A Shift Towards Rural Generalism

New Data Shows Trends in Medical Students' Specialty Preferences: A Shift Towards Rural Generalism

Recent data has revealed significant insights into the specialty preferences of the next generation of medical students. According to RACGP, while general practice remains a favoured choice, concerns are rising about the potential impact of an increasing number of rural generalists on the availability of community GPs.

Shifting Preferences in General Practice and Rural Generalism

According to the latest data from Medical Deans Australia and New Zealand, General Practice was the first preference for approximately 10.5% of medical students in 2023, a decrease from 13% the previous year.

However, a notable trend is the growing popularity of a career as a rural generalist, with 7% of students choosing it as their first preference in 2023, up from 5.8% in 2022.

The Medical Schools Outcomes Database report, which began including rural generalism as a sub-specialty of general practice in 2021, has shown an increasing interest in this path.

In its first year, 4.6% of students listed rural generalism as their preference. Together, General Practice and rural generalism now account for 18% of medical students' first preferences.

Implications for Rural and Remote Healthcare

The report highlighted that in 2023, the combined options for general practice and its sub-specialty of rural generalism overtook adult medicine/internal medicine/physician as the most preferred choice for future medical disciplines. This shift is seen as a positive development by many in the medical community, including RACGP Vice President and Rural Chair, Associate Professor Ayman Clements.

"It is encouraging to see more students selecting rural generalism, which has at its core primary care and general practice," said Associate Professor Clements. "This is good news in terms of serving rural and remote communities with a wide variety of skills."

The RACGP has reported a significant increase in the number of trainees choosing the rural generalism pathway, with over 300 students currently in training. This trend is particularly strong among domestic students, who are more likely to choose a rural pathway compared to their international counterparts – 7.9% versus 0.4%, respectively.

Rural Background Influences Career Choices

The data also reveals that 27% of domestic students in 2023 consider themselves as coming from a rural background, the highest percentage in five years. Among these students, 64% expressed a preference for a future career in rural practice, compared to only 20% of respondents from non-rural backgrounds.

While the increase in rural generalism is promising for rural and remote healthcare, Associate Professor Clements pointed out that it still reflects a broader decline in interest in primary care. According to Queensland Government data, 54% of rural generalists practice in hospitals, emphasizing the need for a balanced approach to supporting general practice in the community.

"This reinforces the need for the Federal Government to respond to incentives and programs that aim to support general practice in the community," he stated.

Addressing the Decline in Community General Practice

The RACGP has long advocated for making the general practice profession more attractive to medical students. A Deloitte consultancy firm analysis predicts a shortfall of 11,392 full-time equivalent GPs by 2032, highlighting the urgency of this issue.

One of the key demands from the RACGP is for GPs in training to receive parity with their hospital counterparts, including access to study and parental leave. This is a central element of their Federal Budget request.

The report identifies the top factors influencing medical students' choice of specialty: alignment with personal values, the atmosphere or work culture typical of the discipline, and their experience in the specialty as a medical student.

Conclusion

The latest data on medical students' specialty preferences underscores the growing interest in rural generalism and its potential impact on the broader healthcare landscape. While the trend towards rural generalism is encouraging for underserved areas, it also highlights the need to address the overall decline in interest in primary care. Ensuring that general practice remains an attractive and viable career option is crucial for meeting the healthcare needs of communities across Australia. As the RACGP continues to advocate for better support and incentives for general practitioners, it is essential to foster an environment where both urban and rural healthcare settings can thrive, providing comprehensive and accessible care for all.