Misconceptions about working as a rural doctor in Australia

For the right person, locum or permanent work as a rural doctor is the best job in the world.

Sometimes known as rural generalists, rural GP or GP surgeons, the role of the rural doctor in Australia is quickly becoming known as an important specialty.

But we’ve discovered that perceptions about rural doctor work, shared as early as med school, put some doctors off considering work as a rural doctor. Some don't explore the option until later in life, often using locuming as a way to ‘dip their toes’ in working and living in remote and regional locations.

For Dr Sneha Kirubakaran, taking an unusual career path has worked to her advantage. Based in Adelaide, she works as a locum rural GP in towns across South Australia and parts of Queensland. But she didn’t set out to become a rural generalist.

Rural doctor misconceptions: being a GP is ‘second class’

“My story is kind of interesting,” says Dr Sneha, “I started training as a general surgeon initially. I thought I did not want to do general practice because I did not enjoy the GP attachment that I had in medical school and also, as a junior doctor, when you are working in a hospital I think general practitioners are given a bum rap by hospital doctors.

“You often get: ‘oh the GP missed the diagnosis’ and a rolling of the eyes, suggesting that GPs cannot be trusted. So, there was a subliminal message given to most junior doctors where if you wanted to be a doctor of consequence you would be a hospital doctor and not a general practitioner.”

Dr Sneha chose (hospital-based) general surgery and initially performed very well. But in her later years, her end of term feedback was hit-and-miss.

“I think the problem was: I was not actually created to be a surgeon. I had erroneously made assumptions about who I was, how I wanted to work and how I worked best.

“When it was clear to me that it was time to leave surgery behind, by then I was so burnt out I decided to look for the quickest and easiest option to get a fellowship.”

General practice was the quickest option. At first, Dr Sneha was worried that she wouldn’t enjoy it, “but by God’s grace, I love it,” she says.

“General practice totally suited me and my personality. It highlighted the best parts about who I am as a human being and allowed me to bring that to my work.”

“I really do blame those hospital doctors that gave me the impression that being a GP would be being a second-class citizen doctor and that influenced those very early choices I made in my career.”

From urban GP to rural doctor

Dr Sneha loved general practice, but wanted to find a way to utilise her many years’ experience in general surgery too. In some states in Australia there’s a category of general practitioners called GP surgeons. She pushed her training body to enable her to do rural doctor placements.

“They sent me to a small town called Jamestown, in rural South Australia. I absolutely loved rural medicine because in urban general practice most things could easily be sent to a specialist or to the hospital down the street. In rural places, you had to go above and beyond what urbans GPs did in their practice. You had the opportunity to do the inpatient work, the opportunity to do the emergency work, as well as the good old general practice work.”

Another stint as an urban GP while completing her PhD made her realise that being rural doctor was her true calling.

“I really felt that rural GP work was value-added medicine. You work much more to the level of a specialist and it was just really interesting medicine.”

Incentives for doctors to work in rural areas

Another misconception that rural doctors face is that the work is more difficult and often round-the-clock.

Rural GP work requires the confidence and experience to know how to balance a lot of responsibilities without taking on too much. An upside to this is that rural doctors are recognised for their additional responsibilities and they are well remunerated.

“There are good financial incentives to being a rural GP. That can be helpful. It’s also well acknowledged that rural GPs don’t have the same sort of collegial support that their urban counterparts have because they cannot access the same courses and that sort of thing. So, the government has poured extra money into allowing rural GPs to get extra leave and be covered by a locum doctor to attend extra courses – and be paid for it.”

Tips for doctors thinking about the rural generalist pathway

Dr Sneha says that there’s a few things to consider before jumping into rural generalist work. Families should carefully consider if rural life will be suitable for the rest of the family. If your spouse can’t find a fulfilling job, or if there’s no suitable schools for your children, rural life might not work for you.

Another good tip is make sure you’re feeling confident and competent. Dr Sneha says that her “detour through surgery” and the years she spent in the hospital system as a surgical registrar have contributed to the confidence and skills she needs to be a rural GP.

“I would highly recommend rural work for junior doctors. Rural medicine is value-added medicine. You get to do all sorts of interesting things that you wouldn’t do if you were an urban GP.

“However, they do need to make sure that they are confident. Rural work does have that extra level of responsibility. It requires that extra level of confidence and competence. You need to feel that you have had adequate training and support, that’s important.

“I feel that the skills I use as a rural GP were not necessarily only given to me in my rural GP training. That should be a consideration.”

Why being a rural doctor rules

“One part of me that was attracted to rural work was an ethos instilled in me by my medical school about social responsibility. So, an ethos that said, in order to provide justice and health equity, you have to go where there is great need.

“So, that was a driving force for me. I didn’t want to go where there were already a thousand other doctors. I wanted to go where there were hardly any doctors because that’s where there was need. That fitted with my ethos of social justice, social responsibility and health equity and sense of service.”