Recognition of Rural Generalist Medicine


The RACGP and the Australian College of Rural and Remote Medicine (ACRRM) are working on a joint application for the recognition of Rural Generalist Medicine as a protected title and a specialised field within the speciality of general practice. The application will be submitted to the Australian Medical Council (AMC) and the Medical Board of Australia (MBA).

The intention of recognising Rural Generalist Medicine as a protected title and specialised field within general practice is to support the development, and enhance the attractiveness to trainees of a specific training pathway for this career and develop a workforce that can provide extended services for the healthcare needs of rural and remote communities. It will also make it easier for rural communities, jurisdictions and employers to identify and understand the scope of practice for Rural Generalists.

Additional skills developed and practised by Rural Generalists will be relative to the specific needs of the communities and regions where they work to add value to the current rural health system.

Progress update

Joint-application to the Medical Board of Australia for recognition of Rural Generalist Medicine as a specialist field.


Rural Generalist Recognition Taskforce Progress Update - June 2022

The Rural Generalist Recognition Taskforce has been meeting on a monthly basis since 2019 to oversee the joint-application to the Medical Board of Australia (Medical Board) for recogntion of Rural Generalist Medicine as a specialised field within general practice. It is chaired by the National Rural Health Commissioner, Associate Professor Ruth Stewart and includes senior representatives of the Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM).

The Medical Board has advised of its determination that the ACRRM-RACGP joint application for recognition has established a case to progress to its Stage 2 (detailed) Assessment. This will be conducted by the Australia Medical Council (AMC).

The AMC have appointed Prof Chris Baggoley to chair the AMC Review Panel and it is expected the full panel membership will be confirmed in the near future. The process guidelines are also expected to be confirmed in the next few weeks.

The Commonwealth Government’s Office of Best Practice Regulation (OBPR) has reviewed the application and advised that the process will not be required to incorporate a Regulation Impact Study (RIS).

The Assessment is expected to take approximately 12 months and to involve a national consultation, review of the current status of the specialist field, and further community impact analyses of the proposal. It is expected that the public consultation will be open for around two months and we would encourage all interested stakeholders to take the opportunity to contribute their feedback.

The Medical Board’s overarching process and guidelines can be viewed here.

The Taskforce continues to meet reguarly to prepare for the upcoming assessment and its national consultation and to discuss related issues.

For further information or assistance, please contact the joint-application secretariat at recognitiontaskforce@acrrm.org.au.


Rural Generalist Recognition Taskforce Progress Update - April 2022

The Rural Generalist Recognition Taskforce has been meeting on a monthly basis since 2019 to oversee the joint-application to the Medical Board of Australia (Medical Board) for recognition of Rural Generalist Medicine as a specialised field within general practice. It is chaired by the National Rural Health Commissioner, Adjunct Professor Ruth Stewart and includes senior representatives of the Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM).

The Medical Board has advised of its determination that the ACRRM-RACGP joint application for recognition has established a case to progress to its Stage 2 (detailed) Assessment.

The Stage 2 Assessment will be conducted by the Australia Medical Council (AMC). As this is a new process, the AMC are currently finalising their process guidelines. The Assessment is expected to take approximately 12 months and will involve a national consultation, review of the current status of the specialist field, and further community impact analyses of the proposal.

The assessment may be required to incorporate a Regulation Impact Study (RIS) for the Commonwealth Government’s Office of Best Practice Regulation (OBPR). The RIS makes a determination regarding whether the proposed regulatory change would be of net public benefit.

The Medical Board has made an application to the OBPR to determine whether the Stage 2 Assessment will involve a RIS. Representatives of the Medical Board, the AMC, the ACRRM and the RACGP met with OBPR officers in March to discuss this, pending a final determination.

View the Medical Board’s overarching process and guidelines.

The Taskforce continues to meet regularly to prepare for the upcoming assessment and its national consultation and to discuss related issues.

For further information or assistance, please contact the joint-application secretariat at recognitiontaskforce@acrrm.org.au.


