There are fewer than 40 dermatologists based in Australia’s rural, regional and remote areas.
Small but significant inroads have been made this year in the quest to boost dermatologist numbers in rural, remote and regional Australia, says the head of the Australasian College of Dermatologists.
These areas have less than 40 dermatologists between them, but the college was committed to increasing numbers, particularly in the First Nations dermatology workforce, said president Dr Clare Tait.
“We graduated for First Nations dermatologists at our ASM [annual scientific meeting] this year and we have appointed four new First Nations trainees to start their four-year training in 2023,” she told Dermatology Republic.
“It’s very exciting for us to have four first-class, high-quality trainees starting, and that will be a significant boost to First Nations workforce.
“If you look at what our First Nations dermatologists are doing already, they are making significant inroads into the care of First Nations people and other individuals living in rural and regional areas.”
Dr Tait said the recently graduated First Nations graduates were already making a big impact through initiatives like the establishment of a tele dermatology service in Victoria, a new community-based hospital service in the greater Darwin area, better outreach services to Darwin and Katherine, and the delivery of dermatology care to the New South Wales prisons system.
“This is a fantastic initiative and also better and more care to the communities of southwestern Sydney,” Dr Tait said. “Already, within a year or two are becoming fellows, they’re making a difference.”
Four new dermatologists focussing their efforts on rural, regional and remote parts of Australia, particularly for First Nations people might not sound like a big increase. That is until you look at the massive maldistribution of dermatologists in Australia.
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dermatology Australia’s dermatology workforce crisis
According to the ACD’s latest snapshot of the Australian dermatologist workforce in 2022, there are 618 dermatology fellows across the nation, meeting the health needs of almost 26 million Australians.
Of these, 94% (581) of dermatologists are based in metropolitan areas, 4% (25 dermatologists) in rural and remote regions and just 2% (12 dermatologists) in regional areas. Half of the workforce is aged 60 years or more.
Dr Tait said addressing this maldistribution was a major priority for the college, and it has several current and new initiatives which show promise.
The ACD recently launched a pilot regional Queensland training position which will start next year. A candidate with a connection to the area has been appointed and will undertake most of their training in Queensland’s major regional centres like Townsville, Cairns and the Sunshine Coast.
“This is exciting,” Dr Tait told Dermatology Republic.
“It is a pilot and we’re certainly very pleased that we’ve been able to instigate this with support of the dermatologists on the ground in those areas and they’re very committed to this. I suspect it will be a model that will be successful in in getting specialists to stay in the area to which they have become attached and hopefully have a career pathway in that regional area.”
The program will be assessed as it progresses to ensure it is meeting the needs of the trainee, trainers and supervisors and patients, and Dr Tait said if it was a success the college hopes to roll it out into other regional areas.
The college also this year received government funding to pilot two other projects that aim to support the training of specialist dermatologists in regional, rural and remote communities.
The projects, already underway in Townsville and Darwin, will trial new ways of supporting dermatologists to deliver regional training and aim to address the issue of workforce shortage by increasing opportunities to work and train in regional, rural and remote areas.
The funding was awarded under the Government’s Flexible Approach to Training in Expanded Settings (FATES) program. The projects will focus on improving the learning experience for dermatology trainees whilst simultaneously providing access to specialist care for local communities.
The Townsville project will involve a networked model linking dermatology services at Townsville University Hospital with the Melanoma Institute of Australia in Sydney. This model provides Townsville-based dermatology registrars with access to “virtual” supervisors, to deliver a high-risk skin cancer service for North Queensland using established telemedicine platforms.
This service, using image-based melanoma detection and diagnostics, will provide Townsville and surrounding areas – areas with the highest rates of melanoma in the world – access to this expanded specialist service delivery
In Darwin, the project will involve a supervisory rotational system for specialist dermatology training. This model will increase trainee supervision and service delivery by adding visiting dermatologists to Darwin.
This increased capacity will provide Royal Darwin Hospital with additional consultant dermatologist supervision and build capacity for a rural training centre, where trainees can build knowledge and expertise in Indigenous, tropical and rural dermatology.
Dr Tait said 2022 had been an “exciting year for dermatology and for the college.”
“We’ve continued to work hard at our main priorities of workforce and education, and I think we’ve had some real wins in both of those areas, but there’s still a lot of work to do,” she said.
“We feel that the work that we’ve been doing over a period of time is beginning to bear fruit, and we have real improvements, but we need to continue to work away at it because there still will be significant shortfalls.”
She said the ACD had made a pre-election submission to the Albanese government asking for a significant increase in training places, and this had been heard.
“We have had some success with increasing training places this year – they are modest but definitely in the right direction,” she said.
“What we’d really like to see now is a commitment from the federal government for either more STP [Specialist Training Program] funded positions or further funding to allow us to grow our workforce. Ideally, another 10 positions nationally would make a big difference to our workforce.”
