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Targeted Recruitment:
A Pathway to Recruit, Retain
and Train Doctors in Rural and
Remote Communities.
Patrick Giddings, CEO & Director of Training.
Remote Vocational Training Scheme.
Veeraja Uppal, Special Projects Development
Officer. Remote Vocational Training Scheme.
To present findings from the
Targeted Recruitment Strategy Pilot
using training as an incentive to
Recruit, Retain and Train doctors in
rural and remote communities.
RVTS: At a Glimpse
PROGRAM
DELIVERY
18 years
DOCTORS TRAINED
301 Drs
SMALL
COMMUNITIES
SUPPORTED
248
Training in ACCHS
47 Doctors
3-4 YEARS IN
LOCATION DURING
TRAINING
90% stay
REGISTRARS FEEL
WELL SUPPORTED
96%
AUSTRALIAN
TRAINED DRS
37%
GP FELLOWSHIP
ACHIEVEMENT
94%
IN SAME LOCATION
2 YEARS POST
TRAINING
39%
248 Communities Served
“I would not be able
to live and work
where I do without
RVTS. This is by far,
the most valuable
part of the RVTS
model for me – and
hopefully for my
community as well.”
(2017 RVTS Registrar)
RVTS is an effective workforce retention
program using Education and Training as its
modus operandi
RVTS as a workforce recruitment strategy……
Medical Workforce Maldistribution
• Remote Australia has 60% doctors per capita than urban areas (AIHW 2016)
• 2028 Projection: 43 GPs per 1000,000 remote : 255 GPs per 100,000 urban
(RFDS 2018)
• Premature mortality rate: 1.6 times higher (remote) and 2.2 times higher (very
remote) than urban areas (AIHW 2016)
• Aboriginal and Torres Strait Islander populations experience a burden of disease
2.3 times greater than the non-Aboriginal population and lower life expectancy
(AIHW 2016), (AIHW 2014) & (Dept PM&C 2018)
• 82% graduating domestic medical students selecting urban locations (Medical
Deans Australia and New Zealand 2018)
2018 Pilot
2 Targeted Recruitment positions filled
•Cunnamulla, QLD – Dr Joshua Dally
•Mallacoota, VIC – Dr Mubasher Sherazi
•A second full-time GP to both towns
•Increased medical service viability
•Mid-year RVTS training intake
2019 Pilot Methodology
•Locations nominated by Rural Workforce Agency or
State Government Department of Health and selected for
• High Medical Workforce need
• Rurality (MMM)
• National Distribution (ABS data)
•Applicants to meet the minimum RVTS entry standards
•Semi-structured interview &
•Standardised online Situational Judgement Test (SJT)
2019 Pilot Results
13 Locations : 6 Training Positions
• QLD – Blackall, Dirranbandi, & St George x 2*
• NSW – Bourke, Lightning Ridge & Norfolk Island
• VIC – Kerang
• TAS – Queenstown
• SA – APY Lands*
• NT – Wadeye*
• WA – Wickham & South Hedland*
• 90% in MMM 6-7
• 4 AMS Posts
• Candidate assessments currently in progress
Targeted Recruitment Locations
2018
2 Training Positions
• Cunnamulla, QLD
• Mallacoota, VIC
2019
13 Locations identified
6 Training Positions
Lessons Learned
• Motivated by early success
• Effective recruitment strategy
• Increased recruitment time required
• RVTS high entry standards
• Mid-year intake
• Program integration
Future Directions
• 2020 Targeted Recruitment roll out
• Ongoing community and stakeholder engagement
• Development of innovative training positions
• Evaluate and publish
“The assumption that quality medical training only occurs in
major centres risks perpetuating Australia’s maldistribution of
medical workforce and health care expenditure by location
rather than clinical need” (Wearne 2013).
ReferencesAustralian Institute of Health and Welfare, 2014. Mortality and Life Expectancy of Indigenous Australians: 2008 to 2012.
Australian Institute of Health and Welfare. (2016) Australia’s Health 2016. Available at: https://www.aihw.gov.au/getmedia/9844cefb-7745-4dd8-
9ee2-f4d1c3d6a727/19787-AH16.pdf.aspx?inline=true
Carson, D, Punshon, K, McGrail, M & Kippen, R 2017, 'Comparing rural and regional migration patterns of Australian medical general practitioners
with other professions: Implications for rural workforce strategies' Australian Population Studies, vol 1, no. 1, pp. 55-68.
