Training future rural doctors and academics to ensure rural communities receive equitable access to quality healthcare is as important today as when the Rural Clinical School of Western Australia (RCSWA) was founded two decades ago.
Spanning some 3,500 kilometres across WA, the school’s 15 sites continue to provide a rich rural educational experience to medical students and drive collaborative community research to improve health outcomes in rural and remote Australia.
In this twentieth anniversary year of the RCSWA, the school's leaders reflect on its humble beginnings, its bold achievements, and its champions who never lost sight of the bigger picture.
The first offices of the Rural Clinical School of Western Australia in Kalgoorlie were mapped out with string on the floor of a former video store.
Long-serving administrator Rhonda Worthington recalls a cleaner throwing the string away but not before she and colleagues Dr Phil Reid and Professor Campbell Murdoch were able to visualise the store’s transformation.
“We didn’t want to spend too much money on the fit out so we didn’t build the walls all the way to the ceiling. We soon discovered that everything said in the back office could be heard in reception,” Rhonda said.
“It was still better than operating from the Yelverton Hotel or the boot of my car. We didn’t have so much as a paper clip at our first meeting.
“I’d never worked so hard in my life as when I started at the school, but I never lost faith.”
Faith, destiny, good fortune. All these forces seemingly conspired to draw Campbell away from his rural practice in New Zealand and towards the mining town of Kalgoorlie. He had established the practice after 15 years of chairing university departments in New Zealand, United Arab Emirates and Malaysia.
“I had a research colleague in Dunedin, Harriet Denz-Penhey, who happened to be speaking to Vivienne Duggin in Kalgoorlie (then Goldfields GP Network CEO) about the WA school plans. Vivienne said the school wanted its headquarters to be in Kalgoorlie but couldn’t find a head to go there,” he explained.
“Harriet said ‘what about Campbell?’ and Vivienne replied ‘Who’s Campbell?’”
Within a few hours, Vivienne and Phil had spoken to Campbell by phone and arrangements were made for Campbell to fly to Kalgoorlie in October 2001. He later flew to Perth to meet with the Dean of UWA, Lou Landau.
“The university initially offered me a six-month contract as head of school just to see how I’d go. I think they were a bit nervous about someone who actually wanted to come to Kalgoorlie,” he added.
Campbell and the team quickly got to work, establishing headquarters in Kalgoorlie and sites in Geraldton, Port Hedland and Broome before welcoming the first cohort of seven students in June 2002.
Image: Vivienne Duggin, Campbell Murdoch and Phil Reid, at the opening of RCSWA Kalgoorlie 2002..
Campbell said the curriculum was the same as the UWA course in Perth but was delivered in the context of the local Aboriginal health services, rural practices and hospitals.
Months later the team relocated to a larger office at 337 Hannan Street, all while negotiating the construction of a new fit-for-purpose office on the Kalgoorlie Hospital site which was finally opened on 6 November 2006.
“Getting our curriculum accepted was really touch and go for a while because there was reluctance, particularly from the Perth-based departments responsible for fifth year students,” Campbell explained.
“They were naturally concerned that their precious teaching time might be farmed out to an unknown outfit that didn’t know what they were doing! The students who were coming for the 2003 year were also concerned that they might be guinea pigs. It was a team effort getting enough people to come.”
Undeterred by these challenges, the school employed a range of qualified medical coordinators, GPs and administrators. It was the student success stories which quickly helped shift the perception of the school from being an unknown outfit to a highly desirable place of study.
Image: RCSWA Staff and Students orientation in Esperance, January 2004.
It wasn’t just as good as what was happening in Perth, it was better,” Campbell said.
“We had people applying not because they wanted to work rural, but because it was better clinical training than they were getting in Perth. The students voted with their feet and within a year or two we were getting twice as many students as we could take.”
The school expanded quickly and opened offices in Esperance (2004), Derby and Albany (2005), Karratha (2006), Bunbury and Narrogin (2007).
In Campbell’s final year at the helm in 2007, the school won a prestigious Carrick Award for its Clinical Learning Embedded in Rural Communities (CLERC) Program. Open to all universities, the award acknowledged the vital contribution made by individuals and teams to the quality of student learning in Australia.
Image: Head of School Campbell Murdoch (centre), to his right Geoff Riley and the late Denese Playford at the Carrick Award ceremony, 2007.
When it was time for Campbell to hand the baton over to new head of school Geoff Riley, Campbell recalls doing so with happy memories.
Spending 18 months prior as deputy head of the RCSWA, Geoff was very familiar with school operations and began his si x-year tenure as head focused on consolidation and incremental development.
Geoff lived in Albany but made a point of visiting each school site at least twice a year. He wanted to ensure his staff felt supported and that the unique culture of the RCSWA was preserved.
