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From a broom cupboard: 20 years of rural health at Monash University

Ch 01. The early years

Initial vision and foundation

Professor Roger Strasser

After graduating from Monash in 1977, I completed an internship at Prince Henry’s Hospital and then undertook general practice training before travelling to the United Kingdom where I met and married Sarah. We then moved to Canada where I undertook academic training at the University of Western Ontario and Sarah completed her general practice training. For me, the evolution of the School of Rural Health at Monash University began in late 1985 when Sarah and I moved to Gippsland from Canada and joined the Moe Medical Centre group practice.

In 1986, I took on the role of regional coordinator for the Royal Australian College of General Practitioners Family Medicine Program in Gippsland. Based on my experience in Britain and Canada, I encouraged the local hospitals and GPs to support the introduction of a Gippsland regional GP training program which would allow medical graduates to undertake all their GP training in the Gippsland region. To my disappointment, relatively small numbers of new graduates signed on for the regional program. This experience started me on the pathway which I am still following. I was very much enjoying life as a rural practitioner with many colleagues, but they were never sufficient in number. When I reviewed the literature and undertook research myself, I realised that the shortage of rural doctors was a problem that began in medical school or even before. Essentially, there were then very few medical students who came from rural areas, and rural practice was seen by the city-based senior medical school teachers as a career for those who could not succeed in other branches of medicine.

Through the late 1980s, rural doctors’ associations in each Australian state were established and began pushing for new initiatives to overcome the chronic shortage of rural practitioners in all parts of Australia. In February 1991, the first National Rural Health Conference was held in Toowoomba, Queensland, and I was one of the invited participants. From this conference emerged Australia’s first National Rural Health Strategy which included recommendations that all undergraduate professional education programs should require appropriate experience in a rural setting, and that regional hospitals should have a role in undergraduate education. To facilitate these recommendations, the strategy proposed the creation of academic departments in regional centres, which would also provide a better regional focus for continuing education, allowing rural practitioners a role in education, reducing professional isolation and creating a pool of locums.

Meanwhile in Gippsland in 1991, the process began of amalgamating the hospitals in Traralgon and Moe to form Latrobe Regional Health. The new hospital was to have a budget comparable with the Box Hill Hospital in Melbourne, and the Latrobe Regional Health leadership was attracted to the idea of hosting an academic unit. Seeing the opportunity, David Birks, a surgeon colleague at Moe Medical Centre, and I prepared a submission which was presented initially to Monash as part of a review of the Department of Medicine at the Alfred Hospital. David and I had worked together previously in 1989 to introduce a three-week rotation for Monash final year medical students to the hospital in Moe. This arrangement was supported by Paul O’Brien, then chair of surgery at the Alfred Hospital in Melbourne. In a sense, this three-week rotation was a sign of things to come. Prior to this, the only rural exposure Monash students had was four weeks in rural general practice, also in final year.

The dean of medicine at the time, Professor Bob Porter, was supportive of the proposal which was to establish a Monash University rural health academic unit at Latrobe Regional Health. This was different from the rural training units attached to regional hospitals of the time because of the university undergraduate medical education component. Other rural training units focused primarily on vocational training and continuing education. Neil Carson, chair of community medicine – later general practice – was overseas when the submission was presented, but he became an advocate within the faculty for the proposal after his return. It was interesting to watch as he persuaded other department chairs to support the proposal and then sought a financial contribution from them! The process was a bit like a poker game. Neil would say that he was putting in $50,000 and then challenged his colleague to ‘see him’ if not ‘raise him’. During this process, I learnt that within the medical faculty ‘multidiscipline’ meant doctors in different medical specialties working together, whereas beyond the faculty, ‘multidiscipline’ referred to doctors, nurses and other health professionals working together.

Suffice it to say that the timing was right for this proposal which, with Neil Carson’s sponsorship and Bob Porter’s support, was ultimately approved by the faculty board. Prior to this formal approval, Bob Porter had encouraged me to apply for funding from the then new Commonwealth Rural Health Support Education and Training program.

