The Aboriginal Mental Health Workers and psychiatry registrar jointly managed a significant number of Aboriginal people, often with assistance from the local mental health service at Kempsey. The registrar gained insight into the local Aboriginal community and more culturally appropriate clinical methods, as well as some cultural factors that can influence the presentation and management of mental illnesses. The Aboriginal Mental Health Workers increased their clinical knowledge and confidence through working with the registrar.

Objective: To discuss the challenges and rewards of training in psychiatry while living and working in a rural area. The authors draw on their experiences as registrars on the mid-north coast of New South Wales, Australia. Conclusions:Rural psychiatrists and mental health workers meet with various challenges and rewards while practising and living in places of relative isolation; these have been described by practitioners in Australia, New Zealand and the USA. Psychiatry trainees often share these experiences but can also feel the impact of the disadvantages shared by most rural communities, particularly the lack of mental health services and maldistribution of mental health professionals. There are also unique difficulties and rewards to do with the process of training.

The Aboriginal Mental Health Workers and psychiatry registrar jointly managed a significant number of Aboriginal people, often with assistance from the local mental health service at Kempsey. The registrar gained insight into the local Aboriginal community and more culturally appropriate clinical methods, as well as some cultural factors that can influence the presentation and management of mental illnesses. The Aboriginal Mental Health Workers increased their clinical knowledge and confidence through working with the registrar.