When Lisa Gilbert was deciding what to specialise in, she had to choose between her dream job of becoming a physician or staying in the region that had become her home.
Key points:
- Lisa Gilbert had to choose between studying to become a physician or remaining in the Gippsland region
- Experts say regional areas are loosing doctors due to the limited availability of specialist training options
- Some colleges say the state government needs to fund resources to train doctors regionally
Originally from Melbourne, Dr Gilbert completed her four-year medical degree at the Monash University Churchill campus, but when it came to choosing a specialty her options were limited.
"I was very interested in being a general physician and neurology, that kind of stuff, but it was not offered here, so I decided to do general practice," she said.
"I stayed in the area purely because my husband was working here, so there was work available for my husband and he was here."
Most specialist colleges across Australia are based in metropolitan areas with only some specialities available in the regions.
For those completing their medical degrees regionally, many are forced to relocate to complete their specialty training.
Traralgon-based Dr Gilbert said the education system for doctors was "almost designed to send people into the cities".
"So then you've got people who are sort of in their mid-20s, they might be looking for partners, they might be having children … and we're forcing them to go back to Melbourne for several years and then wondering why they won't work in the country."
Calls for colleges to expand training
Associate professor Rob Dawson directs Monash University's Gippsland Regional Training Hub, which operates across the region to support the next generation of rural medical practitioners.
It is one of 21 universities funded by the federal government's Rural Health Multidisciplinary Training program.
Dr Dawson is writing letters to various colleges, calling on them to also expand their training outside of cities.
He said the common belief that the best training was provided at metropolitan hospitals was not necessarily true.
"I've worked in Traralgon for over 35 years, and I would suggest that I have a greater breadth of an anaesthetist than any of my anaesthetic colleagues in Melbourne," Dr Dawson said.
According to James Cook University, in metropolitan Australia there are 4.3 doctors per 1,000 people compared with 2.7 doctors per 1,000 in rural and remote areas.
Dr Dawson said recruiting rural candidates who attended a rural medical school and did their pre-vocational training in a local hospital was a good first step, but end-to-end training needed to be available to retain doctors in regional areas.
More challenging to train rurally
Australian Medical Association Victoria president Jill Tomlinson said the organisation was looking to advocate the state and federal government to support equal access to healthcare for rural communities.
"The challenge is that it is, to some extent, easier to bring in 3,000 overseas-trained doctors a year to fulfil positions in rural areas than it is to set up the systems to train our own graduates, and to keep them in or encourage them to stay in rural areas," Dr Tomlinson said.
The Royal Australasian College of Surgeon's Bridget Clancy said the college had based its training in cities because it was easier, but was aiming to locate more of its training in rural areas.
But Dr Clancy said it was up to state governments to support colleges in expanding their training locations.
"Although the College of Surgeons is in charge of selecting people to train as a surgeon and overseeing their training, and our members or our fellows, as surgeons, deliver the training, the trainees are actually employed by the state government in public hospitals," she said.
"For most training programs … [we need] three surgeons to supervise and train the junior doctor or the trainee doctor, so for a lot of rural areas there are just simply not three surgeons in each of the nine surgical specialties."
For Dr Gilbert, who has built a life for herself in regional Victoria, there were many reasons why she enjoyed working regionally, but she said more incentives needed to be provided to doctors.
"It's the simple things, like there's no paying for parking, and rent — although it's gone a bit crazy in the past few years — was much more affordable," she said.