A PATERNALISTIC health system that wasn’t looking after the needs of rural communities was the catalyst for the foundation dean of James Cook University’s medical school to begin a campaign to have the contributions of rural doctors recognised.
Professor Richard Hays was working as a GP in Emerald after an extraordinary series of events in which he was given a rural scholarship but appointed to a metropolitan hospital, when his social justice barometer began quivering.
Delivering the keynote address at the 26th annual conference of the Rural Doctors Association of Queensland in Cairns, Professor Hays told delegates his story to bring medical training to regional Queensland was intertwined with one of social justice, to see healthcare improve for north Queenslanders, especially indigenous communities.
“I gained competencies, became very interested in training and asked questions,” he said.
“I became aware that rural scholarships were not going to solve everything.”
His efforts to develop rural generalist training were scoffed at by the medical establishment.
"There were many who argued the approach would only graduate barefoot unemployed doctors," he said.
"There's still conventional wisdom in some quarters that suggests that in order to be a good medical graduate of any kind you've got to be lectured by Nobel prize winners, and you've got to sit at the feet of the scientific experts and attend very narrow specialist centres in the big cities."
First dean of JCU med school, Richard Hays addressing #RDAQ15, looking back at what was wrong with training #QCL pic.twitter.com/oWXDnVa5WX
Successful models of medical education need Local Leadership #RDAQ15 @RuralDoctorsAus @RuralDocsQ @RuralWonca pic.twitter.com/E2w9tWA2yr
Longitudinal studies at JCU show the strategy of locating health professional programs in regional and rural areas, recruiting a lot of students from that pool, and combining that with curriculum, placement and role-modelling is having the desired effect.
“We always said we wanted 50 per cent of our graduates to work in rural and regional areas and it’s actually higher than that – which is great,” Professor Hays said.
The model has been adopted internationally via faculty development in Thailand, the western Pacific and Canada.
Professor Hays cautioned that while a lot of money had been invested and the world was now a very different place, some data was showing the rural problem hadn’t all been solved.
“We need to think if the model we want is one of the 40 year veteran or not.”
He added that rural workforce reforms were still fragile in the face of a government looking to make savings.
“JCU is the only program that’s been going long enough to show evidence of success. There’s still work to be done to defend the expenditure.”
Professor Hays believed intern and specialist training needed to be brought to regional and rural areas.
At the moment, doctors are leaving the north to get further training.
