Melbourne University third-year medical student Lily Corboy is - in at least one important respect - something of a rarity.
Unlike most of her contemporaries, Ms Corboy has her heart set on a career in rural or regional clinical practice - something which probably owes to her strong Ballarat connections.
"It does sound sort of snobby, but I just really like people from regional Victoria and living in regional Victoria," she said, adding, "nothing against city people".
Ms Corboy is part of a cohort of 50 medical students who, throughout the year, will complete some or all of their clinical training at the Melbourne University Ballarat rural clinical school, which offers an enviable range of rotations through Ballarat Base Hospital.
Like the Ballarat clinical training programs offered through Deakin University and Notre Dame University, one of the objectives of the program is to expose students to the richness of regional practice in the hope the experience might entice students to return to regional areas upon graduation.
"There has been research which shows that students who study in regional areas are more likely to stay in regional areas to work because they know what services are available," Dr Abhishek Mitra said, who is the co-deputy director of medical student education in Ballarat.
"In contrast, most students who've done their training in the city have misconceptions about what happens in regional hospitals, where the medicine is actually a lot more interesting because of its diversity."
It's a view shared by Karen Price, president of the Royal Australian College of General Practitioners, who said there had long been an "obvious maldistribution" in the number of medical graduates willing to practice in regional areas, which had given rise to chronic doctor shortages across regional communities.
"About 50 per cent of rural doctors are international medical graduates because that's the only way we've been able to meet the healthcare needs of rural communities," Dr Price said.
"We know one way of getting people to practise in rural areas is to expose them to rural clinical schools early, which is why these programs are so important."
Part of the difficulty in attracting medical practitioners to the regions, Dr Price said, stemmed from the reality many students were now completing postgraduate medicine courses, meaning they were generally older and thereby based their career choices with a view to their wider family needs.
"The average age of trainee GPs in one of our regional training organisations was 34 and often they already had children," she said.
"So, the chances of attracting a doctor to a regional area and retaining them really depends on whether they can envisage a life there for themselves and their family."
Notwithstanding the merits of regional clinical training models, however, there is increasing concern they - much like their metropolitan counterparts - focus almost exclusively on hospital or specialist training to the detriment of general practice.
Fewer than one in five final year medical students over the last decade chose general practice as their first preference, despite general practitioners accounting for 30 per cent of the medical workforce.
And, as of 2020, for every newly qualified general practitioner, there were 10 newly qualified specialists.
Meanwhile, unfilled general practice rural training places also increased to 30 per cent in the same year, up from 10 per cent in 2018.
Dr Price said the bias towards specialisation and hospital training was exacerbating the nation's GP shortage, with the impact felt most acutely in regional and rural communities.
"We are in danger of running out of general practitioners and that's partly because there's been a lack of exposure to general practice as an exciting, valued and viable career," she said.
"[The RACGP] is advocating that all doctors, regardless of where they end up, should have exposure to the demands of general practice."
The growing crisis comes at a time when demand for generalist care, courtesy of the pandemic, has never been greater.
Dr Price said a failure to properly invest in general practice and "rebalance" it against specialisation would, over time, markedly alter the nature of healthcare in Australia.
"Funding for general practice is less than eight per cent of the total health expenditure in Australia and it's been declining, which is a national tragedy," she said.
"If the [GP shortage] crisis worsens, we will ultimately end up with more of a US-style health system, where the care is provided in the hospital and the cost, both economically and for patient outcomes, is enormous."
In 2019 a report by Deloitte projected a shortfall of nearly 25 per cent of the GP workforce by 2030; a figure, Dr Price said, probably concealed the true scale of problem, given its calculations were based on pre-pandemic conditions.
A Senate inquiry into problems associated with the provision of general practice care in metropolitan, regional and rural areas is currently on foot and is taking submissions.
