It's taken 20 years, but the GP colleges at last agree on what rural generalism is
It has taken more than 20 years, but the RACGP and ACRRM have signed an agreement pledging to work together on a national training pathway for rural generalism.
The deal is being hailed as a “crucial first step”, with the two colleges finally agreeing on a basic definition of what rural generalism is (see below).
Historically, the RACGP has been wary of the push for rural generalist training – particularly in Queensland – arguing that it has been more about training doctors to work in rural hospitals at the expense of providing specialist general practice care in the community.
Significantly, the college refused to endorse the so-called 2013 Cairns Consensus, which outlined the principals of ACRRM’s preferred rural generalist training model.
But the new agreement, thrashed out over two days in January at the Collingrove Homestead in the Barossa Valley, specifies that a rural generalist should provide both comprehensive general practice and emergency care.
The agreement acknowledges the Cairns Consensus, as well as the position statements of both colleges, as the basis of the framework being developed by the new National Rural Health Commissioner Emeritus Professor Paul Worley.
Professor Worley has been tasked with creating a national rural generalist training pathway by 2020.
“The Collingrove agreement is the crucial first step in developing a national rural generalist pathway,” he told Australian Doctor.
“Without the definition, we had no goalposts for a training pathway.
“This has created the goalposts and we will now work towards a national program that will need to be adapted to each context around Australia, but the principals will be a national program.”
Professor Worley said that the time taken debating the definition of rural generalism showed how seriously both colleges viewed the issue.
"It was just really important and, with anything that is really important, people will take their time to get it right," he said.
"We were wanting to ensure that although this needed to be done quickly, it wasn't rushed. It needed to be right."
The full Collingrove Agreement reads:
Representatives from the Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM) recently met with the National Rural Health Commissioner at Collingrove Homestead in the Barossa Valley, South Australia, to explore opportunities for collaboration.
The two Colleges are determined to secure a strong, sustainable and skilled national medical workforce to meet the needs of our rural and remote communities. The two Colleges have agreed to work together to lead the development of a national framework for Rural Generalism.
Consistent with the Cairns Consensus Statement on Rural Generalist Medicine and acknowledging the contextual position statements on Rural Generalism by ACRRM and the RACGP respectively, the two Colleges propose that a Rural Generalist (RG) is a medical practitioner who is trained to meet the specific current and future health care needs of Australian rural and remote communities, in a sustainable and cost-effective way, by providing both comprehensive general practice and emergency care, and required components of other medical specialist care in hospital and community settings as part of a rural healthcare team.
A Rural Generalist Pathway Taskforce is being formed, led by the National Rural Health Commissioner, which will ensure broad input from across the rural health sector into this Pathway. Further details of, and ways to contribute to, this historic work will be announced soon.