The Centre for Rural Health was established in 1992 at the Moe campus of Latrobe Regional Health as Australia’s first multidiscipline, multilevel rural health academic unit. I was fortunate to be appointed Australia’s first Professor of Rural Health and director of the centre. The Centre for Rural Health began upstairs at Moe Hospital in a room which had been the cleaners’ store. When Maria Harkom and I started, the cleaning materials had been removed but it took some time to organise furniture, telephones and office supplies.

Latrobe Regional Hospital, Moe, early 1990s: site of the original cleaners’ store and now home of MUDRIH.

We developed a branch in Bendigo, based around the Primary Care Clinic which the Monash Department of Community Medicine had started in 1992. In 1998, the centre moved into purpose-built premises located at the new Latrobe Regional Hospital on the highway west of Traralgon. Subsequently, the centre expanded to include Mildura in the network. In 2000, it was transformed into the Monash University School of Rural Health with the Centre for Multi-Disciplinary Studies in Rural Health based in Moe, and four regional clinical schools located in Mildura, Bendigo, Traralgon and Bairnsdale; each had a network of teaching and research sites distributed over the surrounding rural area.

We were successful in securing Commonwealth Government rural health funding and moved forward quickly with a range of education, research and community liaison initiatives networked across Gippsland and north-western Victoria. From the beginning, the focus was on working with people in rural and remote communities towards fulfilling the vision of improving rural health.

Educational initiatives included:

  • rural clinical rotations and rural extracurricular activities for medical students

  • interprofessional education initiatives

  • collaboration with other Monash health programs including nursing, pharmacy, radiography and dietetics for rural clinical rotations

  • promoting health careers to rural secondary students

  • collaboration with the Royal Australian College of General Practitioners in developing rural GP training.

Subsequently, in 1998, the college and the Centre for Rural Health established the Gippsland Regional GP Training Program, 12 years after my initial attempt. In 1994, we introduced the Graduate Diploma and Master of Rural Health programs which offered graduate studies for rural health practitioners entirely by distance education. This program was redeveloped to be delivered online in 1998. In 1996, Amanda Young became the first of many rural health PhD students.

From the beginning, research was a major focus including studies of the rural health workforce, rural health services and specific health issues. Prior to 1991, research into the health of people living in rural and remote areas in Australia had been patchy and limited. In this context, the first National Rural Health Strategy recommended the establishment of a National Rural Health Unit which was subsequently funded by the Australian Health Ministers Advisory Council. We took the lead in a five-university consortium which was successful in gaining funding in 1994 to establish what became known as the Australian Rural Health Research Institute. Institute activities included:

  • redevelopment of the Rural Health Research Register which had been developed by the University of Queensland

  • setting the agenda for collaborative rural health research

  • projects on the use of communication information technology in rural and remote health

  • a series of national rural health research workshops which brought together experienced researchers and novices.

In 2000, John Humphreys joined Monash as Australia’s first Professor of Rural Health Research.

Collaborations and partnerships were a feature from the very beginning. These collaborations included:

  • other Monash departments, centres and schools including those at Gippsland campus

  • Latrobe Regional Health and other hospitals/health services throughout Gippsland and beyond

  • divisions of general practice and related organisations

  • vocational training organisations

  • other universities and educational institutions

  • government departments and agencies at local, state and federal levels.

Examples of successful collaborations included:

  • the University of Melbourne, statewide coordination of rural GP placements and teacher training, followed later by the Victorian Advanced Training for General Practice program

  • the Victorian Universities Rural Health Consortium involving five university partners

  • Victorian Rural Divisions Coordinating Unit

  • the Rural Workforce Agency Victoria

  • the provision of ambulance medical officer services to Rural Ambulance Victoria in Gippsland.

