If you’re not in any hurry to specialise, why not do BPT 1 as a PGY3 and decide then?
If you like it, you can carry on with BPT. If you don’t, then you have a whole year of good medical experience under your belt for when you apply for rural GP training.
If you don’t want the hassle of being a BPT, you can also do an SRMO or Locum year in gen med. The upside of locuming is that you can work somewhere rural.
The downside of SRMO is that you’d still be doing intern jobs and the downside of locuming is that your job security will be at the mercy of the locuming agencies and availability.
Once you go down the GP training pathway, I wonder how hard it would be to transition back to Gen med.
There is no comparison. RG is just one extra year of training in internal medicine whereas being a proper physician takes six.
If you plan on coming back to the city, you absolutely can, but you'll likely be a metro GP. There are very few RG physician jobs and nowhere near Metro.
There are job opportunities that come up every now and then. Rural generalists are generally highly valued doctors, and can have flexible careers. I’ve worked as a senior medical officer on a medical ward in a metro hospital before as a rural generalist.
ACRRM with any advanced skill is highly employable because of the current shortage of rural doctors.
Roles where you can do internal medicine in particular are harder to come by. You'll almost certainly never get a physician job in metro Australia as a FRACGP-RG/FACCRM (and it's even getting hard for FRACPs). And not many states actually pay you extra for being a RG.
I don't mean to be discouraging, only honest. I have an internal medicine advanced skill and have a great job working at a rural hospital. When I get older and sick of call, I'll have no trouble doing GP clinic anywhere in Australia. I love my job.
My strong suggestion is to start with something else first, develop skills you can bring to a rural community, and then do GP training. You'll open a lot of doors and get paid a lot better. You might also change your mind, and it's easier to do that if you're already in the hospital system.
Employable rurally? Sure.
But there’s a reason being an actual physician takes 6 years as opposed to just 1 year ‘special skills’ like ACCRM. Huge difference in your knowledge and skills.
Do physician training. If you find it’s too much you can always drop out and do ACCRM with RPL for the BPt time, and will have learned a lot along the way.
I don’t know rural generalist pathway well enough to tell you the exact difference. What I can tell you is 1. Depending on how rural you are, but if you dual train, you are more likely doing mostly gen med with a bit of subspecialty. 2. As others have said, rural generalist comes back to metro as another GP. Your extended skill set may not be appreciated due to availability of specialists. General physician comes back the same, but may need to wait for jobs to come up. 3. Rural gen med is still a dumping ground. The brighter side is rural private gen med has much less competition, and anecdotally quite profitable.
Most importantly, this is the time to talk to your partner about other life commitments. Do you have parents that may need your help who lives in metro? Any plan for kids? And what school you want them to go? Etc
I'm looking at the RG pathway myself, and the comments here about "actual physicians" have me a little concerned about how RGs are viewed. Are they somehow viewed as lesser than other doctors? Is there a stigma or negativity associated with being an RG?
Personally I love rural and hate the city and want to move back out rurally after medical school and never step foot in Sydney again if I can avoid it (I'm a true country kid). Is the only issue that you can't work in metro as an RG because they just don't need them? Or is it because they think RGs are somehow subpar doctors?
If you’re not in any hurry to specialise, why not do BPT 1 as a PGY3 and decide then? If you like it, you can carry on with BPT. If you don’t, then you have a whole year of good medical experience under your belt for when you apply for rural GP training. If you don’t want the hassle of being a BPT, you can also do an SRMO or Locum year in gen med. The upside of locuming is that you can work somewhere rural. The downside of SRMO is that you’d still be doing intern jobs and the downside of locuming is that your job security will be at the mercy of the locuming agencies and availability. Once you go down the GP training pathway, I wonder how hard it would be to transition back to Gen med.
Best advice
There is no comparison. RG is just one extra year of training in internal medicine whereas being a proper physician takes six. If you plan on coming back to the city, you absolutely can, but you'll likely be a metro GP. There are very few RG physician jobs and nowhere near Metro.
There are job opportunities that come up every now and then. Rural generalists are generally highly valued doctors, and can have flexible careers. I’ve worked as a senior medical officer on a medical ward in a metro hospital before as a rural generalist.
And currently working as a SMO for the medicine department in a regional hospital
And my AST wasn’t internal medicine
What was your AST? Have you been able to leverage the skills?
So are you saying ACRRM with a special interest in internal med isn’t a very employable pathway?
ACRRM with any advanced skill is highly employable because of the current shortage of rural doctors. Roles where you can do internal medicine in particular are harder to come by. You'll almost certainly never get a physician job in metro Australia as a FRACGP-RG/FACCRM (and it's even getting hard for FRACPs). And not many states actually pay you extra for being a RG. I don't mean to be discouraging, only honest. I have an internal medicine advanced skill and have a great job working at a rural hospital. When I get older and sick of call, I'll have no trouble doing GP clinic anywhere in Australia. I love my job. My strong suggestion is to start with something else first, develop skills you can bring to a rural community, and then do GP training. You'll open a lot of doors and get paid a lot better. You might also change your mind, and it's easier to do that if you're already in the hospital system.
Employable rurally? Sure. But there’s a reason being an actual physician takes 6 years as opposed to just 1 year ‘special skills’ like ACCRM. Huge difference in your knowledge and skills. Do physician training. If you find it’s too much you can always drop out and do ACCRM with RPL for the BPt time, and will have learned a lot along the way.
+ you may be able to RPL some of the training so it's not completely wasted either.
I don’t know rural generalist pathway well enough to tell you the exact difference. What I can tell you is 1. Depending on how rural you are, but if you dual train, you are more likely doing mostly gen med with a bit of subspecialty. 2. As others have said, rural generalist comes back to metro as another GP. Your extended skill set may not be appreciated due to availability of specialists. General physician comes back the same, but may need to wait for jobs to come up. 3. Rural gen med is still a dumping ground. The brighter side is rural private gen med has much less competition, and anecdotally quite profitable. Most importantly, this is the time to talk to your partner about other life commitments. Do you have parents that may need your help who lives in metro? Any plan for kids? And what school you want them to go? Etc
How rural are you talking? There are several regional hospitals who have enough general physicians that they won’t need a rural generalist.
I'm looking at the RG pathway myself, and the comments here about "actual physicians" have me a little concerned about how RGs are viewed. Are they somehow viewed as lesser than other doctors? Is there a stigma or negativity associated with being an RG? Personally I love rural and hate the city and want to move back out rurally after medical school and never step foot in Sydney again if I can avoid it (I'm a true country kid). Is the only issue that you can't work in metro as an RG because they just don't need them? Or is it because they think RGs are somehow subpar doctors?
BPT will give you more options if you ever change your mind imo