The provision of general surgery in rural Australia: a narrative review

Abstract

Summary Rural surgery is most commonly provided by general surgeons to the 29% of people (7 million) living in rural Australia. The provision of rural general surgery to enable equitable and safe surgical care for rural Australians is a multifaceted issue concerning recruitment, training, retention, surgical procedures and surgical outcomes. Sustaining the rural general surgical workforce will be dependent upon growing an increased number of resident rural general surgeons, as well as changed models of care, with a need for ongoing review to track the outcomes of these changes. To increase recruitment, rural general surgical training must improve to be less stressful for trainees and to be incorporated alongside a rural‐facing generalist curriculum. Rural general surgical outcomes (excluding some oncology conditions) achieve comparable results to metropolitan centres. Access to, and outcomes of, surgical oncology services continues to be inequitable for rural Australians and should be a major focus for improved service delivery.

Association between rural exposure/experience and practice location 10 years postgraduation, stratified by specialty: evidence from a cohort study of graduates from nine Australian universities

“…Between PGY5 and PGY10, there was a net increase in non-metropolitan practice, mainly due to non-GP [18][19][20] Rural sites may need to think outside of the normal structure, such as taking more of a regional hub (or network) approach in order to meet many of the training requirements. These results highlight the importance of nonmetropolitan-based vocational training opportunities for non-GP specialties to address the specialist shortage in regional and rural areas.…”