“This identity and culture were already well established through Campbell’s time. He had recruited outstanding rural GPs and specialists who were creative and innovative teachers,” Geoff said.
“Helping them become the best that they could be became my main goal as a leader. Mentoring, advocating for them, saying yes to new ideas, were paramount. The organisation was never ‘top down’. The MC staff were the creative engine of the RCS.”
Geoff explained that a lot of thought and research went into determining which towns would become new RCSWA sites.
“The critical questions that Rhonda and I would explore were things like - Is there a sufficient population to sustain the clinical experience for students? Are there good doctors that would be willing to step up? If that was the case then the next steps were to find suitable office space and housing for students,” Geoff explained.
“You must have a physical presence in the town. You can’t send students 2,000 kilometres away from Perth and expect them to find accommodation and pay rent.”
During Geoff’s tenure, a further four sites were established in Busselton and Carnarvon (2009), Kununurra (2011) and Northam (2014).
Geoff also helped integrate the UWA-Notre Dame partnership, established several RCSWA committees and witnessed the first groups of RCSWA alumni fill the wards of regional hospitals.
He is most proud of achieving successful consolidation and expansion of the RCSWA while preserving its culture of goodwill, innovation and excellence.
“The RCSWA has wonderful academic and professional staff and students who are creating something genuinely remarkable and with great generosity of spirit. As Campbell used to say, head of the RCS is the best job in the world,” Geoff added.
Professor David Atkinson was director of the UWA Centre for Aboriginal Medical and Dental Health in Perth in 2001 before he moved to Broome to establish both the RCSWA and the GP registrar program across the Kimberley in 2002.
He became the third head of school in 2015 and his leadership over the next four years helped grow student placements and establish the Regional Training Hubs in WA, a rural research platform and final year program. David also saw the addition of Curtin University to the RCSWA through negotiations with the Australian Government.
The WA Integrated Regional Training Hub program was introduced in 2017 with an aim to foster more rural training pathways across the state for medical students beyond their time at the RCSWA.
Former RCSWA project manager Carol Chandler witnessed the program launch and remembers how David’s dedication to boosting the rural medical workforce drove him to create the Hubs program.
“David was a rural champion to set up GP registrar training in the Kimberley and he is proof that if you have a rural champion in a rural town, people will follow,” Carol said.
The primary goals of the Hubs program remain the recruitment and retention of a committed rural medical workforce, and ultimately the development of a diverse range of rural medical professionals and rural generalists.
From the original Hubs team comprised of David, Carol, Dr Brian Cunningham, Dr Angela Glen, Dr Amanda Gee and Dr Bec Ledingham, has grown a team of 20 academics and eight project officers whose work is dedicated to creating rural medical training pathways for students.
David became the longest-serving staff member to be head of school and despite retiring from the RCSWA in 2021, he maintains ties to the school by teaching students on placement at Broome Regional Aboriginal Medical Service and as an honorary senior research fellow.
In reflecting on his tenure, David described the school as a source of joy for him.
“The RCSWA has been a very important part of my life - close to half my working life,” he said.
“There’s about 30 former RCSWA students in Broome and surrounding areas. Seeing those people become wonderful doctors has been such a reward for me.”
Dr Andrew Kirke first encountered the RCSWA in 2003 while working as a GP in Kalgoorlie. Much later he was nominated by David to develop a multidisciplinary teaching program to assist GPs involved in the school. Andrew then stepped up as deputy for two years before taking the helm in 2019.
“It seemed like such a great idea and I thought it would be wonderful to be involved,” Andrew said.
In his first year, Andrew fostered the new collaboration with Curtin University which reaffirmed RCSWA’s status as the only multi-university rural clinical school in the country.
Image: Kalgoorlie MC's - Christine Jeffries-Stokes, Phil Reid, Clare Willix, Andrew Kirke and Kathy Mallory (seated), 2008.
He also opened an office in the Warren Blackwood region (2020) and facilitated the introduction of a Final Year program, commencing in Bunbury (2019) and extending to Albany (2020), Broome (2021), and Geraldton and Kalgoorlie (2022). This meant that students could not only complete their penultimate year of medical study in the country, but also their final year of study.
The boost in student numbers has helped RCSWA inch closer to achieving its mission of training future rural doctors to ensure rural Western Australians receive high quality, equitable healthcare.
“Our strength is our people – getting good people and encouraging them to give it a go,” Andrew said.
“As our alumni become doctors in the bush, we see an organic growth in teachers and training resources to support more students. We really have the potential to be a self-sustaining training program that can create a stable rural medical workforce.
“It’s a big dream but that is at the heart of everything we do at the RCSWA.”
More than 1,500 students have successfully graduated from the RCSWA over its 20-year history.