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14 Mar 2018


We are on the cusp of formulating a National Rural Generalist program. The questions that float to the top are enough to give you a booming headache:

  • What is the difference between a Rural Generalist and a Rural proceduralist?
  • Has the definition of a Rural Generalist been agreed upon?
  • Can we call them specialists?
  • Are specialists feeling threatened?
  • The Cairns consensus Statement for Rural Generalism has not fully been accepted, why not?
  • How can we in Outback tell they are Generalists? Will the credentialing and titles be clear?
  • What if there are 6 minute medicine GPs in the Rural location where they desperately need an extended skills generalist? What then?
  • Will we lose the newly trained generalist to urban practices?
  • Do we need Generalists in the cities?
  • Medical bonding is going nowhere, what is going to happen with bonding with the Generalist program?
  • How can the training of Rural Specialists be tied into the training of a Rural Generalist?
  • Where do Allied health Rural generalists fit in?
  • We know Queensland has the most developed Rural Generalist program, which State or Territory is lagging behind? Why?
  • There are too many FACEMs without jobs so why are we training Rural Generalists with ED extended skills? Why not get the FACEMs outback?
  • Will the Rural Generalist training positions boot out regular GP trainees and specialist trainees from training in the rural facilities?
  • How many do we need?
  • How many per State and Territory?
  • What about the current Rural Generalists without the formal recognition, will they be grandfathered in?
  • How can a fellowed GP become a Rural Generalist?
  • Are we setting a precedent with our program? Has it been done internationally?  Will the world follow us?
  • How does private procedural practice fit in?
  • In some locations, training capacity and procedural opportunities are squeezed by IMGs and / or procedural specialists and their registrars - how do we ensure that there is a future for the rural generalist in ED, Obs and Anaesthetics especially?
  • We now see the Colleges having a greater role in training, the universities having the regional training hubs, the RTOs delivering GP training including rural procedural terms, and the state health departments funding the hospital training terms - looks like a recipe for trouble! How do we sort it out? 

I do not have the answers but your answers and comments need to be communicated to the Rural Health Commissioner. Have compassion for him and hope he can tolerate the headaches. 

Published: 14 Mar 2018