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Tuesday, 3 December 2013
Page: 1498


Dr GILLESPIE (Lyne) (21:00): Tonight I am going to speak about the rural doctor shortage crisis and the solutions that can be offered by rural clinical schools—and I will highlight the achievements of some of those schools. In my electorate there are two rural clinical schools, one run in Port Macquarie by the University of New South Wales and another in the town of Taree run jointly by the University of Newcastle and the University of New England. The University of New South Wales Rural Clinical School has been operating since 2008 and educates many doctors. Over 33 per cent of their current graduating class have spent at least one year in a rural clinical school, either in Port Macquarie, Coffs Harbour or one of the Greater Murray schools in Albury and Wagga. This far exceeds the remit given to them by the Commonwealth when the rural clinical schools were established.

The benefit to the communities where these rural clinical schools have been established is substantial. The aim of providing rural clinical school experience to medical students was to generate medical graduates who end up in some form of rural clinical practice. There is a long gestation before you get a qualified medical practitioner. For five or six years after your undergraduate degree, you have to do postgraduate medical training. The Rural Clinical School program is delivering doctors into a potential rural pathway. In fact, in a survey of students at the University of New South Wales Rural Clinical School, 72 per cent said they wanted to work in a rural location. In a similar survey run at the University of Sydney, 80 per cent expressed a preference for working in a rural location upon graduation.

But there is a great disconnect between medical undergraduate training and the postgraduate training experience. Many of our undergraduates are getting experience in the rural situation, but it is their postgraduate medical training that is the missing piece in the puzzle. One only has to look at the graduates from a similar program run out of Dubbo, where the University of Sydney has been successfully training undergraduates. In the Dubbo region and in Orange, there are currently 36 doctors working either as local GPs or as local hospital doctors who had their first experience in the School of Rural Health. Of all the graduates from that program, 38 per cent are working in rural areas as rural interns.

Many members of the House are aware of the doubling of medical graduates over the last couple of years and that there is an increasing wave of medical students who will require completion of their training in a hospital setting and then in GP training places. That is where the missing piece of the puzzle is. To get the full benefit of these rural clinical schools, we need to support more postgraduate training places for interns, residents and registrars. Otherwise, all this investment the Commonwealth has made will not achieve the outcome we are after.

All the communities where the rural clinical schools exist get huge benefits. Many existing practitioners in these rural centres stay on because of the rural clinical school. They get to be an educator rather than having to work on the front line, in the trenches—seeing patient after patient in their practice or in their hospital. All these rural clinical schools are embraced by their local communities. They are an income generator for the town because it changes the nature of the town. Many practitioners stay on for many more years in clinical practice because they get to be involved in a more academic teaching environment. So the associated benefits of having a rural clinical school are well beyond the number of graduates who end up in rural clinical placements. (Time expired)