NT PHN commissioned this focused research and targeted stakeholder engagement to better understand the current trend of declining GP training uptake in the NT including:
- The impact of the NT Medical Program;
- NT training trends vs the national trend; trends and data relating to interstate trainees including, where possible, the motivation of interstate candidates in opting to train in the NT;
- The reasons for the decline in uptake in GP training in the NT including any NT-specific barriers and any national issues that are impacting the NT
- What options could potentially address the decline.
A mixed methods research approach was taken comprising:
- A scoping review of Australian literature
- Medical student, junior doctor, GP registrar and stakeholder semi-structured interviews
- A validation and prioritisation workshop with key stakeholders, utilising modified nominal group technique
The literature revealed scant evidence of the costs, effectiveness and cost-effectiveness of a broad range of potential strategies to increase GP training uptake. In NT the highest priority was to strengthen prevocational primary care training. The two most important actions were to offer additional primary care training opportunities for junior doctors and to select for interest in rural generalism and interest in staying in NT when selecting candidates for (popular) prevocational training positions.
The top strategies in other training stages were:
- Medical School - ensure adequate infrastructure (spare consulting rooms, tutorial space, reliable internet) for students on GP placements
- Vocational Training - offer high quality, culturally sensitive, flexible professional and personal support
- General Practice - use a broader range of funding levers (beyond the Medicare fee-for-service model) to better remunerate general practice and remote generalists
- Marketing - promote positive aspects of NT GP practice (diverse experiences, expedited career opportunities)
The research concluded that medical student and junior doctors’ speciality decision-making processes are complex, multifactorial and change with life and training stages. Strategies to increase GP training uptake must similarly be multi-pronged and target each of the four stages of the training pathway and communication and marketing.
Since different agencies are responsible for the policy, funding and implementation of initiatives across the training continuum, addressing declining NT GP training uptake is likely to require multiple, coordinated strategies across these agencies.
Keys challenges include evolving changes to GP training governance and delivery and the extent to which jurisdictional and national agencies act in concert in order to execute a substantial, multi-pronged and well-coordinated response. Foremost amongst the multiple interventions required is the urgent need to expand primary care training opportunities in the prevocational stage of training beyond those currently taken up in NT.
- Prof John Wakerman, Menzies School of Health Research
- Dr Deb Russell, Menzies School of Health Research
- Dr Devaki Monani, Charles Darwin University
- Dr Priya Martin, Connected Paths consultancy
- Russell D, Monani D, Martin P & Wakerman J. Northern Territory General Practice Training Pathway Analysis. Menzies School of Health Research, Charles Darwin University, Alice Springs: 2020. (Available on request)
The national trend for declining enrolments in GP training is most profound in the Northern Territory (NT) and could spell disaster for the NT’s future GP workforce according to a study by a leading medical research institute.
The study by Menzies, led by Remote and Rural Health Services Research Professor John Wakerman, aimed to determine the factors underpinning the decline in general practitioner enrolments in the NT and how to overcome these issues.
Led by Menzies Professor of Remote and Rural Health Services Research John Wakerman, the study looked to determine the factors underpinning the decline in GP enrolments in the NT and how to overcome these issues.