The Rural Generalist Recognition Taskforce has been meeting on a monthly basis since 2019 to oversee the application to the Medical Board of Australia (MBA) for recognition of Rural Generalist Medicine as a specialised field within general practice. It is chaired by the National Rural Health Commission and includes senior representatives of the RACGP and ACRRM. 

  • In November 2021, the MBA sent advice that the ACRRM-RACGP joint-application for recognition had been considered and that the Board had been determined that a case had been established for the joint- application to be progressed to the Stage 2 (detailed) Assessment.
  • Both the process for a detailed assessment of a new specialty and the associated requirements to do this in conjunction with the Office of Best Practice Regulation (OBPR), are new and untested. Meetings have been held with the Australian Medical Council (AMC) and the Commonwealth Department of Health to clarify the impending processes. The Taskforce has been advised that the Stage 2 assessment may take from 12 to 18 months.
  • It needs to be determined whether the process will require a Regulatory Impact Study (RIS) in association with the OBPR. This is a predominantly financial assessment of whether the proposed regulation change would have negative community impacts. The Taskforce is currently working with the MBA to finalize an application to the OBPR to determine whether this will be required.

Other key developments include: 

  • The National Rural Generalist Strategic Council establishment in July 2021. This continues to meet to progress the broader national agenda of the National Rural Generalist Pathway (NRGP). It is chaired by the National Rural Health Commissioner and includes the GP colleges, the Australian Medical Association (AMA), the Rural Doctors Association of Australia (RDAA), jurisdictional health services representatives and other key peak bodies.
  • The National Medical Workforce Strategy 2021-31 released in January 2022. This incorporates the Rural Generalist workforce in its planning and action priorities and includes the Collingrove definition of a Rural Generalist.

The Taskforce continues to meet regularly to progress its application and related issues. 


Background 

  • The Specialist Recognition application process involves a Stage 1 (initial) assessment, and if successful, progresses to a Stage 2 (detailed) assessment and may also include a RIS conducted by the OBPR. More information here.
  • The Stage 1 joint-application was submitted by the two GP colleges to the MBA in December 2019. The application’s assessment was conducted by the Australian Medical Council (AMC).
  • The MBA sent advice in August 2020. This requested another national consultation and further research, actions, and information. An Additional Advice paper documenting this further work was submitted to the MBA in July 2021.
  • Over this time, the Taskforce engaged with key bodies, including all medical specialties, NACCHO and other peak Aboriginal and Torres Strait Islander health organisations, jurisdictional departments of health, medical schools, junior doctor groups and other key health professional bodies to discuss the proposal and its implications.
  • The letters of support received and submitted for the joint-application, included correspondence from representatives of jurisdictional health departments, key medical colleges, Australian Medical Students Association (AMSA) and the National Rural Health Student Network (NRHSN), CRANAplus, medical schools, the AMA, the RDAA, the RDAA Specialists Group, the National Rural Health Alliance (NRHA), the Indigenous Allied Health Australia (IAHA), the RFDS, the National Farmers Federation, and the Australian Local Government Association.
  • For further information or assistance, please contact the joint-application secretariat at recognitiontaskforce@acrrm.org.au. 
 
