Are patients willing participants in the new wave of community-based medical education in regional and rural Australia?

Lack of specialists to meet clinical needs and to meet teaching needs are two sides of the same problem.

Specialist clinics and teaching should be done in local hospitals that already have basic facilities, but most rural hospitals are already stretched and cannot take on an extra load.

Medical specialists must be used efficiently. Additional administrative staff are needed to organise appointments, type letters and do general paperwork. Suitable clinic space and nursing assistance are also needed.

Payments to visiting specialists should be sessional rather than case based, so that teaching carries no financial penalty. Payments for clinical and teaching sessions, travel, and accommodation should be sufficient to attract specialists and consultants. Some costs could be recouped by bulk-billing. Ideally, the specialist or consultant would provide long-term continuity to patients and staff — in contrast to registrars, who tend to be transient.