During the early years of rapid growth and development there was also an increasing international dimension to the centre. Between 1992 and 2004, I was chair of the working party on rural practice of the World Organization of Family Doctors (Wonca) and we provided the secretariat. The Wonca working party on rural practice initiated a series of Wonca rural policy statements, rural health world conferences with associated conference declarations, and engagement with the World Health Organization. In 2002, as the School of Rural Health, we hosted the WHO–Wonca co-sponsored consultation – Health for All Rural People – which developed a global action plan for rural health. Also in 2002, in collaboration with other Australian organisations, we hosted the fifth Wonca World Rural Health Conference in Melbourne, which produced the ‘Melbourne Manifesto: A Code of Practice for the International Recruitment of Health Care Professionals’.

In addition to the international networking through Wonca, we attracted many visitors from all parts of the world, including several individuals who undertook six-month sabbaticals. In 1994, Jim Rourke and his wife Lesley contributed to the early development of the centre and returned to Canada where Jim established the South Western Ontario Rural Medicine unit which was modelled on the Centre for Rural Health. Jim is now the dean of medicine at Memorial University of Newfoundland. Ian Couper came from South Africa in 1998 and has, since his return there, become Professor of Rural Health at Witwatersrand University in Johannesburg. In addition, Jim Rourke succeeded me as chair of the Wonca working party on rural practice, and Ian Couper succeeded Jim. The relationships which developed through these visits enriched the centre and enhanced Monash University’s reputation as an international leader in academic rural health.

The people and the projects

There is no doubt that the rapid development and ongoing achievements of the Centre for Rural Health and later School of Rural Health are the direct result of the enthusiasm, commitment and hard work of the many, many people who have been part of it over the years. It was a great privilege and a real pleasure for me to be part of that talented and successful team during the first 10 years. There was a real sense of excitement as we were making it up as we went along, with associated wonderment when our efforts proved to be successful. I am not able to mention all the many people and projects but will highlight some which stand out in my mind.

Maria Harkom was the original administrative officer. She brought a positive, ‘can do’ approach which helped us all in those early years. Before long, Maria was joined by Elaine Evans who has continued with Monash to this day. Elaine’s irrepressible cheerfulness and quirky sense of humour have helped us all through many ups and downs. As well as being my executive assistant, Elaine provided the secretariat for the Wonca working party on rural practice throughout my time as chair. In 1996, Elaine came with us to Shanghai for the first Wonca Rural Health World Conference and provided invaluable administrative support in a totally unfamiliar setting. I well remember her hilarious charade performance as she tried to explain to our Chinese hosts that we needed overhead projector sheets! Elaine’s contribution was invaluable both to the success of that conference, which involved 300 rural practitioners from over 30 countries, and to the effectiveness of the Wonca working party on rural practice during its first 12 years. Over the years, Elaine’s astute observations and commonsense approach have been a great strength.

David Birks is another stayer who has remained involved in one way or another from the beginning to this day. David’s low-key manner can be deceptive. He is universally praised by medical students and other learners who have been fortunate to encounter him as a teacher in the classroom or in a clinical setting. Over the years, David has provided a cool and steady approach as a true psychological leader of the group. As well as teaching and leadership, David has undertaken research including the Special Cooperative Audit of Rural Surgery which gathered data demonstrating that the quality of rural surgical care is at least comparable with surgical care in metropolitan areas. David has also been active in many capacities with the Royal Australasian College of Surgeons over the years. For a time, he was in charge of the rural general surgery training stream for the college as well as participating on many college committees and in various education and outreach initiatives.

Although Associate Professor Elaine Duffy joined the Centre for Rural Health initially on secondment from the School of Nursing, she quickly became a key member of the team and stayed on in 1995 to become associate director/deputy head. Elaine brought her background in remote area nursing and a focus on multidisciplinary collaboration in rural health education, research and service to her new role. Her leadership ensured that the centre was recognised and respected beyond the world of medical education and medical practice, particularly among remote and rural nurses.

