The College’s Connection with the Integrated Rural Training Pipeline

The Integrated Rural Training Pipeline (IRTP) was established in 2015 as part of the Specialist Training Program (STP) in an effort by the Department of Health to extend vocational training for specialist registrars into settings outside traditional metropolitan teaching hospitals, including regional, rural and remote and private facilities. The aim in creating the IRTP is to help build a sustainable Australia-trained future workforce for regional, rural and remote communities. The College now fills four IRTP training posts within Victoria and Queensland, Australia, with a fifth position expected to commence in Queensland in 2022. Training sites need to meet different eligibility requirements to the traditional STP model to participate in the IRTP. Namely enabling a trainee to complete the majority of their training—two thirds—within a rural or regional location and making sure that the trainee selected has shown a real commitment to working rurally or regionally post Fellowship.

In the second of a series of articles about the rural training pipeline, we hear from trainee Dr Andrew Van and Kade Joske, previous Regional Manager I-MED Regional Pty Ltd (Gippsland, Latrobe Regional Hospital Traralgon). Dr Van commenced his training at the site in 2018, as one of the College's first IRTP trainees, and will undertake his final year in the program in 2022.

The training site perspective

At the time I'm fairly certain we were the first in Australia to establish an IRTP radiology training position, so we had to design it from scratch.

To get the program up and going, the first step was to look at the training requirements to ensure these could be met. It became clear on review that we would have to partner with The Alfred if our program was going to succeed.

As such, Mark Simpson, now General Manager Government Relations and External Partnerships, Dr Mohit Gupta and I met with the Director of Training and Operations Manager at The Alfred to see if they could and/or would partner with us. Also to talk about how the program might be structured and to find out how they go about recruitment.

Once we finalised how the program would look, we utilised the I-MED recruitment team as well as The Alfred and the Department of Health to advertise our position on the platforms they use. We had a great response of up to 80 applicants. All applications were reviewed and those who best met the requirements for rural practising and prior training were shortlisted. Eight shortlisted applicants were asked to attend an interview, from which a candidate would be chosen.

To select the final candidate, each applicant was ranked on who was best qualified to begin a radiology training position based on their experience, and most importantly, on their commitment to regional practice (ideally working and living in Gippsland long term). As a requirement of the appointment, as well as a main purpose of the program, this was to ensure medical specialists, in our case a radiologist, would stay living and working in the rural community post Fellowship.

As a result, Dr Andrew Van was offered the position and I'd like to think it has been a positive experience for I-MED and for Andrew.

The trainee perspective

Are there any advantages in your opinion of training at a large regional hospital compared to a metropolitan hospital?

The biggest advantage is the breadth of cases you come across; the rural patient population is diverse with many presenting to radiology without any prior imaging. As a registrar you can therefore provide great value to the referring doctors and have a direct impact on patient health. There are plenty of feelgood moments as patients are especially thankful for being able to access high quality specialist services without having to travel to Melbourne.

Are there any disadvantages in your opinion of training at a large regional hospital compared to a metropolitan hospital?

Regional work is especially busy, and with fewer specialist staff on site there are fewer opportunities for ad-hoc learning. Self-directed learning is crucial to the IRTP training success, and as a solo registrar you miss out on the rivalry that pushes you through the grind of textbook reading and exam practice.

Is there anything you think that the site is doing in the IRTP training post that is of particular help to you in your training?

I-MED is very receptive and approachable, happy to re-work rosters and worklists so that you can have the best training experience possible. Whether it's for Melbourne based lectures/classes, conference/ examination leave, or roster changes for metro rotations, there have been no logistical issues. The subspecialised radiologists, both on and off site, are very helpful; some will share both interesting and/or examination cases to you (shout out to Dr Andrew Kong over in Wodonga).

What advice would you give to a trainee commencing training in an IRTP position?

Keep in touch with your metro or other IRTP colleagues; the camaraderie and rivalry will push you through the sometimes very gruelling training. Trust the process and you'll make it through to the other side!

What would you recommend to get the most out of this type of training experience?

Set yourself short and medium term goals for both learning and College requirements. Being out in the country on your own it's easy to lose track of the hurdles along the way but you'll be able to chunk through it all if you keep organised and plan ahead. What advice would you give a hospital/practice looking to start an IRTP position? In return for an enriching specialist training experience, the IRTP registrar can provide direct and indirect benefits by assisting with workloads; from procedural work to being the first point of contact with hospital staff. That said, the registrar education and training as well as the staff work environment will directly contribute to the likelihood of a candidate wanting to work with the organisation in the future. If well addressed however I think an IRTP position will be a fantastic opportunity for all involved.

A few facts about Gippsland

Stretching from outer Melbourne to the eastern-most point of Victoria, Gippsland has a population of just under 300,000 with health care and social assistance, retail trade and construction constituting its three largest employing industries.

The area’s natural features are many and broad-ranging from mountains to coast and it is home to the rich diversity to be found within no fewer than 14 national parks.

As of January 2022, students at Federation University Australia’s Gippsland campus will have a direct pathway to study medicine locally at Monash University’s School of Rural Health, following the launch of a new degree. The universities are partnering in an effort to improve health outcomes for the region and strengthen the future of the local health workforce by developing the three-year Federation University Bachelor of Biomedical Science (Gippsland Partnership Program).

The degree will be offered from semester one 2022 and enable Gippsland students, subject to entry requirements, to be eligible to apply for graduate entry into Monash University’s Bachelor of Medical Science and Doctor of Medicine program at its School of Rural Health, which is co-located with Federation University at Churchill.

More Information on the Australian Government Department of Health Specialist Training Program

The STP aims to positively influence future workforce distribution and quality. In 2010, the STP became the single Commonwealth grants support program for specialist training in Australia. The program now encompasses three complementary streams:

Specialist Training Placements and Support

Integrated Rural Training Pipeline - STP

Training More Specialist Doctors in Tasmania (Tasmanian Project)

The College administers funding on behalf of the Department for training posts across all three initiatives in clinical radiology and radiation oncology. Colleges receive a set allocation of training posts under individual agreements. Training sites must apply for the program through an Expression of Interest process, which is managed by the Department in conjunction with each state jurisdiction and colleges. Successful posts are placed on the College’s reserve list and must be accredited to fill vacant positions.

The College currently has 27 clinical radiology regional training sites (15 posts filled 1 FTE and 5 posts shared with public metropolitan sites are STP funded) and 14 radiation oncology regional training sites (10 posts are STP funded).

To find out more about the program and funding opportunities, please contact the STP team at STP@ranzcr.edu.au.

Reference

1. Australian Government | Department of Health | Specialist Training Program: https://www1.health. gov.au/internet/main/publishing.nsf/Content/workspec