  • The Rural Generalist Recognition Taskforce was formed in September 2019 to oversee the application to the Medical Board of Australia (MBA) for recognition of Rural Generalist Medicine as a specialist field within general practice. It was chaired by Foundation National Rural Health Commissioner (Commissioner), Prof Paul Worley and included representatives of both general practice colleges. A secretariat was established to support this work.
  • A national roundtable was held in September 2019 which included Taskforce members, the Chief Medical Officer (CMO) Prof Brendan Murphy and representatives of the Commonwealth Department of Health (DOH), the Executive Officer of the MBA, Australian Medical Council (AMC) representatives and other key stakeholders. This provided guidance for the Taskforce on the expectations for the process.
  • The application process involves a Stage 1 (initial) assessment, and if successful progresses to a Stage 2 (detailed) assessment and may also include a Regulation Impact Assessment conducted by the Officer of Best Practice Regulation (OBPR).
  • The Stage 1 joint-application was submitted to the MBA in December 2019. The application’s assessment was conducted by the Australian Medical Council (AMC).
  • The MBA sent advice in August 2020. This did not specify an assessment outcome but requested that further information be provided. From this advice, there was uncertainty regarding the actions and advice that would be regarded as sufficient to enable proceeding to Stage 2.
  • The new Commissioner, A/Prof Ruth Stewart was appointed in September 2020. The Taskforce was reconstituted and reaffirmed its commitment to continue to progress the application.
  • A roundtable meeting was convened on the 9 October 2020 which included Taskforce members and key DOH staff led by Deputy CMO, Prof Michael Kidd. This discussed progress, timeframes, and implications for the NRGP implementation.
  • A meeting was convened of the Taskforce with AMC representatives on 20 January 2021. This provided opportunity for the Taskforce to seek clarity regarding the AMC decision process and expectations. Based on the AMC advice, the key areas of action required were, (1) to undertake a further national consultation, (2) to provide further evidence of RG specialist title’s impact on workforce outcomes, and (3) to provide more detailed analysis of the alternative mechanisms to achieve workforce outcomes without RG specialist title.
  • The Taskforce has been undertaking national consultations since that time. A presentation on the application was made to the Council of Presidents of Medical Colleges (CPMC) on 18 Nov 2020. A follow up letter was sent to all College Presidents which included details of the application and invited further discussions. Similar letters were sent to key stakeholders including to rural and remote community representative groups, medical schools, medical and health professional associations, jurisdictional health services and medical colleges. On request the Taskforce has met with key groups including specialist medical colleges, medical schools, state and territory health departments, and the Northern Territory Health Minister, NACCHO, and CRANAplus. It has received letters of support from peak professional associations including Rural Doctors Association of Australia, the Australian Medical Association, medical colleges, jurisdictional health services, junior doctors and medical students, medical schools, and rural community representative groups.
  • The Taskforce continues to meet to progress its consultations and related issues. ACRRM and RACGP signed a Memorandum of Understanding to reflect their commitment to working together toward progressing the application and the delivery of training in the specialist field.
  • The additional advice report was submitted on 5 July 2021. If the MBA supports progress to Stage 2 (detailed assessment of the proposal) it is estimated to take a further 12-18 months. The level, type and timing of consultation is to be determined by the AMC and possibly also by the Office of Best Practice Regulation (OBPR).

 



Find the answers to frequently asked questions about the Rural Generalist Recognition process

 


A rural generalist is a medical practitioner who is trained to meet the specific current and future

healthcare needs of Australian rural and remote communities, in a sustainable and cost-effective way, by providing both comprehensive general practice and emergency care and required components of other medical specialty care in hospital and community settings as part of a rural healthcare team.


Rural and remote communities offer diverse health presentations and provide opportunities for GPs to expand their skills to support their communities. Rural Generalist Medicine is a specific approach to general practice that is particularly relevant to these rural and remote communities.

Rural and remote settings are characterised by their restricted access to the range of services, staff and resources available in urban centres. Whilst a rural GP is trained primarily in community general practice, a Rural Generalist is someone who has done the rural GP training plus a further year of training in an additional skill that addresses their community need and may involve the provision of secondary care in a hospital environment, while also being skilled to provide emergency services. RGs are trained to apply these services in an effective way given a relatively low resource base, including working in community general practice, local healthcare teams and providing local medical leadership in managing patient support from specialists and resources based in urban centres.

Rural generalist practitioners are a key component of the multi-professional teams that together deliver high quality care in rural and remote communities.


The successful application to have Rural Generalist Medicine recognised as a specialised field within general practice would result in doctors with appropriate rural generalist qualifications, having these indicated in their Ahpra registration within the discipline of general practice.

