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Virtual Supervision of Rural GP Trainees shown to be effective

Updated: Nov 2, 2023

When Armidale GPs Maree Puxty and Terry Bolshen decided it was time to retire they had a problem - there was no-one suitable to take over their practice. With chronic shortages of doctors in rural and remote communities, there was little interest from potential buyers.

With other practices in town facing similar challenges, there was no-one in a position to take responsibility for the 6,000 patients at the West Armidale Medical Centre, meaning that around one fifth of the population of Armidale would be without a doctor.

This is when the Healthy Communities Foundation Australia stepped in to buy the practice from the outgoing GPs to ensure that 6,000 residents of Armidale could continue to receive quality primary health care.

Partnering with the Royal Australian College of General Practice (RACGP), the Foundation established the first mainland trial of virtual clinical supervision for rural GP Registrars. Under the model, senior GP registrars can work in Armidale under the supervision of a GP located in another location.

The Foundation CEO said: "The reality is that we need new models of supervision for rural trainees to break the back of the rural doctor crisis. All the doctors that used to provide clinical supervision in rural and remote towns have retired or left practice. This means we will soon be unable to train any doctors in rural and remote practice without fundamental changes to our approach to training.

"We were thrilled when the RACGP decided to take the leap into virtual supervision. The fact is that virtual supervision is far superior in our view to the traditional on-site methods of supervision.

"With virtual supervision trainees have immediate access to a senior GP when they need it, rather than waiting for a senior GP supervisor to have time to provide advice which we know in a busy practice often doesn't happen.

"Virtual supervision also means you have an auditable trail from the phone and video records to make sure that supervision is actually being provided in accordance with the requirements and for patient safety.

"Our aim with the trial was to evaluate whether virtual supervision was appropriate for Registrars, would assure quality care for our patients and could address the current shortage of training opportunities in rural areas" said Mr Burdack.

Dr Dan Mastroianni took up the opportunity to train in Armidale in this innovative remote supervision program.

Taking up a 6 month placement, Dr Mastroianni (or Dr Dan as he was affectionately known to patients) saw patients at the West Armidale Medical Centre while the former GPs from the practice provided supervision.

Dr Mastroianni said the whole experience was fantastic.

He told the ABC: "I .. feel really supported through the process and know [my supervisors] are just a phone call away."

"It's been initially overwhelming, but also quite heartening as well, just seeing how appreciated I am within the community and how much difference it does make seeing a doctor face-to-face."

"This has opened my eyes to training in a rural environment and I don't see any reason why I wouldn't expand those horizons."

In an interview for GP News Dr Mastroianni said: "The orientation has been fantastic. From the moment I first messaged [to apply for the registrar role] I have felt looked after".

Dr Mastroianni was full of praise for the staff at the Foundation and West Armidale Medical Centre who supported him throughout his time in Armidale.

The Foundation CEO said: "The trial surpassed our expectations, and our patients were full of praise for Dr Dan. It shows what can be done when the health system focuses how to get doctors into rural areas to meet the needs of rural communities.

"The Foundation is now recruiting a new GP Registrar for Armidale, and is talking with the College about how we can work together to address the backlog of international doctors who are desperate to work in rural practice, but who are currently unable to do so because of a lack of virtual supervision options for these experienced practitioners".



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