Another major contributor from the early days was Dr Robert Hall. I had known Robert since I was a medical student as he was one of the first national medical educators for the Family Medicine Program, which was later renamed the Royal Australian College of General Practitioners Training Program. For a time he was director of vocational training at Box Hill Hospital before moving to Gippsland as a goat farmer’s husband. Over the years, Robert was involved in developing a range of new models of community health/general practice services, always with an emphasis on education and research. Robert provided significant leadership in education, particularly vocational training, and in research/development projects including the Rural Hospital Quality Assurance Project with the West Victoria Division of General Practice, the Extended Latrobe Valley Injury Study, the Rural Men’s Health Project, and the Moe After Hours Medical Service. Robert was remarkable for his irrepressible creativity, boundless enthusiasm for innovation, and consistent tendency to think outside the box.

There were many general practitioners, particularly in Gippsland, who contributed to the development and implementation of rural health education and training. Dr Allin Marrow in Traralgon had worked with me as area coordinator when I was the Family Medicine Program regional coordinator and he continued to contribute through teaching medical students and vocational trainees. Dr David Campbell and Dr Patrick Kinsella in Lakes Entrance were also enthusiastic participants in rural GP training, and they contributed to the development of the Centre for Rural Health and later School of Rural Health. Dr Peter Stevens in Heyfield took on the role of program director of the Gippsland Regional GP Training Program. Among the other GP contributors over the years were Doctors Paul Flood, Sue Deed, Ken Mulligan, Darra Murphy, Brian Cole, James Brown, Chris Lampel, Charles Kerr, Gary Bourke, Leon Malzinzinskis and Sarah Strasser. Sarah had taken on leadership roles in rural GP vocational training nationally, but continued as a part-time senior lecturer at the Centre for Rural Health with particular responsibility for electives.

David Campbell undertook the Study of GPs in Towns Without Hospitals, as well as developing an increasing involvement in all aspects of rural medicine and rural medical education. This involvement included state and national leadership roles, including the presidency of the Australian College of Rural and Remote Medicine. When the East Gippsland Regional Clinical School was established, David became the director and continues in that role to this day.

Jane Greacen joined the Centre for Rural Health in 1997 after a period of working for the Victorian Government. She brought with her expertise in occupational health and public health which strengthened our education, research and workforce development activities. Subsequently, Jane was seconded to help establish the Rural Workforce Agency Victoria and stayed on as CEO.

Heather Kelly came to the centre with the idea for what became the A Great Career Where You Live Project which promoted health careers to rural secondary school students. This project – which included audiovisual materials and support for rural health professionals to present at local high schools – expanded to become a state-wide program with residential workshops in Melbourne. It also spawned similar programs in other states. Meanwhile, Heather became involved in various research and community projects including collaborative projects with the Centre for Research in Health, Education and Social Sciences at Monash Gippsland, led by David Harvey.

David Harvey and I were co-investigators on a series of studies focused on the health services in small rural communities, as well as a Study of Doctor and Patient Perceptions of General Practitioners as Resource Managers/Gatekeepers, and an evaluation of the Rural Health Support Education and Training Program.

Initially, Jo Wainer joined the Centre for Rural Health in 1995 as the research associate working on the Study of Health Service Delivery in Rural Communities. Subsequently, Jo, whose background is medical sociology, stayed with us as a senior lecturer involved in education and research. She focused particularly on her interest in gender in medicine, especially women in rural practice. This extended beyond Monash to the Australian College of Rural and Remote Medicine and internationally with the Wonca working party on rural practice. Jo went on to complete her PhD on women in medicine.

Bill Darmody, a partner in the Moe Veterinary Clinic, and his colleagues provided half-day case-based sessions for students to learn health issues at the human–animal interface. In addition, Bill organised for the students to visit local dairy farms and learn from the farmers about agricultural occupational health issues.

