![Figure](https://www.cmaj.ca/content/cmaj/166/6/791.1/F1.medium.gif)
Figure. A recent CMAJ article on the cardiovascular effects of adult recreational hockey (CMAJ 2002; 166 [3]:303-7) struck a chord with Halifax Chronicle-Herald editorial cartoonist Bruce MacKinnon, who came up with this rendition of the type of person who plays in “oldtimer” leagues. The Globe and Mail also produced a cartoon on the subject. Photo by: Bruce MacKinnon, Halifax Herald Ltd.
In an unusual move, the state government in New South Wales (NSW), Australia, is set to launch a Can$1.6 million advertising campaign designed to entice foreign doctors to settle in the state's rural areas. Recruitment has traditionally been the responsibility of financially strapped local hospitals and communities, and the state-sponsored campaign represents a significant change in direction. The Ministry of Health in NSW is banking on a relaxed lifestyle, warm climate and invitation to adventure to lure physicians to their rural and remote communities. And even though the ads have yet to be placed in international journals, there has already been a surge of media interest, says Kathy Connell, a spokeswoman for NSW Health.
![Figure](https://www.cmaj.ca/content/cmaj/166/6/791.1/F2.medium.gif)
Figure. Recruiting for the outback Photo by: NSW Health
Both Australians working overseas and foreign-trained doctors are to be targeted in the advertisements, which are scheduled to appear soon in newspapers and journals in Australia, Canada, New Zealand, Great Britain and the US. But NSW will face some stiff competition, since shortages of rural physicians, many of them critical, are an international problem. Many communities in these countries are already offering similar incentives to entice rural doctors.
A doctor working in rural NSW can expect to earn about Aus$150 000 (Can$123 000), says Connell. Incentives offered by the NSW Rural Doctors' Network include relocation and continuing education grants, and rural communities have upped the ante with offers of rent-free medical premises, subsidized accommodations, cars and even office furniture and computers.
Canadian-trained doctors have a significant advantage over some other potential medical immigrants because their training exempts them from writing a qualifying exam administered by the Australia Medical Council and generally eases their admission into the country.
The NSW campaign may be extended to other, non-English speaking countries if it proves successful, but that is a big if because the campaign has already generated intense criticism from the powerful Australian Medical Association (AMA). No one argues over the existence of a rural physician crisis in NSW — nationwide, the shortages are estimated to stand at between 1100 and 1600 doctors in rural areas alone. According to Connell, foreign-trained doctors already represent a significant and growing percentage of the current medical workforce in Australia.
But there is considerable argument about whether the ad campaign is the way to solve the crisis. The AMA's NSW division has called it absurd. The NSW rural doctors' representative, Dr. Aniello Iannuzzi, comments: “The Aus$2 million for this scheme would be better spent on elective surgery waiting lists or on rural health.” And in a message that will sound familiar to Canadian doctors, he says the government would be further ahead to make medicine more attractive to graduates of Australian medical schools. — Jennifer Crump, Smooth Rock Falls, Ont.