A growing number of Australian medical students are choosing to train as rural generalists, after the practice was formally recognized as a specialty within the field of general practice last year.

The Australian College of Rural and Remote Medicine has seen a significant increase in students applying for its Rural Generalist Training Program in the past few years, with far more students applying than there are places.

There has been a change in attitudes toward rural medicine, and it’s now increasingly been seen as providing greater opportunities than metropolitan practice, college president and rural generalist Rod Martin, MBBS, from Armidale, told Medscape News Australia.

The view in medicine used to be that “if you couldn’t cut it, you’d go to the bush,” said Martin. “Now it’s much more that if you want diversity of practice, and have [a practice in which] you are either being challenged or challenging yourself, then rural is the place to do that.”

Diversity and Challenge

Rural generalists practice general medicine and emergency care, as well as other specialty care such as obstetrics, pediatrics, general surgery, and anesthetics, in hospital and community settings in rural areas.

“We expect people to do primary care, we expect people to be comfortable in an emergency department, and then they choose from, at the moment, one of 12 skills,” said Martin.

While rural generalist medicine has long been a field within general practice, it was only formally recognized as a specialty in September 2025 after decades of campaigning by the Australian College of Rural and Remote Medicine.

“It’s a really useful selling point; we already have people increasingly coming our way because they could hear more about it,” said Martin. Many students were also interested in rural medicine because they originally came from rural areas, he said, but the appeal also lay in the diversity of medicine they could practice.

“Most people that are rural generalists need three or four different things to keep them ticking over because they have lots of interests,” he said. “That diversity and challenge, and the comfort with working with uncertainty and independent practice, typically are the things that attract and keep people in rural.”

Mitigating Staffing Shortages

Carrie Davenport, MD, practices rural generalist medicine and pediatrics in Port Macquarie, a coastal town with a population of around 48,000. She moved to Australia after completing postgraduate training in pediatrics in the UK. “The Rural Generalist Training Program gave me the opportunity to use that specialist interest and that specialist skill within Australia in communities that I really wanted to work with,” she told Medscape News Australia.

Davenport also appreciated the flexibility of the program, which has allowed her to work as a medical educator and lecturer at the UNSW Rural Clinical Campus and set up a school clinic in the smaller and more rural town of Kempsey. “That kind of flexibility means that you can shape your career how you want it,” she said. “I can totally then see why more and more people are drawn to it because it allows you to have a really diverse and varied career.”

The increased interest in rural generalist medicine comes at a time when Australia has been struggling with a shortage of general practitioners, particularly in rural areas. One report found that people in rural areas can wait up to 12 weeks to see a general practitioner, and the number of general practitioners per capita in very remote areas is around half that in metropolitan areas.

Patients in rural and remote areas also face challenges accessing specialist care. “If you have a sick child in Port Macquarie, the biggest center for you is Newcastle. That is a 3-hour road trip,” said Davenport.

In Australia, primary care is subsidized by the federal government under Medicare, which pays rebates according to the nature and duration of a consultation, action, or procedure. That means that rural generalists must carefully choose how to label and charge for their services in different contexts.

“In pediatrics, for example, if they’re seeing kids that are of an appropriate level, then the argument that we are making reasonably successfully to government is that if they function like a pediatrician, they should get paid like a pediatrician,” said Martin. But there is careful auditing to prevent a free-for-all. “[It’s] being able to use those numbers appropriately but not make a mess of the system by treating every single time you see a child with a sore ear as a pediatric consultation.”

Martin is president of the Australian College of Rural and Remote Medicine, which runs the Rural Generalist Training Program. Davenport reported having no relevant financial relationships.