Anne Leversha combined her clinical pharmacy role at Latrobe Regional Hospital with a joint academic position that connected the Centre for Rural Health with the Victorian Pharmacy College, another faculty of Monash. Among Anne’s contributions were: a teaching program on practical therapeutics for final year medical students; rural clinical placements for pharmacy students; and the Rural Pharmacist Support, Education and Training Project. Along the way, Anne attained a Master of Rural Health.

Dr John Togno was a driving force in initiating the Bendigo branch of the Centre for Rural Health. After establishing the Bendigo Primary Care Clinic, John became involved in a wide range of education and research activities. He took the lead in developing rural health options for medical students which were so popular that the faculty introduced a week-long rural medicine rotation for all Year 2 students. John’s involvement in curriculum innovation came to the fore again through developing the rural health curriculum for the new five-year medicine course introduced in 2001. In addition, John contributed to various rural GP initiatives in Victoria and Australia, as well as to international initiatives through Wonca. John’s participation in research and development projects was also wide-ranging, as demonstrated by the Study of Sustainable Models of Rural and Remote GP Services and the GP Workforce and Skills Minimum Dataset Project. His easy-going style, effective leadership and great networking abilities helped foster the Centre for Rural Health’s development, particularly during the first decade.

Having worked as a draughtsman, Steve Kirkbright joined the Centre for Rural Health as a project officer and soon showed his strength in graphic design and use of communication information technology. Steve’s contribution is evident in the full range of publications and audiovisual output up until he left Monash in 2006. Often Steve collaborated with Joe Hovel in Bendigo; Joe contributed to various projects drawing on his background in psychiatric nursing as well as his knowledge and expertise in information technology. Through the 1990s, Steve, Joe and John Togno helped to ensure that the Centre for Rural Health led the way in the use of communication technology to enhance our education, research and community development activities. From 1998, there was a formal information technology working group which enhanced many Centre for Rural Health projects, including the Rural Undergraduate Medical Placement System.

Dean Carson joined the centre as a research associate on the National Rural General Practice Study and stayed on for the Study of Sustainable Models of Rural and Remote GP Services and the GP Workforce and Skills Minimum Dataset Project. Dean’s background in remote area demography and his practical approach to dealing with research challenges were invaluable contributors to the success of these projects.

Steve Kirkbright teaching students.

Tutorial with Wildfire students 2003: Steve Kirkbright regularly taught communication and access to information skills to students and staff.

After a career in the ambulance service, Peter O’Meara joined the Centre for Rural Health as resources manager while undertaking his PhD through the University of New South Wales. In addition to his administrative role, Peter became involved in various projects and transferred in 1999 to the academic side of the centre. Peter’s contribution included several Transforming Rural Urgent Care System projects, the Moe After Hours Medical Service and the Evaluation of the Alberton Project. Since completing his PhD, Peter has pursued a successful academic career and is now with La Trobe University in Bendigo.

When Peter O’Meara left, after the usual national advertising of the position was unsuccessful, we decided to take the unusual step of engaging an executive search firm to assist with recruitment. To our surprise, the head hunters found Rob Clough across the road from the Centre for Rural Health on the Latrobe Regional Health site at Gippsland Pathology. Rob brought his gentlemanly charm to the challenging, but essential role of keeping us all organised, and to balancing the books. This was no mean feat as the centre had grown quickly with numerous part-time clinical staff, as well as full-time academic and professional staff at multiple locations. In addition, Rob had the challenge of learning how the University expected things to be done, which did not always work in distributed rural settings.

From a nursing background, Mollie Burley joined the Centre for Rural Health as a research assistant. Over the years, Mollie was involved in many research and community projects including the Community Health and Health Promotion Program for Maffra and district, as well as various educational activities.

Anske Robinson brought her library background to the centre to assist with redevelopment of the Rural Health Research Register and stayed on contributing to many data-related projects including the Health Education Rural Remote Database, the Literature Information Service for Rural and Remote Health and the Victorian Rural Health Data Access Service which was known as Echidna. During her time with Monash, Anske studied part-time, first attaining her bachelors degree and ultimately her PhD.

