At the recent national rural health conference in Perth, Professor Max Kamien, Emeritus Professor of General Practice at the University of Western Australia, warned that rural clinical schools would eventually lose funding if they can’t prove that a significant proportion of graduates have ended up working in rural, remote or Indigenous health (you can watch his presentation here).

Rural health advocates need to ensure that the medical deans are tracking what is happening to the graduates from rural clinical schools, he said.

But another presentation at the conference suggests that perhaps any evaluation of rural clinical schools should also consider their broader impacts upon rural communities.

Thanks to Marge Overs, Editor of Australian Rural Doctor magazine, for sharing this report from the conference with Croakey readers.

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Rural clinical schools have unexpected benefits

Marge Overs writes:

The enthusiasm of a small town for undergraduate medical training had led to unexpected benefits, Dr Peter Arvier told the National Rural Health Conference.

Dr Arvier, associate head of the University of Tasmania rural clinical school, said the success of undergraduate training in Smithton/Circular Head in north-west Tasmania showed universities could help sustain rural health services.

Smithton/Circular Head was a good choice for undergraduate education because it has a stable GP population and good health facilities. Economically the town isn’t faring so well, with local agriculture and industry battling loss of jobs.

Dr Arvier said medical education started in the community because of the need to place increased numbers of students.

After initially placing final-year students in rotations at the hospital and in general practice, students from earlier years are now training in Smithton.

A highlight of the medical education calendar is an annual emergency weekend, which involves more than 150 health workers, students and community volunteers.

Dr Arvier said there had been unexpected benefits. The influx of students had attracted funding to expand the general practice, to renovate the hospital and to build student accommodation, creating a raft of spin-off economic benefits.

“It has breathed new life into the hospital, turning a good facility into something much better,” he said.

Medical students had become role models for high-school students for whom health careers, or even tertiary education, was not really on their radar.  “Students run career camps and go into local high schools to talk to the students and this works much better than us older adults going into the schools, as the students can identify with them,” he said.

Dr Arvier said the links with the town had evolved to the extent that the community felt it owned the undergraduate education in town. “The community now very proudly sees themselves as a teaching community of health professionals. There is a pride that has gone with that because of the benefits that have flowed through.”

He said the model of a university driving sustainability of health services might apply to other parts of Australia.

“Instead of asking what these communities can do for our students, we need to look at it from the other side – what can we do for those communities?

“If the commitment to teaching and learning can be sustained, I think we will see a breaking away from that cycle of reliance on locum services, agency nurses and fluctuating levels of morale.”

The proof of that impact is shown with the first graduate from the rural clinical school returning to Smithton as a GP in training.

• This article is published in the current issue of Australian Rural Doctor.

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PostScript from Croakey: Perhaps this is an example of how health services and organisations can influence the social determinants of health beyond the more obvious ways. They are major employers after all…

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