A Charles Sturt University medicine academic and regional GP from Orange says women are hit hardest by Australia’s rural doctor shortage, and more needs to be done to ensure all women have access to a female doctor, regardless of where they live.

Opinion piece by Dr Sandra Mendel, Medicine Year 2 Convenor for the Charles Sturt University and Western Sydney University Joint Program in Medicine and GP for a private practice in Orange, NSW.

It is no secret that regional, rural and remote areas of Australia need more doctors. But something we don’t hear about as often is how this GP shortage is more likely to disadvantage women in these areas.

Historically, female doctors have always been outnumbered by their male counterparts in Australia, and this still rings true in our nation’s rural communities. For years numerous studies have shown females are disproportionately poorly represented in Australia’s rural medical workforce. Having lower rates of female doctors in rural areas means it is often even more difficult for women in these areas to see a female doctor or medical specialist. This is an important issue Australia needs to address and discuss, particularly during Women’s Health Week, Monday 7 to Friday 11 September.

All women should have access to a female clinician, regardless of where they live. There are numerous aspects of wellbeing that many women would prefer and be more comfortable to discuss and manage with a female doctor.

Having access to appropriate healthcare means a patient is more likely to seek care earlier and have better health outcomes.
As a GP with 20 years’ experience working in regional Australia, I know first-hand the issues that patients and their families face in accessing healthcare and that more can be done to improve this access and, in turn, improve their health and wellbeing.
Research shows women who live in rural and remote areas are less likely than urban women to visit GPs frequently or to see specialists.

The lack of doctors, particularly the lack of female doctors, in rural areas exacerbates this situation, and often means that many women will not access healthcare. This is putting their health at risk as their morbidity and often mortality from preventable diseases will increase.

For years studies have shown that, on average, Australians living in rural and remote areas have poorer health outcomes than people living in metropolitan areas. There are many factors, including lifestyle differences, financial disadvantage, and education, that contribute to these results.

Two significant contributing factors are that people in rural and regional Australia have poorer access to health services and poorer use of health services. This needs to be addressed. It isn’t enough just to discuss these issues, action needs to be taken to address the lack of healthcare services and the lack of access to doctors patients feel comfortable seeking treatment from.

We need to recruit more doctors to work in rural Australia; however, we can’t expect more doctors to work in regional and rural areas unless they are trained to do so.

Many Australians living in rural areas have different health needs. Practicing medicine in a rural setting is different to practicing in a metropolitan city, and tertiary training in medicine needs to incorporate these differences.

University programs such as the Charles Sturt University Joint Program in Medicine, run in partnership with Western Sydney University, brings us one step closer to solving Australia’s doctor shortage, particularly our female doctor shortage.
Data trends suggest that in Australia “

as the proportion of female practitioners increases, the likelihood that they will choose to practice remotely will decrease – except in the case of a rural clinical school training intervention.” Researchers have also found that “rural background, rural intention and rural experience during medical school all need to be factored into programs for redressing deficits in rural workforce levels.” All of these factors have been incorporated into the Joint Program in Medicine.

The Joint Program in Medicine has been designed for rural contexts, taking into account the healthcare needs of rural communities and the capabilities of local health services.

The program has a strong focus on training doctors for a career in rural and regional medicine, with 80% of the cohort’s intake reserved for students from rural and regional areas. Under the Rural Entry Admissions Scheme, students from these areas applying via the University Admission Centre have a lower ATAR requirement (91.5) compared to their metropolitan counterparts (95.5).

Students accepted into the program will complete most of their training at the Charles Sturt School of Rural Medicine in Orange in Central West NSW and will also be required to complete regional and rural clinical placements.

This program will play an important role in addressing our rural doctor shortage, but there are other steps we can take to recruit rural doctors, especially rural female doctors.

The shortage of rural female doctors can be addressed by encouraging and providing opportunities for more females to enter the profession, undertake training in differing medical specialities, and undertake training in rural settings.

Female students also need to be provided with the ability to combine this type of training with flexible study and placement options. Having female mentors in positions that train female students gives these students opportunities to learn from experienced female clinicians and understand some of the barriers that women can and still face.

Encouraging women to pursue medicine, undertake their training in a rural setting, and then go on to work in rural locations will be one important part of my role as Year 2 Convenor for the Joint Program in Medicine.

In February 2021, our program will welcome a number of female medicine students and provide them with the training and rural placement experience they need to provide high-quality healthcare to people in regional, rural and remote Australia. Our program is incredibly fortunate that Orange has a strong female doctor workforce in a variety of specialties. Being a larger rural centre, this is unique from many other communities in similar settings in that Orange has women in many differing specialities of medicine. This has meant access to female clinicians has dramatically improved and provided role modelling for many young doctors and will for our new medicine students.

I look forward to helping train Charles Sturt and Western Sydney University’s future Doctor of Medicine students, so more people in rural, regional and remote Australia get access to the doctors they deserve.

Applications for the Joint Program in Medicine can be made via the Universities Admission Centre until Wednesday 30 September.

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