WHEN Australia faced a national doctor shortage crisis 20 years ago, it embarked on a policy of national self-sufficiency. 

With 10 new medical schools established over the intervening years, metropolitan Australia now enjoys a reliable supply of locally educated, locally trained doctors. 

But the story is very different in rural and regional communities across the country. 

Nine of those 10 new medical schools were located in metropolitan areas, and over this period our rural and regional communities have continued to suffer doctor shortages and reduced access to necessary care, which has resulted in increased rates of chronic disease and lower life expectancy. 

When devised, the policy was envisaged as the foundation of a reliable pipeline of new doctors for rural and regional practice but a recent report showed  the most notable result has been an oversupply of doctors in our cities.

At the time these policies were developed, we understood very little about the factors that influenced medical students to make the decision to work rurally.

The research suggested that recruiting more ‘rural’ students and exposure to rural practice would be enough to solve shortages. We now know this is not the case. 

Selecting students from rural and regional Australia, who also intend to practice in rural and regional Australia, is one. 

Educating and training students in rural and regional Australia, with a medical curriculum specifically designed for the work they will encounter, is another. 

But with the exception of James Cook University, the one and only rural medical school in Australia, this is not what happens. 

In a major recent study, approximately 60 per cent of rural medical students sent to a metropolitan medical school expressed a preference for rural practice when they started their study. 

By their final year, this number stood at just 10 per cent. 

At James Cook University, this intention to practice in rural areas actually increased during the same period: from 68 per cent to 76 per cent. 

The experiences of Charles Sturt University have reinforced this. 

Seventy-five per cent of our students studying health-related disciplines are from rural areas. 

By educating them in rural and regional Australia, 85 per cent of our graduates subsequently live, work and make their life in a rural or regional community. The same is true of La Trobe University. 

Our two universities have been advocating on behalf of our communities for a rural medical school for the Murray Darling Basin for years. 

Under our proposal, four out of five students will come from a rural, regional or Indigenous background. 

This means more opportunities for students from Orange, Wagga Wagga, Bathurst and Dubbo to become doctors.

Yet the NSW Medical Students’ Council opposes this new school.

Why? Because even if they were initially interested in rural or regional practice, the medical schools’ own statistics show that the current system will have switched the majority of them off. 

Our school reflects the model of self-sufficiency championed 20 years ago to help create more doctors for the bush. 

We’re hopeful that the medical school places assessment will provide the foundation for a rural medical school to be established in our communities. 

Though we eagerly await assessment findings, due next year, we believe the evidence supporting the MDMS solution is clear. 

It’s time for the city elites to start listening to rural and regional communities. 

Then, it’s simply a case of political courage to implement a solution that will deliver for all of Australia.