Echidna was developed by Matthew McGrail who joined the centre as a research fellow and contributed his statistics expertise to many projects and activities. Subsequently, Matthew completed his PhD, supervised by John Humphreys, and has become a national leader in rural health workforce research.

Lauren Stephens was the only dietitian in the Latrobe Valley when she became one of the very early recruits to the centre. She was successful in implementing a project which educated GPs on nutrition and dietetics. Rather than reducing the need for dietitians, this project raised the doctors’ awareness of the services that dietitians offer, and increased the demand. Subsequently, Lauren established a rural dietitians’ network, and helped implement rural clinical placements for students in the Monash nutrition and dietetics program.

Janice Chesters came to the centre in 1998 fresh from completing her PhD. She quickly became a strong contributor to many educational, research and community activities including the Graduate Diploma/Master of Rural Health, Doctoring Towns: Narratives of Rural Practice, and the renewed and expanded secondary schools project, A Great Career Where You Live. Janice also travelled to Melbourne regularly to ensure that rural health would be well represented in the new five-year medical curriculum.

Raf Dua and Greg Beevor became known to us through their work on the project to build the new Latrobe Regional Hospital. With the development of regional clinical schools, there was a need to build new facilities which Raf and Greg coordinated in their inimitable style. Like the Latrobe Regional Hospital, all these projects were completed on time and within budget. In fact, Raf and Greg also provided assistance to me in the early years in Canada with planning and implementing development of the Northern Ontario School of Medicine.


Inspecting the new premises in Traralgon 1998: left to right – Roger Strasser, Lexia Bryant, Nick Saunders, Elaine Duffy, Peter O’Meara, Jo Wainer, John Pinnegar.

I had known Lexia Bryant when she was associate director of the Family Medicine Program in Victoria, and I was pleased to recruit her to the Centre for Rural Health in 1996. Lexia brought a passion for enhancing the quality of medical education, a commitment to the learners and an effective leadership style. She strengthened rural undergraduate initiatives including the rural GP mentor scheme, the rural students club, MURPA (Monash Undergraduate Research Projects Abroad) – later Wildfire – and rural health curriculum development for the new five-year medical course. In addition, Lexia worked with the Monash Department of General Practice and the University of Melbourne on the Victorian Advanced Training for General Practice, and collaborated with Jo Wainer on various research and education initiatives for women in rural practice. Lexia helped raise the national and international profile of Monash as a leader in rural health through her role as the second president of the Australian College of Rural and Remote Medicine, and as chair of the scientific program committee for the fifth Wonca World Rural Health Conference.

Di Wyatt came to the centre, after previous roles with the Victorian Government and as executive director of the Coordinating Unit for Rural Health Education in Victoria. With this background, Di was well placed to work with government on a range of health workforce activities and policy initiatives. She also took a major leadership role with the fifth Wonca World Rural Health Conference and other Wonca initiatives. Subsequently, Di moved to Brisbane and became an important contributor to the development of the Australian College of Rural and Remote Medicine.

We could not and would not have functioned successfully without the dedicated work of many administrative and support staff. Julie Luke started as a receptionist and became an award-winning undergraduate student coordinator. Among the others were Joy Beckman, Paula Robinson, Kay Barrow, Michael Elswyk, Sarah Bamford, Sarah Evans, Heidi Robinson, Louise Bassam, Linda Kruger and Marg Bibic.

Achievements

By the time I left for Canada in 2002, Monash University was recognised as a national and international leader in rural health education and research. First the Centre, then the School of Rural Health, had pioneered a wide range of specific rural health education, workforce, research and community initiatives mentioned in the previous section, as well as multidisciplinary education for rural health practitioners and the double degree – Bachelor of Nursing/Bachelor of Rural Health Practice – which was designed to educate nurses prepared to practise in small communities.

In a real sense, we provided the prototype for subsequent Australian government programs including Rural Undergraduate Support and Coordination, University Departments of Rural Health, Rural Clinical Schools, and Regional Training Providers for regionalised GP training.