It is hoped this national formalisation of their qualification status will:

  • enable health service quality and safety and employment systems to consistently recognise and understand these doctors’ capacity and appropriately utilise their skills
  • simplify the processes for training, employment and hospital credentialing for RG doctors (which are currently complex and onerous due to lack of coordination)
  • enable rural patients to better understand the training and capacity of their doctors
  • provide a mechanism for RGs and their skillsets to be counted in rural workforce and resource planning
  • make it easier to promote rural careers as RGs to the next generation


An application for national recognition of Rural generalist Medicine as a specialist field within the specialty of general practice must be submitted to the Australian Medical Council (AMC) and the Medical Board of Australia (MBA) for consideration.

Stage 1 initial assessment of proposal

A proposal is submitted to the MBA, describing the objectives of the proposal in broad terms. The Board seeks the AMC’s advice and based on this advice will determine whether the application is eligible to proceed to a stage 2 assessment.

Stage 2 detailed assessment of proposal (application)

During this stage, the AMC assesses the detailed case for recognition of a new field of specialty practice on behalf of the MBA.

This stage is a rigorous assessment of the case that includes a public consultation process and results in a recommendation being made to the Council of Australian Government (COAG) for final approval which is projected to take around 18 months. This process may also involve an assessment of the proposal by the Commonwealth Government’s Office of Best Practice Regulation.


The Rural Generalist Recognition Taskforce was established in June 2019 to oversee the application process. It comprises the National Rural Health Commissioner as chair and the chief executives, and senior representatives of both general practice colleges including the President of ACRRM and the RACGP Rural Council Chair.

Further information can be found on these issues at:

How can rural generalists improve service provision for rural and remote communities?

Rural generalists (RGs) are trained to deliver an extended scope of services in a rural or remote clinical context either independently or as part of a healthcare team. For people who live in places isolated from city-based resources this scope is critical to providing them with safe, high-quality care. Many of these services are especially important to patients without the social, physical or financial capacity to travel to cities for care, such as the socioeconomically disadvantaged, the aged or people with disabilities. RGs are trained to provide continuing, primary care, as well as care in emergencies, hospital based care and care in other medical specialist areas such as obstetrics, anaesthetics or mental health.

They are also trained in telehealth, retrieval and other systems for working effectively with city-based specialists and specialised services. Rural Generalists and rural GPs often work together as leaders and as part of primary care teams. Both rural GPs and Rural Generalists are important for a strong primary care system.


Yes, the term ‘rural’ is intended to reflect the nature of ‘rural generalist’ training which requires these practitioners to attain skills reflecting the needs of both rural and remote clinical contexts.


Should the Medical Board of Australia confer recognition on Rural Generalist Medicine as a specialist field within general practice, rural generalist’s qualifications would continue to be registered as a General Practice (GP) qualification and as such they would be eligible to practice as Vocationally Registered (VR) General Practitioners and to provide services billable under the Medical Benefits Scheme (MBS).


The general practice colleges have different models for delivering rural generalist training.

The ACRRM Fellowship qualification (FACRRM) is AMC accredited as a general practice qualification and is designed to reflect attainment of the requisite professional standards for the practice of Rural Generalist Medicine.

The RACGP offers the AMC accredited Fellowship of the RACGP which enables a GP to practice unsupervised anywhere in Australia. They also offer a Rural Generalist fellowship which includes strengthened core-emergency training and additional rural skills training.


The two general practice colleges, ACRRM and RACGP, currently provide the training, continuing Professional Development and Fellowship qualifications which the Medical Board of Australia recognises for Vocational Registration purposes for specialist general practitioners. If recognition is achieved, these existing arrangements are expected to continue.


This is the name the Commonwealth Department of Health have given to their commitment to constructing a national framework to support doctors to train, qualify and practice as rural generalist practitioners in a way that is structured and consistent and which enables portability across health services and jurisdictions.

 
 

Enquiries

For further details please contact the Rural team on:
1800 636 764
rg@racgp.org.au

Advertising

Advertising