A government-backed initiative aimed at tackling Scotland’s rural GP shortage has been met with criticism, as it appears to have fallen far short of its intended impact. The Scottish Graduate Entry Medicine (ScotGEM) program, designed to encourage medical graduates to work in rural areas, has yielded disappointing results—out of 52 graduates, only 10 pursued GP training, and just two accepted roles in the rural north.
For an initiative intended to bolster primary care in remote areas, these numbers raise serious concerns. Why is it failing to deliver on its promise?
Does the Model Work?
At its core, the ScotGEM program offers financial incentives and a clear pathway into general practice, particularly in rural communities. On paper, this should be an effective way to encourage new doctors to establish themselves in underserved areas.
Yet, the figures suggest otherwise. If only two doctors have taken up posts in rural Scotland, why are the remaining graduates choosing different paths?
Are Incentives Enough?
One of the key components of the scheme is financial support, with bursaries available for those committing to work in rural areas. But is money enough to keep doctors in these regions?
Healthcare professionals often cite workload, professional isolation, and career development limitations as key concerns when considering rural placements. A well-intentioned bursary can help attract interest initially, but does it provide long-term motivation?
Additionally, do these incentives even match what doctors can earn elsewhere? If urban areas or international opportunities provide more competitive salaries with better work-life balance, why would a newly trained GP choose a rural practice instead?
What About Retention?
Recruiting a doctor to a rural area is one challenge—keeping them there is another.
Rural GPs often face:
❌ Long hours with little backup
❌ Limited access to specialist support
❌ Professional and personal isolation
❌ Fewer opportunities for career progression
So even if more doctors were placed in these areas, how many would actually stay long-term? Without a sustainable retention strategy, the ScotGEM program risks becoming a short-term fix for a much deeper problem.
Is It Time for a Different Approach?
Rather than just financial incentives, a more comprehensive strategy could involve:
✔ Flexible working models – Can part-time or rotational roles make rural GP work more appealing?
✔ Better career progression – Could mentorship programs and research opportunities encourage long-term commitment?
✔ Stronger community integration – How can rural practices make new doctors feel more connected, both professionally and socially?
These are the kinds of questions policymakers need to be asking if they truly want to tackle Scotland’s GP crisis in rural areas.
The Scottish Government argues that it’s too early to judge the program’s success since graduates have only recently completed their foundation training. But with urgent workforce shortages, is waiting really an option?
The Bigger Question
Scotland is not alone in struggling to attract doctors to rural areas—this is a challenge seen across the UK, Canada, and Australia. But if financial incentives and structured training pathways aren’t enough, then what will it take to make these roles more desirable?
The conversation around rural GP recruitment needs to shift from just “how do we place doctors here?” to “how do we make rural practice a viable, long-term career choice?”
What do you think? Are schemes like this doomed to fail, or can they be improved?
📩 Would love to hear your thoughts!
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