Rural medical training key to stronger healthcare in First Nations communities

Training doctors in rural and remote communities and embedding First Nations knowledge and leadership in medical education could be key to strengthening healthcare access, building a sustainable workforce and improving health outcomes in communities across Australia, the United States and beyond.

A new paper published in prestigious British Medical Journal (BMJ) and led by Flinders University says that medical schools have a unique opportunity to support healthier communities by preparing future doctors to deliver care that is locally relevant, culturally responsive and grounded in community needs.

Drawing on evidence from Australia and around the world, the paper highlights the benefits of place-based learning and community partnerships, arguing that where doctors train can play a major role in where they ultimately choose to work.

Lead author Professor James Smith, says rural medical education is one of the most effective ways to strengthen healthcare in regional, rural and remote communities.

“Where someone lives should not determine the quality of healthcare they receive,” says Professor Smith, a Matthew Flinders Professor (Health and Social Equity) and Co-Director of the FHMRI Health Equity Impact Program at Flinders University.

“We need to continue building opportunities for doctors to train in rural and remote communities and ensure they are equipped with the skills, relationships and cultural understanding needed to thrive in those settings.”

The paper points to Australia's investment in rural medical education over the past two decades as evidence that targeted training programs can deliver real benefits.

Between 2016 and 2018, more than 30 per cent of government-supported medical students spent a year or more at a rural clinical school, while graduates with substantial rural placement experience were significantly more likely to enter rural medical practice.

“When students spend meaningful time living and learning in rural communities, they develop a deeper understanding of local health priorities and are more likely to build their careers in those areas,” says Professor Smith.

Co-author Associate Professor Emma Kennedy AM says successful healthcare is built on strong community connections.

“Healthcare is about more than treating illness, it is also about understanding people, families and communities. Rural medical education is at its best when future doctors learn alongside the communities they will one day serve.”

The paper says reconciling and recognising First Nations sovereignty is critical to advancing health and wellbeing outcomes, and calls on medical schools to increase support for First Nations students, strengthen opportunities for First Nations leadership, and embed cultural safety throughout medical training.

Co-author, Professor Jaquelyne Hughes, a Torres Strait Islander woman (Wagadagam) says First Nations perspectives are essential to building effective healthcare systems.

“Communities hold valuable knowledge about what works for their people,” says Professor Hughes.

“When First Nations voices are included in education, research and healthcare delivery, we create stronger systems that are more culturally responsive and more effective for everyone.”

The authors also highlight the importance of encouraging more students from rural backgrounds to pursue medical careers, noting they are often more likely to return to regional and remote communities after graduating.

Professor Smith says investing in rural medical education is ultimately an investment in healthier communities.

“By investing in rural medical education and listening to communities, we can build a stronger workforce, reduce health inequities and improve health outcomes for future generations.”