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Meeting Communique: Moving towards an integrated rural generalist pathway in Victoria

Tuesday 14 August 2018

In attendance at this meeting were representatives from the Australian College of Rural and Remote Medicine (ACRRM), Royal Australian College of General Practitioners (RACGP), EVGP Training (EV), Murray City Country Coast GP Training (MCCC), Department of Health and Human Services Medical Workforce and Rural branches (DHHS) and Rural Workforce Agency of Victoria (RWAV).

The purpose of the meeting was to share information on current rural generalist activities and initiatives and determine the extent that existing programs can support the future workforce needs of rural Victoria.

Creating pathways for rural generalists in Victoria

There was agreement that a renewed focus was needed to attract and retain doctors to rural communities. It was acknowledged each community and/or region within Victoria had specific and at times differing needs, and that these needs change over time.

Creating training and career pathways for rural generalists is gaining momentum. This is being led at a national level by the National Rural Health Commissioner and through initiatives such as the Collingrove Agreement, the future quarantining and funding of 100 rural generalist places in the Australian General Practice Training (AGPT) program, a new AGPT program policy for rural generalists, and greater involvement by ACRRM and RACGP in the selection and management of AGPT.

In Victoria, the Department of Health and Human Services is funding the Rural Workforce Agency Victoria (RWAV) to administer 15 rural generalist posts for registrars on the AGPT program. RWAV also administer 20 advanced rural skills training posts for general practitioners and registrars on the AGPT program. Development of rural generalist pathways in Victoria involves the collaboration and cooperation of all key stakeholders – RWAV, health services, general practices and rural training organisations with on-going support of both colleges.

Scope of practice

It was agreed that a rural generalist is defined as per the Collingrove Agreement i.e. “a doctor is a medical practitioner who is trained to meet the specific current and future healthcare needs of Australian rural and remote communities, in a sustainable and cost effective way by providing both comprehensive general practice and emergency care and required components of other medical specialist care in hospital and community settings as part of a rural healthcare team”.

A rural generalist needs to have specialist general practice qualifications with either RACGP or ACRRM.

It was agreed that the core advanced skills of obstetrics, anaesthetics or emergency medicine make up a rural generalist skill set. To support local needs, advanced skills such as palliative care, Aboriginal and Torres Strait Islander health and mental health are also recognised by ACRRM and RACGP as an advanced skill for rural generalist training.

Improving outcomes for trainees

There was agreement that all relevant medical students and interns in Victoria should be given early opportunities to learn about a career as a rural generalist in rural practice and to register their interest if they have a desire to pursue a rural vocation. Rural retention is more likely for trainees who have completed multiple years of training in a Victorian rural setting. Examples where the majority of training from PGY 1-5 occurs in a rural setting, with the option of temporary rotation/s to a metropolitan setting for specific skill acquisition, are recognised as conducive to positive outcomes. Equally important is quarantining procedural posts for doctors training as rural generalists and in doing so, ensuring sufficient posts exist to meet training needs. Approaches exist to support the nurturing of rural intention in students and interns, and this was acknowledged as an important contributor to a sustainable rural workforce for Victoria. Providing further support in this area would be beneficial.

Creating pathways that lead to employment opportunities

There was agreement that better pathway integration is needed to assist medical students, interns and registrars understand the possibilities that a career as a rural generalist in Victoria can lead to. More work is required to build pathways to employment while retaining existing, already established training posts relevant to rural generalists. Where possible, trainees need to be offered 2-3 year contracts by health services and be given a variety of options and rural settings for acquiring advanced skills. Health services and hospitals should be supported to understand the value of rural generalists for their community and the benefits of future employment opportunities, if flexible pathways for training can be created. Where possible, advanced skills posts should be aligned with community need and future job prospects.

Paramount to improved rural generalist pathway outcomes are:

  • Early identification of suitable trainee;
  • Localised connection, support, guidance and mentoring of the trainee;
  • Continuity of training within a particular region for the majority of training time;
  • Well supported training environment involving senior medical supervision; and,
  • Alignment of program models and funding arrangements at undergraduate, prevocational and vocational levels.

Overcoming challenges

A lack of financial recognition for doctors acquiring and using non-procedural advanced skills in Victoria was acknowledged as a barrier that needs to be addressed if trainees are to be encouraged to acquire these skills. At present, remuneration is at an equivalent specialist rate for emergency medicine, paediatrics, obstetrics and anaesthetics only. To foster attractive and sustainable training pathways, further efforts which boost accessibility of quality teaching and supervision in rural Victoria are required.  Innovative models and remote supervision should be explored. The lack of an industrial framework to underpin GP VMO roles in hospitals was also acknowledged.