Department of Prime Minister and Cabinet. (2018) Closing the Gap Prime Minister’s Report 2018. p.104-108, Available at:
https://closingthegap.pmc.gov.au/sites/default/files/ctg-report-2018.pdf
KBC Australia. Evaluation of the Remote Vocational Training Scheme – Impact and Outcomes, 2016
Giddings P. Where are they still? The Remote Vocational Training Scheme and workforce retention. Presented at the Remote Medical Education
Conference. Sydney, Australia. July 28, 2012.
Giddings P, McLaren J. Rural medical training via distance education and remote supervision. In Chater AB, Rourke J, Couper ID, Strasser RP, Reid S
(eds.) WONCA Rural Medical Education Guidebook. World Organization of Family Doctors (WONCA): WONCA Working Party on Rural Practice, 2014.
Hays, R.B., 2012. Remote supervision of health professionals in areas of workforce need: time to extend the model. Rural and remote
health, 12(2322).
Humphreys, J., Wakerman, J., Pashen, D. and Buykx, P.,. Retention strategies and incentives for health workers in rural and remote areas: what
works? Australian Primary Health Care Research Institute, 2009
McGrail, M.R. and Russell, D.J., 2017. Australia's rural medical workforce: Supply from its medical schools against career stage, gender and
rural‐origin. Australian Journal of Rural Health, 25(5), pp.298-305.
Medical Deans Australia and New Zealand Inc. (2018) Medical Schools Outcomes Database National Data Report. Available at:
https://medicaldeans.org.au/md/2018/09/2018-MSOD-National-Data-Report.pdf
Remote Vocational Training Scheme. (2017) Registrar Satisfaction Survey.
Royal Flying Doctor Service of Australia. (2018) Looking Ahead: Responding to the health needs of Country Australia in 2028, The centenary year of
the RFDS.
Strasser, R.P., 2018. Will Australia have a fit-for-purpose medical workforce in 2025?. The Medical Journal of Australia, 208(5).
Wearne, S.M., 2013. Remote supervision in postgraduate training: a personal view. The Medical Journal of Australia, 198(11).

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NACCHO 2018 National Conference – Targeted Recruitment

  • 1. Targeted Recruitment: A Pathway to Recruit, Retain and Train Doctors in Rural and Remote Communities. Patrick Giddings, CEO & Director of Training. Remote Vocational Training Scheme. Veeraja Uppal, Special Projects Development Officer. Remote Vocational Training Scheme.
  • 2. To present findings from the Targeted Recruitment Strategy Pilot using training as an incentive to Recruit, Retain and Train doctors in rural and remote communities.
  • 3. RVTS: At a Glimpse PROGRAM DELIVERY 18 years DOCTORS TRAINED 301 Drs SMALL COMMUNITIES SUPPORTED 248 Training in ACCHS 47 Doctors 3-4 YEARS IN LOCATION DURING TRAINING 90% stay REGISTRARS FEEL WELL SUPPORTED 96% AUSTRALIAN TRAINED DRS 37% GP FELLOWSHIP ACHIEVEMENT 94% IN SAME LOCATION 2 YEARS POST TRAINING 39%
  • 4. 248 Communities Served “I would not be able to live and work where I do without RVTS. This is by far, the most valuable part of the RVTS model for me – and hopefully for my community as well.” (2017 RVTS Registrar)
  • 5. RVTS is an effective workforce retention program using Education and Training as its modus operandi RVTS as a workforce recruitment strategy……
  • 6. Medical Workforce Maldistribution • Remote Australia has 60% doctors per capita than urban areas (AIHW 2016) • 2028 Projection: 43 GPs per 1000,000 remote : 255 GPs per 100,000 urban (RFDS 2018) • Premature mortality rate: 1.6 times higher (remote) and 2.2 times higher (very remote) than urban areas (AIHW 2016) • Aboriginal and Torres Strait Islander populations experience a burden of disease 2.3 times greater than the non-Aboriginal population and lower life expectancy (AIHW 2016), (AIHW 2014) & (Dept PM&C 2018) • 82% graduating domestic medical students selecting urban locations (Medical Deans Australia and New Zealand 2018)
  • 7. 2018 Pilot 2 Targeted Recruitment positions filled •Cunnamulla, QLD – Dr Joshua Dally •Mallacoota, VIC – Dr Mubasher Sherazi •A second full-time GP to both towns •Increased medical service viability •Mid-year RVTS training intake
  • 8. 2019 Pilot Methodology •Locations nominated by Rural Workforce Agency or State Government Department of Health and selected for • High Medical Workforce need • Rurality (MMM) • National Distribution (ABS data) •Applicants to meet the minimum RVTS entry standards •Semi-structured interview & •Standardised online Situational Judgement Test (SJT)
  • 9. 2019 Pilot Results 13 Locations : 6 Training Positions • QLD – Blackall, Dirranbandi, & St George x 2* • NSW – Bourke, Lightning Ridge & Norfolk Island • VIC – Kerang • TAS – Queenstown • SA – APY Lands* • NT – Wadeye* • WA – Wickham & South Hedland* • 90% in MMM 6-7 • 4 AMS Posts • Candidate assessments currently in progress
  • 10. Targeted Recruitment Locations 2018 2 Training Positions • Cunnamulla, QLD • Mallacoota, VIC 2019 13 Locations identified 6 Training Positions
  • 11. Lessons Learned • Motivated by early success • Effective recruitment strategy • Increased recruitment time required • RVTS high entry standards • Mid-year intake • Program integration
  • 12. Future Directions • 2020 Targeted Recruitment roll out • Ongoing community and stakeholder engagement • Development of innovative training positions • Evaluate and publish “The assumption that quality medical training only occurs in major centres risks perpetuating Australia’s maldistribution of medical workforce and health care expenditure by location rather than clinical need” (Wearne 2013).
