Rural preferential scheme for internship in NSW

Matt

Emeritus Staff
Emeritus Staff
I'm starting this thread because this is something I'm considering doing next year and it might be useful for me to have somewhere to collect my thoughts and experiences. Especially if I end up doing interviews later in the year it might become a valuable resource.


For NSW graduates, a rural preferential program exists to encourage those with an interest in rural health to spend more of their prevocational training in rural and regional hospitals such as Wagga, Orange, Tamworth, and Lismore. The contract is for two years which is part of the selling point: you get to stay in one hospital for two years without the threat of secondment.

The disadvantage is largely in the lack of clinical support after hours (in Lismore the most senior doctor in the hospital is an anaesthetics resident - not registrar - folllowed by the intern who is first on the scene to any emergencies. Similarly the level of clinical education and teaching for interns is not as good as the major teaching hospitals where this is much more well-established.


My reasons for considering this are largely because I think somewhere like Lismore or Tweed Heads would be a much nicer place to live than the rat race of inner-city Sydney. I'll post more in this thread as I think about this over the next couple of months and look forward to hearing the perspectives of others.
 

chinaski

Regular Member
Devil's advocate:

Why would you sign up for this scheme when you could get the best of both worlds: get a two year contract with an urban mothership network, with the option of rural secondments?
 

Season

Emeritus Staff
Emeritus Staff
Its definitely cheaper out there. Particularly when compared to the nicer parts of Sydney. It could be a good way to save up money for a house/holiday/managed fund. Additionally, things like commutes, and parking are not issues.

For me, I think the biggest drawback would be losing my social support system. I think its something I'd want particularly in the transition from slacker medical student --> adequate intern
 

Matt

Emeritus Staff
Emeritus Staff
Devil's advocate:

Why would you sign up for this scheme when you could get the best of both worlds: get a two year contract with an urban mothership network, with the option of rural secondments?

That's definitely something I've considered and am still considering. I guess part of the reason is that secondments are quite disruptive and two years in the one place would be nice in terms of pursuing interests outside of med e.g. clubs, gyms, etc; being able to rent somewhere for the long-term, and a personal sense of stability and planning.
 

chinaski

Regular Member
I'm not trying to talk you in or out of anything - but I would say that it's quite possible to rent long term when you work in an urban setting with secondments. When you are required to relocate, generally your accommodation is provided, so you just continue to pay rent (or mortgage) at your home while you live somewhere else, rent free. Similarly, it's not impossible to gain stability in so far as outside interests - the main stumbling block is the demands of the job itself (which is universal), rather than geography per se.
 

Matt

Emeritus Staff
Emeritus Staff
That's true, and the demands of the job.... well, basically the hours, I see as a pretty big threat to maintaining outside interests. Part of the issue in the city is commuting both to and from work and to places where my interests are carried out. If I can find somewhere to live that's close to the hospital then that shouldn't be too great a problem.

Season makes a good point about pricing as well. I would really like to live somewhere like Randwick or surrounds because of how close it is to the beach as well as great places to cycle but that would be expensive. Although, on the other hand, UNSW students seem to manage without too much expense so maybe it isn't that bad.
 

chinaski

Regular Member
Once you're actually earning money, it's amazing what you can afford after being a pov student - even moreso if you don't have any ongoing outside expenses (eg children, loans etc). I have paid an extraordinary (read: criminal) amount of rent over the years, and still have managed to save and invest a lot. Nonetheless, regional areas are generally cheaper and more laid-back, no question. I guess it depends how you prioritise your personal life goals and preferences against professional advancement.
 

JeremiahGreenspoon

Regular Member
This is an interesting idea for someone like me who, in spite of the financial benefit of taking the allowance and spending it on rent during a secondment, would rather minimise the shifting of family around if it's avoidable. Plus I would likely not want to be living in a metro area anyway. Is it open to all Aus med graduates or just NSW school grads?

The disadvantage is largely in the lack of clinical support after hours (in Lismore the most senior doctor in the hospital is an anaesthetics resident - not registrar - folllowed by the intern who is first on the scene to any emergencies.

Could this in some senses be an advantage in terms of steep learning curve/thrown in the deep end kind of thing?
 

hildy

Lurker
Devil's advocate:

Why would you sign up for this scheme when you could get the best of both worlds: get a two year contract with an urban mothership network, with the option of rural secondments?

Backdoor way to get to the urban mothership of your choice. Doesn't count for tamworth, but lismore and wagga have links with nice urban motherships that you can get multiple term secondments to.

lismore is a great place to be a registrar. it didn't seem as though the interns there really clicked with the RPR ones.
 