With the awareness of rural generalism increasing, and the demand for rural generalist training increasing as a result, it is recognised that the number of Victorian rural generalist posts currently funded may need to increase to accommodate future numbers of rural generalist registrars training under the Commonwealth AGPT program. Without future increase, AGPT program rural generalist registrars will be unable to complete their rural generalist training in Victoria. Losing rural generalist registrars from the state during their training is not conducive to delivering better health workforce outcomes to Victoria. While in training, rural generalist registrars also deliver and support workforce need within their relevant community.

New opportunities

To overcome some of the system challenges in Victoria, it was acknowledged that greater promotion of existing rural generalist pathways for trainees should occur. This could lead to conversations with other rural health services about new models for supporting trainees to acquire the required skills to be a rural generalist. Enhanced alignment between commonwealth and state funding and priorities should be emphasised and new funding secured to create additional training posts that reflect community need. Local level health planning data and workforce data should be more effectively utilised to determine training posts and future employment opportunities.


There was agreement that the meeting had raised awareness of current rural generalist initiatives and explored the potential for new collaborations and strategies to support sustainable rural workforce outcomes in Victoria. It was suggested a follow up meeting in three months be held to progress a number of strategies. In the meantime, participants committed to the following actions:

  • Determine where rural generalists can work in Victoria.
  • Explore further the existing mechanisms for medical students and interns that enable them to receive information about integrated rural generalist training pathways in Victoria.
  • Progress the development of the fifteen current rural generalist posts into a more formalised pathway structure.


Snezana is a Human Resources leader with more than 15 years of experience in management, playing a pivotal role in driving team transformations across diverse industries, including FMCG, automotive, government, and non-profit sectors.

With a curiosity for business and its associated complexities, Snezana fosters collaborative partnerships to cultivate a highly motivated workforce that effectively executes strategic plans.

Msc (Fin), FCCA, FGIA, CA

Shay brings over 20 years of financial
management experience in commercial and not-for-profit organizations. He has a
rich and varied experience in multiple finance and leadership roles in the
United Kingdom and Australia, including CFO, GM Finance & IT, Commercial
Manager Operations, Finance Manager and Accountant.

His extensive leadership experience is
augmented by an FGIA, FCCA, CA, a Masters in Finance and an undergraduate degree in
accounting and finance.

RN, GradDip(Health Promotion), PRINCE2, Mini MBA

Kate is a Registered Nurse highly experienced in health promotion and project management. Her people and program management skills enable her to be agile and adaptable while maintaining an outcomes focus on improving quality access to primary healthcare.

Kate’s extensive experience working with all levels of government, the community and stakeholders across the sector have provided her with insights into the challenges rural communities and health professionals face. Kate has led the design and delivery of many innovative and strategic health promotion and grants programs, supporting better access to health services, health information and activities across communities. Whilst at RWAV, Kate has led the transformation of the RWAV grants program, enhanced the administration of a number of programs and developed the RWAV allied health portfolio. She has also led the development of the RWAV research program of activities.

Having worked at RWAV since 2020, Kate will continue positively influencing the rural healthcare workforce and access to services.

Social Work (BA Hons), DipSW

With a background in social work and a proven record in recruitment, project management, and business development, Jo brings strategic leadership and a wealth of experience in driving positive outcomes within the health, human services, and State Government sectors.

Jo specialises in managing health professional recruitment and outreach programs, including the More Doctors for Rural Australia and 3GA programs. Her focus is on implementing innovative workforce strategies and clinical governance to bolster RWAV’s mission of enhancing healthcare accessibility in rural and regional Victoria.

Having previously excelled at RWAV, Jo spearheaded successful internal change initiatives while fostering strong relationships with external stakeholders. Her efforts consistently align with RWAV’s strategic direction, ensuring a cohesive approach to driving impactful change.

Beyond her professional expertise, Jo’s passion lies in uniting communities and championing positive transformations in rural healthcare in Victoria.

Martin is a governance professional and lawyer with experience in private practice and in-house legal roles. He has been a company secretary for public and private sector organisations across a range of industries including VicTrack, Regis Healthcare Limited and Dairy Australia Limited. He holds Bachelor of Laws and Bachelor of Commerce degrees from the University of Melbourne, a Graduate Diploma in Applied Corporate Governance from the Governance Institute of Australia (GIA) and is a fellow of the GIA.

With a rich background of consulting and in-house people and culture roles with the corporate, government and community sectors, Andrea is responsible for leading the implementation of RWAV’s People and Culture strategy, policies, processes, functions and team.

Andrea has significant experience in leading teams across culture, capability, diversity, equity, leadership, organisational development and learning programs as well as core human resources partnering.

With a strong focus on building and maintaining psychologically safe organisations, Andrea’s team is dedicated to ensuring that RWAV is a place where people can work well and be well at work.


Rosemary has had a varied career as an academic teaching economics, public policy and industrial relations, and as a consultant, advocate, health union official and as a director.

