Why filling medical positions in remote areas is such a challenge

While most of us living in metropolitan areas enjoy easy and affordable access to health care, for many living in remote areas it is a luxury they can only dream of. We take a look at why it is so difficult to recruit for medical staff in remote areas of Australia and New Zealand.

Australia has a medical problem. We have plenty of students graduating from universities with medical degrees – in theory enough to ensure the health and wellbeing of every Australian is well managed.

However, theory and reality do not always make for a perfect match and for Australians living in remote and rural areas of our vast country, the struggle to find medical staff who are willing to live and work in areas far from metropolitan centres is expected to remain an enduring problem.

In a February 20, Shortlist spoke with medical recruiters about what they expect the trends and challenges for the sector will be in the next year, and a recurring theme was a shortage of locums for rural and remote areas.

It seems the problem is not a lack of talent to choose from; it’s that the talent wants to stay in metropolitan areas.

In 2017, the Australia Government announced it would be reviewing its Skilled Occupation List. The list includes sectors in the Australian workforce which are experiencing a shortage of local candidates and allows international candidates to work here under strict rules and using specialist visas.

The Australian Medical Association in February 2017 called for all medical occupations to be removed from the Skilled Occupation List saying “Australia has more than enough doctors to meet its long-term needs”.

“A surge in the supply of medical graduates in the past decade means the country is quickly shifting away from its reliance on international medical graduates to plug gaps in the workforce,” the AMA said in a statement at the time.

“With so many future doctors in the training pipeline, policymakers need to put more effort into developing a rural training pipeline, providing sufficient prevocational and vocational training places, and encouraging locally trained doctors to work in the specialties and locations where they are needed.”

General practitioners and a host of specialist medical positions remain on the SOL list meaning, if they meet criteria, they are able to work in Australia. However, this does not address the issue of attracting medical professionals and locums to remote areas.

As an example of the scope and cost of sourcing locums, in the 12 months to March 2016, Tasmania spent $12.2 million paying for fly-in, fly-out locums to work in regional and rural areas, according to an ABC news story.

At the time, Tasmanian Health Minister Michael Ferguson released a statement acknowledging the need to source more locums to fill gaps in the State’s system.

“We are not hiding this issue,” Minister Ferguson said. “Locum usage remains high, particularly on the north-west coast of Tasmania.”


Malcolm Reeve, General Manager of specialist locum and permanent medical recruitment agency Ochre Recruitment, explained that workforce shortages in this sector in rural and remote areas were a common theme between Australia and New Zealand.

“I think primarily it’s a result of the broader urbanisation that has occurred in most developed countries,” Reeve said. “As metropolitan areas have grown, regional, rural and remote locations have become more marginalised, and the services delivered to those locations have contracted accordingly.

“Understandably, many doctors prefer to stay close to the support networks, facilities and services available in cities. Increasingly medical graduates make the decision on their career path in keeping with this trend.

“The solutions that have been prevalent in providing doctors in rural and remote locations – overseas trained doctors and short-term locums – have served a purpose in supporting the medical services to those communities, but at the same time have perpetuated the trend of Australian trained doctors basing themselves closer to cities.”

Reeve said it’s not just an Australian problem for the sector.

“There are many significant differences but there also some consistent themes across both Australia and New Zealand,” he said. “The main similarity I believe is the issue of workforce shortages in rural and remote locations.

“Obviously this presents many challenges for health care provider employers and recruiters supporting the industry in both Australia and New Zealand.

“To date, a lot has been done in both countries from a policy and teaching perspective to address medical workforce distribution issues, but there is still a significant requirement for recruitment of medical practitioners from overseas to help fill gaps.”

What do you think the industry can do to address skills shortages in rural and remote regions?

Did you know RCSA has a membership group, Association of Medical Recruiters Australia & New Zealand (AMRANZ), which represents the interests of medical workforce agencies in Australia and New Zealand? Members work closely with health services to identify and bring together a highly skilled and experienced medical workforce. Subjects similar to this topic are often discussed and workshopped.

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