Case Studies & Profiles

Rural Generalist Training

Case study

A training pathway benefitting junior doctors and rural communities

To negotiate your way through Rural Generalist training can be difficult. Having a professional body that will help you do that – and give you support along the way – is extremely useful. It also helps to ensure services are available for rural and remote communities.

Dr Luke Manestar-Forde, NSW Rural Generalist Medical Training Program graduate.

Dr Luke Manestar-Forde realised early on in his medical training that he wanted to pursue a career as a Rural Generalist with specialist advanced skills that could support a regional community. Now two years on from completing HETI’s Rural Generalist Medical Training Program, Luke feels settled in his role as a GP Anaesthetist in the rural community of Griffith in south west NSW. He divides his week between delivering anaesthetic services at the local hospital and primary care as a General Practitioner. He couldn’t be happier with his decision – or the path he took to reach this destination.

“I did my third year of medicine in a rural clinical school in Cooma, south of Canberra. I was really inspired by the work of the Rural Generalists there. There were five or six General Practitioner Anaesthetists and two or three General Practitioner Obstetricians. While it’s been a fairly long road, I knew then that rural general practice with an advanced skill was something to consider,” he says.

Luke admits he hasn’t followed the typical rural doctor pathway, coming to medicine as a mature age student and completing his General Practice training prior to entering HETI’s NSW Rural Generalist Medical Training Program. However, the flexibility offered by HETI was one of the reasons the training program appealed to him – as was the support and coordinated approach.

“The NSW Rural Generalist Medical Training Program wasn’t established when I started my general practice training so I only did my advanced skills training in anaesthetics through HETI. Having the entry point at different stages was a definite advantage for me, as well as the flexibility to come in for only one year,” he says.

The NSW Rural Generalist Medical Training Program is a supported training pathway for doctors wishing to pursue a career as a rural general practitioner who is able to provide primary care within a community setting as well as advanced skills services within a rural hospital. The program, which commenced in 2013, aims to increase the numbers of rural general practitioners with speciality skills so patients in rural communities have access to advanced skills services without the need to travel long distances.

Growing from an initial intake of 13 trainees in the first year to 50 in 2019, the program now offers advanced skills training in mental health, palliative care, paediatrics and a combination of obstetrics and emergency medicine, in addition to its initial pathways of anaesthetists and obstetrics. While the majority of trainees commence the program with a Foundation Year, the program recognises the diverse backgrounds of trainees and many join either during or after completing community general practice training and prior to college fellowship, like Luke.

“I worked out my own pathway [to become a rural generalist], but it is fairly complicated, with many people and organisations involved. Everyone will have different experiences and different motivations. To try to negotiate your way through can be a little bit difficult so having a professional body that will help you do that – and give you support along the way - is very useful,” Luke says, adding that HETI staff were extremely helpful in answering his questions and connecting him with other training and networking opportunities.

“For me, this program isn’t just important for training rural general practitioners to have advanced skills. Providing access to this training also helps to ensure services are available in rural and remote communities where there are shortages. Ultimately, we are providing services so people don’t have to travel 500 kilometres to deliver their baby or have other treatments and that’s crucial.”

Key benefits

  • Choice of advanced skills pathways
  • Flexible entry points
  • Access to additional training, conferences, networking, mentoring
  • Career advice


  • >130 trainees in the program
  • 6 advanced skills pathways

The Program