had the best time and then I was sort of just hooked from that point and didn’t really consider a solely metro career or training from that point,” she said. 

“I’d really like to stay regional and rural for my medical career as well.

“I really I love Brisbane, but I also really love being outside of Brisbane.

“And I enjoy being in a smaller community, smaller hospital as well.”

Ms Traves spent two years training in regional Queensland, one year in Hervey Bay and one in Toowoomba, as part of the University of Queensland’s medical program. 

All of the university’s medical students must do a six week placement in a smaller rural community in their third year.

Ms Traves chose to double her stay to 12 weeks. 

“The hospital time and the doctor-student ratio is really, really great,” she said.

“There’s just less people, so you’re often getting asked to do things that you potentially wouldn’t have the opportunity to do in a metropolitan hospital.

“You really have the chance to actually get to know the people that you’re serving in the hospital, and the community around you, in a way that you just can’t in Brisbane.”

Jessica Traves says she enjoys the easy access to nature in regional Australia.(Supplied)

As well as the professional opportunities, Ms Traves enjoyed the social side of working in a smaller community and the easier access to nature that rural Australia can provide. 

“The regions are just beautiful in terms of getting out into nature and exploring and so I really value that life balance that living out here really affords you,” she said.

Regional medical training gets ‘bums on seats’

Ms Traves is that rare thing that health policy makers have been looking for — a city kid who embraces the life of a country doctor. 

Her training in rural and regional Australia was the key, according to Bruce Chater, the professor of rural and remote medicine at the University of Queensland. 

Professor of rural and remote medicine at the University of Queensland Bruce Chater. (Supplied)

He is one of the authors of a new study, published on Friday in the peer-reviewed British Medical Journal, which shows that where a medical student is trained can have a huge impact on where they work as a doctor. 

“This work actually tells us where there’s bums on seats … [and] doctors working in rural areas,” Dr Chater said.

The study looked at 2,806 University of Queensland medical students between 2011 and 2021, 106 of whom chose to extend their rural placement like Ms Traves. 

Those who also did two years of training in the regions were seven times more likely to choose to work in regional Australia, compared to their colleagues who did neither.  

But even those who just did the 12 week placement were three times more likely to work outside the major cities. 

“If they do two years in a regional area, a third of them go, if you give them 12 weeks in a small centre, a third of them go,” Dr Kater said.

“If you give them both [the 12 week placement and the two years of training in regional Australia], two thirds of them end up in a rural regional centre,” Professor Chater said. 

Professor Chater said one of the most encouraging pieces of data was that the doctors involved were not heading back to the big cities. 

“This is data on doctors who are now four to 10 years post their medical school, so they’re actually out there and staying there,” he said.

“They might not stay forever, but they they are out there and working.”

Importantly, the study found that there was no difference whether a medical student came from the city or the country, as long as they took part in both aspects of the training. 

The study acknowledges that the sample size of students who trained in regional Australia is small, and that it is difficult to differentiate between people who were already interested in working rurally and those whose intentions changed because of the training program. 

Rural doctor numbers declining

Attracting new doctors to smaller rural towns has long vexed policy makers, and the problem is only getting worse.

Data from the Australian Institute of Health and Welfare shows the number of doctors in small towns and remote parts of the country is already much less than regional centres and big cities — and it is still declining. 

A graph showing the number of GPs per 100,000 people in different parts of Australia. (ABC News: Sharon Gordon)

According to a survey by the Royal Australian College of GPs, rural and remote doctors are more likely to retire in the next 10 years compared to their city colleagues.

President of the Australian College of Rural and Remote Medicine Danial Halliday.

Australian College of Rural and Remote Medicine president Dan Halliday said the new research backed up a growing body of evidence that training doctors in regional Australia was crucial. 

“Repetitive positive experiences for medical students during those critical years of their training, actually does align with increased recruitment and retention once they graduate,” he said.

But while other universities also place a strong emphasis on rural training, it is far from universal.

Dr Halliday said encouraging medical students to consider rural practice should start before they were even enrolled. 

“We’d like to see a continuum … that high school students looking towards medicine can actually go into regionally-based medical schools and actually have that opportunity to experience it once they’re training and follow that through the continuum to specialty training, once they actually graduate.”  

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