Matt

Emeritus Staff
Emeritus Staff
The current group of interns click very well with rural preferential ones, Lismore is a very friendly place to be an intern or a resident (or a student for that matter). The potential for multiple secondments to POW is interesting but I don't think it's a particularly strong selling point because you will be completing at least 3 out of your 5 terms in your 'home hospital'. It is reassuring however, to know that the rural preferential scheme doesn't preclude you from spending time in bigger urban hospitals. Especially to me, since I haven't spent all that much time in big tertiary hospitals.

I was talking with my registrar again today (we're having a very unusual run of few admissions) and he didn't think the rural preferential scheme would be particularly detrimental to registrar posts in the future, especially as a BPT since these jobs seem to be in high supply. He also thought some recruiting-consultants might see rural preferential students as being more prepared to tackle a BPT through their rural experience but I have trouble believing that. I suspect the people most advantaged in gaining registrar positions are those already working in the hospital. Still it's reassuring to hear this.

More and more I am forming the opinion that the rural preferential spots will be quite competitive as they continue to grow in popularity. I certainly think it would be nice to work in a hospital where you know and are friendly with everyone as seems to be the case in Lismore. Rural preferential interns also get first dibbs on terms within the hospital, athough, of course, all terms will be quite general. This also seems like quite a good thing to me.

Will try to keep you guys posted with my thoughts but my up-and-down decision making is leaning more towards applying for the scheme at present.
 

chinaski

Regular Member
I was talking with my registrar again today (we're having a very unusual run of few admissions) and he didn't think the rural preferential scheme would be particularly detrimental to registrar posts in the future, especially as a BPT since these jobs seem to be in high supply. He also thought some recruiting-consultants might see rural preferential students as being more prepared to tackle a BPT through their rural experience but I have trouble believing that. I suspect the people most advantaged in gaining registrar positions are those already working in the hospital. Still it's reassuring to hear this.

I'm not sure if it's reassuring because I'm not really following what you mean in that paragraph. :huh:
 

Matt

Emeritus Staff
Emeritus Staff
I'm not sure if it's reassuring because I'm not really following what you mean in that paragraph. :huh:

It's not so clear now that I read back on it. My concern is that BPT is conducted through urban networks and that doing the rural preferential scheme may make it difficult to get a job as BPT since you're working outside of those urban hospital-centred networks. My advice is that most hospital networks are crying out for BPTs (the garbage collectors of the hospital system, some say) and that getting a job should not be a concern.
 

chinaski

Regular Member
Basic training is also offered in regional areas; it's not something that's exclusive to urban centres. The problem is getting the inside running on jobs in the high yield hospital networks, which boast a consistent record with exam results and working conditions. In that sense, coming in from the outside would likely be a disadvantage. Nonetheless, med reg jobs as a basic trainee, as you say, are reasonably easy to come by (with the exception of the aforementioned highly subscribed networks). Don't muddle advanced training jobs with basic training - the former tends to be more competitive across the board (and geography does matter more).
 

Matt

Emeritus Staff
Emeritus Staff
I think that point might be where the difficulty lies. For example, my registrar, an advanced trainee, has trained in Brisbane and was discussing with my resident those hospitals (Qld is moving away from a hospital system and toward a network system like NSW, mind) which he thought were the best for exam results. I am, more and more, beginning to appreciate the benefit of such hospitals and I do worry that coming from a regional system might make it harder to get the jobs in the highly subscribed networks. This would be applicable were I to cross the border and head to Brisbane/Gold Coast or if I went back to Sydney.

It's difficult to know how seriously to take something that is two years away and that I'm far from convinced I actually want to do.
 

chinaski

Regular Member
People can and do succeed in the less popular networks, it's just (much, much) easier to get through the exams in a supportive environment. If you want to get into physician training, there's little doubt that you could land a med reg job somewhere, regardless of where you do your prevocational years (though, again, you can start as a PGY2 so would likely start wherever you began as an intern). Nonetheless, as per previous conversations, if you could see yourself happy as something other than a physician, you should seriously consider that as a pathway... so you might be worrying about RACP training for nothing!
 

Matt

Emeritus Staff
Emeritus Staff
People can and do succeed in the less popular networks, it's just (much, much) easier to get through the exams in a supportive environment. If you want to get into physician training, there's little doubt that you could land a med reg job somewhere, regardless of where you do your prevocational years (though, again, you can start as a PGY2 so would likely start wherever you began as an intern). Nonetheless, as per previous conversations, if you could see yourself happy as something other than a physician, you should seriously consider that as a pathway... so you might be worrying about RACP training for nothing!

I agree, and I am taking your advice about RACP training seriously (really I am, I take all your advice seriously :)), but I am also wary of committing myself too early because, lets face it, I don't know what I'm talking about. I feel like the two other most likely options, however, GP regging and Psych regging, aren't things I need to worry about as much in advance. If I do end up committing to med regging, then I might need to be a bit more prepared and have a bit more forethought.
 
Today I went to the GP and thought how lovely it would be to be a GP. Then I thought that lovely was not something I saw myself being.
 
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