Supporting and Training Registrars in Poorly
Resourced Environments

This webpage complements the webinar recordings on this topic, available either via our YouTube channel or in audio format by clicking on the corresponding button below:

Frequently Asked Questions

How is it possible to effectively support and train registrars in poorly resourced environments?

To effectively support and train registrars in poorly resourced environments, RVTS has identified that addressing the registrar’s professional and non-professional needs is crucial. By considering the contexts of person, place, and program, a supportive environment can be created where registrars feel comfortable, confident, competent, and have a sense of belonging and bonding with peers. This promotes effective training in challenging settings.

The Remote Vocational Training Scheme (RVTS) uses distance education and remote supervision to deliver training without requiring registrars to leave their communities. This model has proven successful over 24 years, training more than 500 doctors in 350 communities. Almost 80% of participants achieve fellowship while providing an average of 5.2 years of service in their training location.

Three key take-home points:

  1. Training registrars in resource-poor environments involves more than providing remote supervision; a holistic professional support package must be in place for success.
  2. It’s not for everybody. Training in poorly resourced environments requires resilience and resourcefulness and is better suited to more experienced doctors.
  3. Family support as part of the training package is highly valued.

What strategies can be implemented to support registrars in poorly resourced environments?

RVTS has used multiple strategies over the years, each tailored to individual registrars and settings. However, the following have been important.

  • Regular Contact and Supervision: Frequent interactions with supervisors and medical educators through phone calls, emails, and visits ensure continuous support and guidance. RVTS employs a structured supervision schedule with initial frequent contacts tapering over time as registrars become more confident and experienced.
  • Flexible Approach: Adopting a flexible training approach to account for the varied situations faced by remote doctors is crucial. This involves tailoring supervision and support to meet individual needs and circumstances.
  • Face-to-Face Meetings: Organising regular face-to-face meetings to build group cohesiveness and update essential skills, especially in emergency medicine. RVTS schedules workshops twice a year, which also include social events to foster building a network and community.
  • Collegial and Peer Support: Encouraging peer interactions through weekly teletutorials, WhatsApp groups, and peer study groups, fostering a sense of belonging to a special group.
  • Family Support: Incorporating family support in the training package, such as enabling families to attend workshops, significantly contributes to retention and well-being.
  • Simple Technology Solutions: Using straightforward technology solutions such as phone, email, web-based resources, and Zoom/Teams avoid the need for on-site technical support.

What is an evidence-based framework for supporting registrars in poorly resourced environments, and how can I apply it?

The University of Queensland recently undertook an evaluation of RVTS since its inception in 2000 and found evidence to support the effectiveness of RVTS ‘ efforts in training doctors in poorly resourced environments. This has informed the development of an evidence-based framework that includes:

  • Personalised Support: Tailored education and personal support from supervisors, many of whom are former registrars familiar with the local context. These supervisors serve as independent longitudinal mentors throughout the training, providing continuous, unbiased, and empathetic guidance that is relevant to the specific challenges faced by registrars.
  • The provision of holistic professional support that promotes comfort, confidence, competency, belonging, and professional bonding (the “3Cs and 2Bs”) among the registrars.
  • Continuity of Care: Provides consistent, quality care tailored to community needs in low-resource areas. This fosters…
  • Community Trust: Doctors’ longer tenure builds patient trust and deeper learning. RVTS Doctors spend an average of 5.2 years in the same practice, fostering stability.

To effectively apply this framework:

  • Consider the registrar as a whole person by recognising the educational and psychosocial needs of registrars.
  • Encourage registrars to stay in the same practice for stability and community integration.
  • Implement supervision models that ensure independent, structured, unbiased, and continuous support throughout training.
  • Tailor training to the registrar’s specific work environment.
  • Foster community building through social and professional networks.

Date reviewed: 05 July 2024

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.
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