Training our future rural medical workforce

To the Editor: I recently had the opportunity to analyse the home postcodes of medical students at the University of Adelaide over five recent consecutive years. Although this analysis is rather simplistic, its findings are quite startling (see Box).

Between 50 and 60 students per year were from the Adelaide metropolitan area. My colleagues in the Department of Human Services tell me that we struggle every year to fill the junior posts at our metropolitan public hospitals.

A considerable number of students (25–41) were from outside South Australia. It is only natural that these students would want to go home after completing their degree, and I believe that considerable effort is made every year to encourage these students to stay and staff junior positions in our hospitals.

There has been much discussion about students from outside Australia and I will not add to the debate on this complex issue.

The most alarming feature is the small number of students from rural South Australia. This ranged from zero to three or four. Moreover, I have included in this category students whose home address was in the Adelaide Hills, which is between 5 and 20 km from the Adelaide metropolitan area.

We spend a lot of time encouraging students who grew up and were educated in cities to come to rural settings, using various schemes of bonding and financial inducement, with limited success.

After 18 years’ practice in a rural area, I am firmly of the belief that we should be starting much earlier. If a person is born and reared in the country, and has their secondary schooling in the country, it is much easier to transplant that person back to the country after tertiary eduction.

If these figures of students’ home residence are representative, we will always be fighting an uphill battle to attract doctors to rural areas.This is not the fault of our universities, as they are constrained by federal regulations. I believe the solution lies in Canberra.

In our parliaments, we have proportional representation. As far as medical students are concerned, I think South Australia has disproportionate representation.