Rural Health Equity Strategic Action Plan
RACS acknowledges its social responsibility to address health inequity, through its levers of selecting, training, retaining and collaborating for rural surgical services and rural communities. It’s well known that rural people have poorer health outcomes than urban people. They have all kinds of surgical problems which need the care of all kinds of surgeons. The RACS Rural Health Equity Strategy aims to improve health equity for remote, rural and regional/provincial people in Australia and Aotearoa New Zealand. The strategy embeds actions for rural health equity in all RACS activities and across all specialties. The strategy addresses the goals to:
1. Increase the rural surgical workforce and reduce workforce maldistribution, through the Select for Rural, Train for Rural and Retain for Rural Strategies.
2. Build sustainable surgical services in Australia and Aotearoa New Zealand, through the Collaborate for Rural Strategy.
The Rural Surgery Section Committee was instrumental in developing this key RACS strategic action plan. RACS Council has approved the implementation of the overarching strategy for rural health equity across all RACS portfolios as well as establishing a Rural Health Equity Steering Committee for managing the principles outlined in the action plan and prioritising the actions for implementation.
The following four supplementary papers were written by the Rural Surgery Section to support the development of the Rural Health Equity Strategy Action Plan, and were approved in principle by the relevant Committees or Boards. Each paper provides the evidence base for the Action Plan’s recommendations and sets out proposals for consideration, engagement and collaboration.
- Select for Rural (PDF 336.69KB)
- Train for Rural (PDF 674.73KB)
- Retain for Rural (PDF 328.71KB)
- Collaborate for Rural (PDF 521.45KB)
Developing a Rural Curriculum
Rural training with an aligned rural curriculum enables surgeons to develop rural practice capability and rural self efficacy. A rural-facing curriculum is a key action identified in the Rural Health Equity Strategic Action Plan. The RACS Rural Curriculum Project is an ongoing activity fully funded by the Australian Government Specialist Training Program (STP).
The development of the rural-facing curriculum framework in 2021 included input from trainees, rural and urban surgeons and external educational specialists. This comprehensive process included a literature review and a Delphi method with subject matter experts which identified how and where rural surgical practice differs from urban practice in the context of the RACS Surgical Competence and Performance Guide. The area of most divergence was considered to be the non-technical skills of judgment and clinical decision making, specifically, understanding the rural context, rural contextual decision making and Rural Focused Urban Surgical skills (RUFUS). RUFUS surgeons care for rural people through inreach, outreach, telehealth and design of surgical systems, and provide peer support to rural surgeons.
A copy of the final report is here. (PDF 4.68MB)
The next step is to develop an online module for trainees to access as a non-compulsory add on to existing curricula.
Rural Health Equity Steering Committee
The RACS Rural Health Equity Steering Committee is responsible for overseeing the implementation of the Rural Health Equity Strategic Action Plan. Associate Professor Kerin Fielding, Chair, and Dr Bridget Clancy, Vice Chair, presented updates on the strategy implementation at the 2023 RACS Annual Conference. Dr Clancy gave the ANZJS Lecture at the 2022 RACS Annual Conference. Click below to view their presentations.
Activities of the Rural Surgery Section include:
- Rural Surgery program at the Annual Scientific Congress
- Rural Surgery Fellowship for Provincial Surgeons - This travelling Fellowship aims to assist provincial surgeons who wish to spend time away from their practice to travel and develop existing skills or acquire new skills in a field to benefit the surgeon, the College and the community. Further information.
- Rural Coach Program for Surgical Trainees – This program has identified and supported more than eighty Trainees interested in a rural surgical career. This has been through ongoing support, advocacy and the opportunity to build their rural connections by offering financial assistance to Trainees who attend the Provincial Surgeons of Australia conference;
- Rural Surgeons Award – An award acknowledging significant contributions to surgery in rural settings in Aotearoa New Zealand and Australia. The award, in the form of a certificate, is presented to the winner at the annual meeting of Provincial Surgeons of Australia (PSA), the RACS Annual Scientific Congress or the Aotearoa New Zealand Association of General Surgeons. Further information.
- Position papers – The Rural Surgery Section provides advice and input into various College position papers such as farm injury, quad bikes, gun safety, the use of chainsaws, GP procedural surgical training and locum surgeons;
- Surgical Skills Course Grant for Rural Junior Doctors - A grant for rural-based doctors to support their attendance at a surgical skills course. Further information.
Rural Surgery Section newsletters