The Rural Undergraduate Support and Coordination Program, which was part of the GP Rural Incentives Program, provided $2.5 million per year for rural undergraduate medical education initiatives. Published in 1994, ‘Rural doctors: Reforming undergraduate medical education for rural practice’1 set out recommendations based on research evidence which showed that two major factors associated with entering rural practice after training are: a rural upbringing – that is, having grown up in a rural area – and positive clinical and educational experiences in the rural setting as part of undergraduate medical education. Medical schools were challenged to develop specific plans to achieve nine key targets for which they would receive ongoing funding subject to satisfactory annual reports. Within two years, all 10 medical schools in Australia at the time had signed on to the Rural Undergraduate Support and Coordination Program targets which included recruiting rural background medical students; ensuring that all students undertake a minimum of eight weeks clinical education in rural settings; and supporting rural practitioners as teachers and contributors to curriculum development.

University departments of rural health are academic units in rural or remote locations which have a multidisciplinary focus on public and Aboriginal health education and research. Monash’s Centre for Rural Health provided a model for university departments of rural health, the first two of which were in the University of Sydney, Broken Hill, and the University of Queensland, Mt Isa. Subsequently, it was decided that each state should have a university department of rural health and the Victorian Government insisted on a collaborative model involving five universities which became the Victorian Universities Rural Health Consortium. The partners were Monash University, Gippsland; the University of Melbourne, Shepparton; La Trobe University, Bendigo; the University of Ballarat; and Deakin University, Warrnambool. The consortium facilitated networking of rural health initiatives across the state, including the secondary school program, A Great Career Where You Live.

Rural clinical schools have a focus on rural undergraduate medical education and research. Commonwealth Minister for Health, Dr Michael Wooldridge, came to Bairnsdale to launch the Rural Clinical Schools Program in 2001. Like the University Departments of Rural Health Program, the Rural Clinical Schools Program invests in rural academic infrastructure including purpose-built facilities and academic staff. In addition, the program provides funding to support the recruitment of rural background students and medical students undertaking clinical education in rural settings. Several medical schools have combined their university department of rural health and rural clinical school into a school of rural health following Monash University’s lead.

In 1997–98, I was a member of the panel which undertook the Review of General Practice Training initiated by Minister Wooldridge. At his request, the panel recommended four options for the future. It was several years before the minister decided to establish General Practice Education and Training Ltd, which established contracts with regional training providers for general practice training along similar lines to the Gippsland Regional GP Training Program initiated by the Centre for Rural Health.

It is fair to say that the School of Rural Health has changed the perspective on universities of people living in rural and remote communities. Rather than being a distant ivory tower, the School of Rural Health is a local partner with hospitals, health services, and other community organisations. They work together to enhance retention and recruitment of health professionals and to improve the health status of the community. In this sense, the school thinks and acts locally, and has an impact at state, national and global levels.

For the last 10 years, I have been an occasional visitor to the school. I continue to be impressed by the commitment to improving rural health, and the spirit of innovation which are its hallmarks. The centre that began in 1992 as an idea which was ahead of its time, has continued through the first decade of the twenty-first century to set the trend in academic rural health for Australia and around the world.


Sarah and Roger Strasser 2001: ‘Yes, Sarah, I have taken a job in Canada!’

 

Endnote

1 Rural Undergraduate Steering Committee. 1994. ‘Rural doctors: Reforming undergraduate medical education for rural practice’. Final report of the Rural Undergraduate Steering Committee for the Department of Human Services and Health. Canberra: Department of Human Services and Health.

Strasser, Roger. 2012. ‘The early years: Initial vision and foundation’, in Clough, Robert, editor, From a Broom Cupboard: 20 Years of Rural Health at Monash University. Melbourne: Monash University Publishing. Pp. 1–16.

From a broom cupboard: 20 years of rural health at Monash University

   by Robert Clough, editor