  • 13. ReferencesAustralian Institute of Health and Welfare, 2014. Mortality and Life Expectancy of Indigenous Australians: 2008 to 2012. Australian Institute of Health and Welfare. (2016) Australia’s Health 2016. Available at: https://www.aihw.gov.au/getmedia/9844cefb-7745-4dd8- 9ee2-f4d1c3d6a727/19787-AH16.pdf.aspx?inline=true Carson, D, Punshon, K, McGrail, M & Kippen, R 2017, 'Comparing rural and regional migration patterns of Australian medical general practitioners with other professions: Implications for rural workforce strategies' Australian Population Studies, vol 1, no. 1, pp. 55-68. Department of Prime Minister and Cabinet. (2018) Closing the Gap Prime Minister’s Report 2018. p.104-108, Available at: https://closingthegap.pmc.gov.au/sites/default/files/ctg-report-2018.pdf KBC Australia. Evaluation of the Remote Vocational Training Scheme – Impact and Outcomes, 2016 Giddings P. Where are they still? The Remote Vocational Training Scheme and workforce retention. Presented at the Remote Medical Education Conference. Sydney, Australia. July 28, 2012. Giddings P, McLaren J. Rural medical training via distance education and remote supervision. In Chater AB, Rourke J, Couper ID, Strasser RP, Reid S (eds.) WONCA Rural Medical Education Guidebook. World Organization of Family Doctors (WONCA): WONCA Working Party on Rural Practice, 2014. Hays, R.B., 2012. Remote supervision of health professionals in areas of workforce need: time to extend the model. Rural and remote health, 12(2322). Humphreys, J., Wakerman, J., Pashen, D. and Buykx, P.,. Retention strategies and incentives for health workers in rural and remote areas: what works? Australian Primary Health Care Research Institute, 2009 McGrail, M.R. and Russell, D.J., 2017. Australia's rural medical workforce: Supply from its medical schools against career stage, gender and rural‐origin. Australian Journal of Rural Health, 25(5), pp.298-305. Medical Deans Australia and New Zealand Inc. (2018) Medical Schools Outcomes Database National Data Report. Available at: https://medicaldeans.org.au/md/2018/09/2018-MSOD-National-Data-Report.pdf Remote Vocational Training Scheme. (2017) Registrar Satisfaction Survey. Royal Flying Doctor Service of Australia. (2018) Looking Ahead: Responding to the health needs of Country Australia in 2028, The centenary year of the RFDS. Strasser, R.P., 2018. Will Australia have a fit-for-purpose medical workforce in 2025?. The Medical Journal of Australia, 208(5). Wearne, S.M., 2013. Remote supervision in postgraduate training: a personal view. The Medical Journal of Australia, 198(11).

Editor's Notes

  1. Outside of GPET Own application and selection Different eligibility Australian Standard Geographic Classification – Remoteness Areas
  2. RVTS was established in 2000 and in its 18th year of operation Delivered General Practice and Rural Generalist Training to over 301 doctors in 248 communities Supports doctors practising in rural and remote communities and Aboriginal Medical Services who would have to leave their community to undertake training Training is delivered by distance education and remote supervision over 3 to 4 years More than 94 percent of participants in the program have achieved GP Fellowship on completion of training
  3. RVTS doctors commonly work in communities with a higher incidence of disease and lower life expectancy, serviced by fewer doctors per capita when compared to Australian urban centres.
  4. Anecdotally RVTS sees this directly affecting the viability of many rural and remote medical services and ACCHSs.