Aotearoa’s GP shortage won’t be fixed by doing more of the same. This paper argues for a bold, socially accountable, fully distributed medical programme that trains students in the rural and provincial communities that need them most.

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Abstract

Aotearoa New Zealand faces an ongoing shortage of GPs (family physicians), disproportionately affecting rural and underserved communities. Although this issue is global, solutions must be context-specific. Traditional medical education pathways in New Zealand have not produced a workforce representative of or committed to serving these populations. This has created a situation where primary health care is increasingly difficult to access, particularly for rural and marginalised communities, with inevitable consequences of poor health outcomes and increased secondary care utilisation. Social accountability as a basic principle of undergraduate medical training has been suggested since the 1990s as a method of solving some of these issues. Distributed learning with a significant portion of experience and training in rural and provincial community primary care practices as well as utilisation of rural and provincial hospitals, embedded within a socially accountable framework, offers an innovative model of medical training. This short communication outlines the rationale for and structure of a proposed new graduate-entry, 4-year medical program in Aotearoa New Zealand that emphasises rural and provincial community-based training. We argue that this model is both urgently needed and potentially generalisable to other nations grappling with similar workforce inequities.