One for all, not all for one: Emergency medicine training beyond the metropolis

Rural, regional and remote Australian communities continue to suffer higher mortality and poorer access to healthcare compared with those residing in metropolitan centres. Part of this can be explained by the significant shortage of skilled clinicians, with the ratio of medical specialists to population being up to four times higher in the cities compared with remote areas. Over recent years, there has been an increase in the number of Fellows of the Australasian College for Emergency Medicine (FACEMs) working in regional areas. However, the FACEM training programme lacks prioritisation of the nuances of regional and rural emergency medicine (EM), producing new FACEMs preferentially suited to metropolitan EM practice and subsequently encountering significant challenges when lack of specialist positions compels them to work in regional sites. The Australasian College for Emergency Medicine (ACEM) needs to consider strategies that not only ensure it is producing excellent generalist emergency physicians but also fulfilling its obligation to the regional communities those physicians serve.