Ten reasons why every junior doctor should spend time working in a remote and rural hospital

Abstract

Large and particularly urban hospitals no longer offer a true general medical take. For very good reasons, acute myocardial infarction and stroke are hived off to subspecialty services. 4 In a wider context, major trauma, oncology, paediatrics and obstetrics are often not co-located with acute medicine. These are understandable but artificial silos and, as a junior doctor, being exposed to the complete spectrum of medicine provides a holistic perspective and a very broad clinical challenge. Everything learnt at medical school (and quite a lot that wasn't) may be needed. The importance of generalism is being revisited in medical training, not least with the introduction of the 3-year internal medicine training programme, but nowhere can offer better general experience than a small remote or rural hospital. 5,6

Technological developments driven by COVID

“…1 Fox and colleagues state that a number of specialties, including oncology, are often not co-located with acute medicine. 2 The implication is that in the more remote hospital they might be so co-located. In reality, there will often be some non-surgical oncological work in such a hospital, at least the delivery of chemotherapy, and it is to be hoped that full medical oncology services for common epithelial tumours will be developed there.…”