Parallel Rural Community Curriculum: is it a transferable model?

BACKGROUND: The chronic shortage of doctors in rural Australia has been well documented. Enabling medical students to undertake positive rural experiences during their undergraduate course is a well-supported long-term strategy to provide a sustainable solution to this problem. The Parallel Rural Community Curriculum (PRCC) was developed by Flinders University, South Australia, in 1997 to enable senior medical students to undertake an entire clinical year based in rural general practice in the Riverland region of South Australia. The academic success of this program has been widely acknowledged. Many institutions are planning to use this model as a basis for their own curriculum reform. However, questions have been asked as to how well this program would translate into another region. Due to the success of the Riverland program, Flinders University decided to commence a second PRCC program in 2002, this time in the Greater Green Triangle (GGT) region of South Australia and Victoria, Australia. This new program was developed collaboratively by the GGT University Department of Rural Health and the Flinders University Rural Clinical School.

RESULTS AND DISCUSSION: The mean student rank improved by an average of 17 places out of a class of 90 students. Partnership development took time. General practitioners (GPs) initially showed significant anxiety particularly in regard to their teaching capacity, time commitment of students and the infrastructure demands on their practices. Specialists' engagement was a challenge, requiring a significant change to their teaching paradigms. Horizontal and vertical integration of teaching was complex and required ongoing effort to maximize efficiency. The community had high expectations of the workforce outcome and these needed to be tempered with realistic expectations about the length of time required to train doctors, and an understanding of workforce mobility.

CONCLUSIONS: The initial evaluation of the GGT PRCC suggests that the Riverland PRCC is translatable. Successes, including student performance, GP acceptance and community ownership have been replicated in the GGT community-based medical education program. A key to the success has been the recognition of the crucial role of partnerships in an environment where, for clinicians, clinical service provision and other personal needs take precedence over teaching roles and responsibilities.