If you are a Fellow who is passionate about rural surgical training, and have experience and knowledge of rural training networks, and/or of supervision, mentoring, and orientation models and hospital training post accreditation and want to share your experiences with us, please email Erika.Polman@surgeons.org or fates@surgeons.org with your contact information.

Background

Aligned to the development and implementation of the Rural Health Equity: Strategic Action Plan in 2020, RACS has been championing the provision of high quality and safe surgical services to the 29 per cent of Australians and 25 per cent of New Zealanders living in remote, rural, or regional areas. Everyone will be a winner if solutions are provided for local specialist surgical care for the under-served, and often most disadvantaged communities who are already experiencing high health inequities.

The Rural Health Equity Steering Committee and Rural Surgery Section Committee, Chaired by Associate Professor Kerin Fielding and Dr Bridget Clancy respectively, are leading the College’s work to address the geographical maldistribution of specialist surgical services. The numbers are low, with only 12 per cent of RACS Fellows (FRACS) living and working in rural settings, with less than five per cent of surgeons providing rural services. To follow through its commitment and vision, RACS has secured funding from the Australian Department of Health and Aged Care (DoHAC) to conduct research to explore the barriers and facilitators that could reduce this workforce maldistribution in Australia.

The DoHAC funded a Flexible Approach to Training in Expanded Settings round 1 project (FATES 1) is focusing on identifying barriers and facilitators to accreditation in rural settings, i.e. The Modified Monash (MM) 2-7 areas.

For this project, RACS formed a consortium with the Royal Australasian College of Medical Administrators (RACMA) and will use the findings to support the provision of high-quality surgical training in remote central and northern parts of Australia. The key aims of FATES 1 for 2024 are the completion of the research components (literature review and qualitative research findings synthesised) and to develop resources to support both public and private hospitals to overcome accreditation barriers.

In 2023, RACS received follow-up funding from DoHAC for the FATES 2 research project, which will be completed in 2025. For the delivery of this project, RACS formed a consortium with the Australian and New Zealand College of Anaesthetists (ANZCA), Royal Australasian College of Physicians (RACP), Royal Australasian College of Medical Administrators (RACMA), and Royal Australian and New Zealand College of Ophthalmologists (RANZCO). This consortium will research, develop, implement, and evaluate a pilot project of rural training networks in the Northern Territory, with the first Trainees starting in 2025.

RACS, with its consortium partners, is currently undertaking research (literature review and qualitative research) to specifically identify rural training networks and supervision, and mentorship and orientation models that can work in the Australian rural surgical context. In collaboration with Indigenous researchers, RACS will also identify culturally safe pathways for Indigenous surgical Trainees.

Through a series of workshops in 2024, RACS will develop an evidence based Rural Training Model (RTM) for each of the above mentioned areas with key stakeholders.

The RTMs will be implemented and evaluated in 2025. The outcomes of the FATES 1 and 2 research projects will enable RACS to provide a framework that describes how to establish a robust rural surgical infrastructure through a networked system of specialists to reduce the societal costs of not having such services.

Preliminary findings show that having RTMs will increase the capacity for surgical care. We need your help to understand this better. We are collecting case studies that we could integrate into our research findings.