How big a population base is needed to support a subspecialist? (CREI or MFM)

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Hi all,

An Aussie med student here, I have tried to find info on this related to Australia, but have had no luck, so am asking here in the hopes that there will be similarities between our two countries.

Here is my dilemma: I am very interested in infertility or MFM. Here is Aus we have similar probs with attracting physicians to rural/remote areas as you do in the states. The govt has introduced a few schemes to help with this, one of which is a scholarship which pays about $20K a year through med school (5 years for me as a grad in an undergrad program, makes life a LOT easier!) with the proviso that once you have a fellowship (can be GP or any specialty) you spend six years working in a rural area. For specialists this is defined as anywhere with a population under 100K.

My question is this: can a CREI or MFM be supported in this size population, given that for Aus this is the size of a large regional centre and referrals from surrounding areas would be expected.

(I am aware that if I were to go this route, CREI would probably be more feasible as most hospitals outside the state capitals in Aus do not have NICUs above level 2a (infants requiring 2b or 3 care are usually airlifted to capitals by the flying doctors).)

If not, I would definitely consider doing basic Ob/Gyn training, working the six years as an Ob/Gyn and then returning to the city for subspecialising, but here it is much easier to do fellowship and subspeciality training joined together as it takes about two-three years off the length of training, so I would prefer that.



Can anyone help me out with opinions?

Thanks!

It depends on the location of the 100,000 population city.

If the city is a regional center and the largest city within several hundred miles the answer is yes.

If the city is adjacent to a large metropolitan area that serves as the regional center, then less likely.