Have you worked in a regional or rural area? Are you planning a career in remote medicine?
Many believe all doctors should try out rural medicine at some time during their careers.
Some understanding of the conditions and resources available to your rural colleagues will give you a far better ability to coordinate patient care in the future.
Why Work in Regional or Rural Medicine
There are many benefits to getting out of the big city.
There is of course a huge difference between regional, rural and remote. Regional towns have most amenities of big cities, with reasonable transport links and often large hospitals.
Rural and remote towns can be an hour drive to a big city, or an RFDS flight away from anything resembling a large centre.
There is usually lots of clinical variety in a more rural setting. Junior doctors get to step away from administrative duties to assess and treat, as well as practice procedural skills.
There is more independence and autonomy on offer. Although still supervised, a rotation in rural medicine is a good opportunity to practice stepping up.
Local communities in smaller town often have a buzzing social calendar that compensates for the lack of expensive entertainment and retail.
Rural doctors often enjoy the closer relationships and mentorship with senior medical staff, and a deeper connection with the local community.
Many of these regional and remote locations are in stunning areas. If you’re more into hiking and waterfalls than lattes and nightclubs, you will find plenty of entertainment on days off.
Check out this rural doctor post about remote medicine from beautiful Thursday Island.
Financial Benefits of Regional or Remote Medicine
Most professionals outside medicine are paid significantly more to work in the big centres of Australia. Sydney and Melbourne are the place, but suffer a very high cost of living.
Doctors are needed everywhere in Australia, with smaller towns often having difficulty recruiting and retaining skilled staff.
Many specialties have the option of metropolitan or a regional centre, and general practitioners can obviously work wherever they like.
The pay for a GP or more general specialist (general medicine, anaesthetics, emergency, general surgery) is not necessarily less in a regional or rural setting.
In some circumstances, doctors can be rewarded with more pay as an incentive to leave the big smoke to work in a smaller centre. Skilled doctors often feel more appreciated in smaller locations.
The difference in cost of living between big cities and regional or rural areas is an important factor to consider.
The largest expense in most households is housing. Transport and food are runner up expenses for Australian households. Reducing the amount a household spends on the three biggest expenses is one of the most powerful ways to build financial security and eventual wealth.
Accommodation purchase prices and rentals tend to be dramatically cheaper in smaller cities and towns. The median house price in Sydney is over 1 million dollars!
Even at our current record low interest rates (3%) the mortgage repayment for the median house (100% Loan to value ratio) would come to ~ $4226 per month! A mortgage for $500,000 would currently cost you around $2116 per month, leaving over $1000savings monthly to invest. Some locations may even subsidise accommodation.
The caveat to this is that houses in regional and remote areas may not benefit from the same capital growth you can expect from a carefully selected capital city property. A house purchase is a massive financial decision, with long term consequences. Consider carefully whether your location is a good place to purchase a property, and whether renting, or rent vesting may be a better option for you.
Commuting Time and Cost and Groceries
Traffic in smaller cities and towns tends to be far less severe than that in the big cities (although locals everywhere will still moan bitterly about horrendous traffic)!
Coming from Sydney or Melbourne, you will usually find a far shorter commute and hours of time freed up a week as a result. With a far shorter commute (or a bike ride), travel costs are also significantly reduced, and more importantly time freed up for more important hobbies.
Food can, however, be significantly more expensive in rural (not so much regional) towns.
When is the Best time to Try Regional or Remote Medicine?
As A Resident Medical Officer
By PGY 3, most junior doctors are into the groove of hospital medicine, becoming more independent and considering stepping up to registrar.
A rural rotation at this point, in my opinion, is a fantastic opportunity to practice stepping up in a location with lower acuity patients.
This will allow a doctor to take on more responsibility and develop independence in decision making. These are skills crucially required for working as a registrar, many would agree the most difficult transition in the journey to specialisation.
If your single, without dependents it is obviously a lot easier to move around than to uproot a young family. Early in your career is a great time to indulge that inner travel bug and see more of this great country (once COVID-19 restrictions lift)!
Trying rural medicine at this stage also provides opportunity to change careers if you fall in love with living and working outside of the city, before you have wasted time and money on exams.
As a Registrar
Life often gets pretty serious as a registrar, with postgraduate exams, increased responsibility and often marriage and babies often mean not much sleep between night shifts!
Life may be too busy to fit in a move, but if you get the chance an opportunity to work in your regional network before starting as a consultant, it will give you far better insight into the conditions and resources available to your rural colleagues, allowing you to provide better advise, coordination and education.
Doctors often take time out of training to travel and locum around Australia. This is a wonderful opportunity to see more of this enormous and varied country, and check out some regional and rural medicine along the way.
Accommodation and travel expenses to the work place will usually be covered, allowing long stretches of time without accommodation costs.
I have little doubt that anyone who undertakes a year of adventurous work doesn’t have an amazing time, meet lots of new friends and develop into a better doctor as a result.
The term “Geographic arbitrage” means moving to a different location to take advantage of lower costs of living. It’s why so many retirees move to countries like Thailand, Bali and South America.
But it doesn’t have to be an international move. Many older Sydney residents have benefited from the property boom over the past 20 years. Many have sold up to relocate to cheaper towns, freeing up plenty of equity to retire in luxury with.
So even if you want to become sub-specialised and want to enjoy the career and research opportunities the tertiary centres have to offer, geoarbitrage can be something you utlise at the end of your career.
How to get into Regional or Remote Medicine
Almost all hospitals are linked to a regional network, and often organise rotations out to rural hospitals from their junior doctor pool. These rotations can be very popular, so express interest early.
Locum agencies are advertising work opportunities all the time, mostly for regional centres and rural towns. There are several such agencies, “Locum Doctors Australia” is a facebook group you can join and ask for agency recommendations.
Regional and rural medicine offer great opportunities to develop skills, increase responsibility and see more of Australia. As an added benefit, pay can be excellent with far lower cost of living than in the major capital cities. This kind of geographic arbitrage is a powerful lever to pull in order to accelerate your journey to financial freedom. It would be a shame to miss out!