She brings strong governance and strategic skills to the Board, as well as knowledge and depth of experience in health policy, economics and investment.

Rosemary was a Director of Aware Super for nine years, and Chair of the Investment Committee for three years. She was also a member of the Audit, Risk and Compliance Committee, the Governance Committee and the REM and HR Committee. Rosemary is currently a member of the Investment Committee of Cbus.

She was the Secretary of the Victorian Psychologists Association Inc for 20 years and knows first-hand the difficulties in attracting and retaining health professionals in rural and regional Victoria.

Dr Louise Manning is a rural GP Obstetrics trainee practising in Central Victoria where she delivers general practice, obstetric and sexual health services. Growing up in a small town she has lived experience of the difficulties accessing healthcare in rural and regional areas, and is dedicated to advocating for equitable health outcomes regardless of geography.

Louise is also a Board Director of the Rural Doctors’ Association of Victoria.

BAppSci GradDipBus MBus GAICD FIML

John Biviano is an experienced senior executive who has held many senior roles in government (Health Dept) and also in professional associations related to healthcare. Until recently, John was the CEO of the Royal Australasian College of Surgeons, where he oversaw the digitisation of a range of Member offerings, including aspects of training. 

BA (Politics/Philosophy) BEc GDipBus MBA GAICD FGIA

Roger is an accomplished CEO, Non-Executive Director and Chair with experience in the health, human services, law enforcement, education, transport, and environmental industries – across private, public sector and not-for-profit organisations

.He brings strong governance experience, commercial acumen, risk management and strategy skills combined with a passion for innovation and business development having also been Chair of numerous Finance, Audit, Risk, Investment and Community Advisory Committees.


Assoc Prof Phelps has practiced as a Gastroenterologist and Acute Physician in regional Victoria for more than 20 years.

He trained in safety and quality at Dr Brent James’ Institute at Intermountain Healthcare in the US and has held management and leadership roles in Victoria and Tasmania. More recently he completed a two-year project as Director of Clinical Governance for Central Adelaide Local Health Network.

Grant currently works as an independent consultant providing advice to hospitals and organisations on clinical leadership and safety and quality

LLB BSc MMgt (Strategic Foresight) GAICD

As a lawyer and business consultant Jane has worked with company boards and senior management across a range of areas including IP commercialisation, internet-based businesses, healthcare products/services, privacy and data/IT security. Jane is currently general counsel for .id Consulting – population demographers, economists and forecasters.

Jane served as a director of BreastScreen Victoria for 10 years, is a current director of Ballarat Health Services and chairs RWAV’s Governance Committee.

BMed MMedSci FRACGP FARGP FACRRM DipPractDerm DipMedHyp DipFP DipBusAdmin GAICD

Assoc Prof Rawlin is an experienced General Practitioner and medical educator. He is currently in clinical general practice in suburban Melbourne and previously practiced in rural Victoria for 10 years.

Assoc Prof Rawlin is Chair of the General Practice Mental Health Standards Collaborative and a past Chair of the Mental Health Professionals Association and is a board member of the Mental Health Professionals Network. He is also the Medical Director of the Royal Flying Doctor Service in Victoria.
He is a member of the RACGP Victoria Council.

Albert Giorgini is the Senior Advisor to CEO at RWAV.

As an experienced finance executive, with an extensive career in public transport and in the automotive and industrial gas sectors, Albert has honed his skills in driving financial performance improvements with a commercial and business transformation focus.

Through his strategic financial skills, Albert has demonstrated an exceptional capacity to lead and develop large teams in complex and changing environments to achieve the financial and regulatory requirements of the business. His extensive experience has given him a deep understanding of the industry and its challenges, equipping him with the expertise to drive impactful change.

Albert has highly developed communication and stakeholder management skills to support his strong planning, analytical and financial performance improvement acumen, always striving to create innovative solutions that drive growth and success.


Lauren commenced in the role of Manager People and Culture in August 2018 and is responsible for leading the implementation of RWAV’s People and Culture strategy, policies, processes, functions and team.

Lauren’s team is committed to implementing activities and initiatives to support the achievement of RWAV’s strategies and strengthen RWAV’s position as an ‘Employer of Choice’.

Lauren is an experienced Manager and HR professional, with a career spanning the professional services, automotive, defence, and not-for-profit sectors.

BHlthSci(Hons) MPH PostGradDipMgt GAICD AFCHSM

Lauren Cordwell commenced in the role of Chief Executive Officer in August 2023. She took on the role of Acting CEO in April 2023 and previously served as the General Manager since February 2020.
Lauren has leadership responsibilities for strategy, communications, data, stakeholder engagement and program delivery.

Lauren’s team is committed to supporting communities in rural and regional Victoria to have timely access to affordable and safe health care.

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