For nearly two decades, the University of Otago’s Rural Medical Immersion Programme (RMIP) stood as New Zealand’s sole initiative offering fifth-year medical students a full year of hands-on training in rural communities.
In 2024, the University of Auckland launched its own rural immersion programme.
The RMIP was established to address the shortage of rural doctors in New Zealand by providing medical students with a year-long, hands-on experience in rural communities, and currently places 35 students in nine rural locations across the South Island.
Unlike traditional urban hospital-based training, RMIP immerses students in small-town practices, exposing them to the realities of rural healthcare, from primary care to emergency medicine.
35 students live and work in one of nine rural communities across the South and lower North islands. Image / Supplied
The programme has been successful in influencing many graduates to pursue careers in rural medicine.
It offers students the chance to build strong relationships with both their mentors and the communities they serve, fostering a deeper understanding of the unique challenges and rewards of rural healthcare.
Dr Matt Bell, a former RMIP student and now its co-ordinator, has worked as a general practitioner on the West Coast for the past six years.
As a city-born doctor who never initially planned to work in rural medicine, Bell now plays a key role in training the next generation of rural doctors.
He told the Herald his motivation for joining the RMIP wasn’t necessarily only a passion for rural medicine.
“It’s that more hands-on, apprenticeship kind of model, and the ability to follow patients rather than just sit in an area of medicine. I really enjoyed that.”
His experience in the programme ultimately shaped his career path, leading him to settle on the West Coast.
“The programme worked because I’ve come back, I’ve placed myself rurally, and now I’m teaching on the programme, which is a weird full-circle moment really,” Bell said.
Since taking on a teaching role about five years ago, and later becoming a co-ordinator four years ago, Bell has observed significant shifts within the RMIP.
“When I started teaching on the programme, I was the youngest by decades, probably. But in the last couple of years, there are more and more people involved in delivering the programme who are my generation, my age, which has been awesome,” he said.
“It’s a really energetic, passionate group of people that I’m really lucky to work with.”
Bell said that, like elsewhere in the country, one of the biggest issues facing rural healthcare is the recruitment and retention of staff.
“Part of our job is to show students that despite the challenges it’s a really rewarding and enjoyable career, and they shouldn’t be put off. It’s never going to improve if we don’t encourage people to come back and work.
“The hope is that by immersing them in a community, rather than just being a visitor for three or four weeks, they get involved and feel part of something. There’s real power in that.
“And it does work – people do come back who have been on the programme, which is awesome.”
Bell said the scheme was great for dispelling misconceptions about rural medicine.
“There’s this idea, which is unfounded and not true, that in the sticks, it’s all a bit wild – but it’s not. There are really skilled, professional people that work out here, and they have a skill set that’s absolutely incredible. It’s a team sport, and without the support of all those other players, you just can’t do your job. And everyone really gets along really well.”
Bell said the RMIP made a clear impact on the communities where students train.
“My regular patients know that I’ll often have a student with me.
“Some of them will come in and say, ‘Oh, where’s your student? I was hoping to see them first today’.
“The community knows that our students have come back to work, so they are really supportive of the programme, which is awesome.”
He said living and working on the West Coast has been fulfilling.
“The really incredible part about my job is how varied it is. If you have an interest or something you think you can offer your community, there’s a fairly good chance you can go and do it.
“I sit in a clinic some of the time, but I also do minor operations or skin cancer work ... It all feels like really valuable work. So it’s awesome.”
Janine Lander is the RMIP director and its local Ashburton Hospital co-ordinator. Image / Supplied
Programme clinical director and RMIP co-ordinator at Ashburton Hospital Dr Janine Lander said the programme played a role in strengthening rural healthcare networks.
“It brings rural community health providers together over shared interests, strengthening relationships between primary care and hospitals. Some sites even receive philanthropic support for accommodation and funding.
“And the students are an absolute joy.
“It’s a privilege to see their professional identities develop and maintain relationships with them as they return to rural practice.”
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