Showcasing and Brainstorming
Each Rural Clinical School provided a slide identifying one success and one challenge associated with the new RCTS program. RCS representatives introduced their teams, slides were displayed & discussed (Attachment 2).
Recurring themes from strength/challenge slides were identified and clustered for further discussion at the afternoon’s “Breakout & Problem Solving” sessions.
Some issues identified included:
- Rural Preferential Recruitment scheme in NSW (clarified). Statewide intern allocation system, a ‘pre-match’ can take place, i.e. in top category students can apply for a rural hospital, primary allocation sites. Hospitals can also rate and choose students, prior to main allocation process. FRAME may play a role in advocating this policy in other states. Within Victoria, the Rural Generalist Program will potentially drive this beyond 2013.
- Strengths in increasing implementation of vertical integration of medical education.
- Celebration of the RCS program; 10-15 years on, still going strong; need a global publication about rural health, i.e. MJA supplement; marketing.
- Staff recruitment, retention and faculty development remain ongoing issues, with constant shortage of clinical academics, and fatigue of clinicians & tutors.
- Difficulty linking undergraduate course selection to postgraduate rural student numbers, and keeping up the rural student cohort in that dual entry.
- Some RCS have no problems meeting 25% rural student recruitment requirements; others having difficulties – particularly graduate entry/postgraduate programs.
- Research, innovation and opportunities arising, however structures within universities can create a lack of control and influence on admissions processes. Some RCSs started as sub-branch of universities, initially accountable for outcomes, not necessarily processes.
- As senior academics, it is important to have an influence on university policy.
- Research outcomes creative - research strategies could be stronger.
- Interprofessional learning achievements were acknowledged. Managed in cross-institutional environment (not all universities have all health profession students), demonstrating the opportunities for policy and innovation and integration of programs. Issue of how to capitalise & build strengths within the relationships between UDRH and RCTS programs.
- Short term (4 week) placements; major problems include underfunding due to distance, cost of travel and accommodation. Students go for four weeks (not always in a block) & can leave without making it a meaningful experience within a rural community.
- John Flynn Placement Program. Seems a more sustainable model for practitioners and communities. From exit survey feedback, students acknowledge the six week rural placement as a worthwhile educational experience. Longitudinal experience could be more valuable.
- Short term placements enable a connection to community hubs to potentially send students. Established resources, infrastructure etc. kept the cost down with the integration with RCS.
- Accreditation processes proving helpful for implementing change.
- Strong commitment for students to spend three years attached to one clinical school, difficulties in the areas of women’s health, children’s health, aged care and psychiatry. Students who wish to stay rural are being sent back to metro and vice-versa, with some negative implications.
- Difficulties finding placements for students, competition that exists for rural clinical placements, pressures of HWA funding, integrated regional clinical networks.
- Lowijta O’Donohue Foundation – looks at Aboriginal health workers’ career pathways. Within many communities, the healer is someone who is nominated by community. It’s about engaging community and understanding their approach, relationships, dynamics.