A country practice: How to become a rural GP

When Associate Professor Michael Clements arrives in Karumba, a remote Queensland town of around 500 people, he knows he could be treating almost anything.

"We fly in every two weeks, and it doesn't matter what I'm interested in or what I'm particularly good at. I'm the only doctor there," says Associate Professor Clements, who runs a private GP practice in Townsville and is Rural Chair of the Royal Australian College of General Practitioners (RACGP).

"Whether it's ADHD, menopause, contraception or mental health, we have to treat everything."

It's this variety and autonomy that attracts many doctors to become a rural GP or rural generalist, where limited access to specialists can mean taking on responsibilities rarely encountered in metropolitan general practice.

Why choose rural medicine?

For Associate Professor Clements, the appeal began during medical school placements in places such as Broken Hill and Wilcannia, where he experienced the breadth of rural medicine.

"I learned very quickly that rural medicine was where we got hands on a bit more," he says. "We had a lot more variety, I felt a lot more engaged and connected."

Another attraction is the continuity of care doctors can provide to patients.

Dr Rod Martin, a rural generalist, anaesthetist, obstetrician and President of the Australian College of Rural and Remote Medicine (ACRRM), has experienced this firsthand. He began his career in the small Queensland town of Theodore before moving to Armidale, NSW, where he has practised and taught rural medicine for nearly 18 years.

"It's more of a one-stop shop, and the smaller the community, the greater the responsibility typically is," says Dr Martin.

He recalls caring for a woman diagnosed with bowel cancer during pregnancy. He helped her navigate treatment, provided anaesthesia for her cancer surgery and later delivered her child.

Rural GP or rural generalist: what's the difference?

Rural GPs provide primary healthcare in rural communities, while rural generalists (RGs) undertake additional training in emergency medicine, hospital-based care and advanced clinical skills.

These may include obstetrics, anaesthetics, paediatrics or palliative care, depending on community needs.

"Every community needs a rural GP, but some also need a doctor who can work in the hospital," Associate Professor Clements explains.

A national rural doctor pathway

Australia continues to face a doctor shortage, particularly in rural and remote communities. According to the Australian Institute of Health and Welfare, remote areas have 2.7 full-time equivalent medical practitioners per 1,000 people, compared with 4.8 in major cities. 

The Australian Government's National Rural Generalist Pathway aims to attract, train and retain rural generalist doctors, with state and territory programs providing career guidance and training coordination.

In September 2025, Australian Health Ministers also formally recognised rural generalist medicine as a field of specialty practice within general practice.

How to become a rural GP or rural generalist

The Royal Australian College of General Practitioners (RACGP) and Australian College of Rural and Remote Medicine (ACRRM) offer two main pathways:

• RACGP: The standard three-year program leads to Fellowship of the RACGP (FRACGP), allowing doctors to practise anywhere in Australia, including rural communities. Those pursuing rural generalism undertake an additional year of emergency medicine and advanced rural skills training, leading to the Rural Generalist Fellowship (FRACGP-RG).
• ACRRM: Its four-year program trains doctors as rural generalists from the outset. The standard training program takes four years: three years of Core Generalist Training in rural/remote locations and minimum 12 months of Advanced Specialised Training. Graduates receive the Fellowship of ACRRM (FACRRM).

Financial incentives and relocation support

Funding remains a challenge despite growing investment in rural GP training. Dr Martin says ACRRM has been calling for 500 funded training places per annual intake, compared with approximately 360 trainees currently entering each year.

Both colleges deliver training through the Commonwealth-funded Australian General Practice Training (AGPT) program. Government-funded GP and rural generalist training places are being expanded, with more than 2,000 commencing places planned annually. 

“At the beginning of this year, the government also introduced a $30,000 incentive to encourage doctors to move into primary care rather than remain in the hospital system,” says Dr Martin, who hopes the incentive will also encourage more doctors into rural generalism.

For doctors providing rural primary care and advanced skills, the Workforce Incentive Program's Rural Advanced Skills Stream offers up to $21,000 annually to eligible practitioners in MM3–7 communities, classified according to remoteness and population size.

Dr Martin also highlights the Single Employer Model, which allows eligible rural generalist registrars to retain employment entitlements as they move between hospital and community-based general practice training.

“One of the challenges is that doctors might spend two or three years working in hospitals, accumulating sick leave, long service leave, parental leave and other entitlements,” he says. “Then, when they move into community-based primary care, they can lose those entitlements.”

Other support may include HELP debt reduction, relocation allowances and accommodation assistance.

The realities of rural medicine

While rural medicine offers considerable professional autonomy, it can also mean working with fewer resources and limited specialist support.

Associate Professor Clements describes the need for "clinical courage", particularly when doctors need to make decisions outside their usual comfort zone. “We all joke about burr holes,” he says. “None of us ever want to do a burr hole, but if I'm the only doctor in town and, and a burr hole's needed, then I'll do it, because that's just what I need to do.” 

There's also challenges outside of work, including maintaining boundaries in tight-knit communities.

Dr Martin describes a strong sense of belonging in rural towns, but acknowledges that patients may know where their doctor lives, who their family members are and what they do outside work. 

“On the plus side, I used to always joke that I could drop my wallet down the street and it would be back home before I was,” he says. 

For doctors considering rural practice, starting in a community with experienced colleagues who can provide support and building an ongoing relationship with the local practice can help ease the transition. And protecting personal time and maintaining interests outside medicine are also important for building a sustainable career.

Opportunities for the future

Both the RACGP and ACRRM expect continued demand for rural GPs and rural generalists, particularly as communities face ageing populations and changing healthcare needs.

Dr Martin says a generational shift is changing how rural doctors work, with younger practitioners increasingly looking to share responsibilities rather than work alone.

"We're seeing successful rural generalist towns where there might previously have been one GP obstetrician, but now there are three doctors sharing that responsibility," he says. "That makes the service more sustainable. Doctors are less likely to burn out because they've always got a colleague they can call."

For Associate Professor Clements, there's also an opportunity to involve more metropolitan GPs through regular outreach and telehealth.

He points to a doctor employed by one of his practices who lives in Brisbane, visits a rural community every few months and provides weekly telehealth consultations.

 ”Not everybody needs to be able to put a chest drain in and intubate somebody,” he says. “We just need people that are interested in the community.”

Whether as a rural GP or rural generalist, a career in rural medicine could open the door to a different kind of medicine, and a different kind of life.