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GEIR O’ ROURKE THE RACGP is warning against a‘ one-size-fits-all’ approach to creating a new generation of rural generalists after Parliament voted to establish a Rural Health Commissioner to create a national training pathway.

The legislation to create the position passed both houses last week, making good on a promise the Coalition took to the 2016 election.

Increasing the numbers of rural generalists— usually seen as GPs with additional training in areas like obstetrics, emergency medicine and surgery— is being sold as one way to fix the rural health workforce shortage.

But the vexed questions of who should be called a rural generalist, where they should work and how they should be trained have long divided the RACGP and ACRRM.

The RACGP is nervous about anything that creates

ACRRM president Professor Stewart is calling for a single national pathway based on the 2013 Cairns Consensus.

national standards based on the rural generalist program in Queensland, where doctors receive hefty pay packets and secure hospital credentialling, but supposedly have limited focus on GP care.

RACGP rural chair Dr Ayman Shenouda says:“ A

rural generalist is a rural GP working to the full scope of their practice, with skill sets informed by the needs of the community they serve.

“ While we support a national generalist pathway, we also acknowledge that states and territories need

flexibility... and the pathway can’ t be one size fits all.”

ACRRM president Professor Ruth Stewart says the first job of the rural health commissioner will be replacing the hodgepodge of programs created around the country, where hospital doctors, obstetric specialists and private GPs all work under the title of‘ rural generalist’.

She is calling for a single national pathway based on the 2013 Cairns Consensus, which is seen as heavily influenced by the Queensland program. Significantly, the RACGP has consistently refused to back the consensus’ recommendations.

“ It is fairly obvious that ACRRM and the RDAA are committed to the consensus definition of rural generalism, and it seems that the RACGP has a dissenting view,” Professor Stewart says.“ The new commissioner will need to broker that space.”