We’re showcasing how RANZCP members have a positive impact on their communities and collectively help to build a connected, strong and thriving psychiatric profession across Australia and New Zealand. Dr Steven Blefari generously shared with us his reflections on establishing the Rural Psychiatry Training WA program and how this program has strengthened rural workforce retention while fostering a strong culture of connection, belonging and community across the program.

Tell us about your current role

In my current work, I hold two roles. Clinically, I’m a consultant child and adolescent psychiatrist in a rural Infant, Child and Adolescent Mental Health Service. Alongside that, I’m the Director of Training for Rural Psychiatry Training WA (RPTWA), supporting trainees across rural WA.

What led you to establish the Rural Psychiatry Training WA (RPTWA) program?

A few things led me to establish RPTWA, but the main driver was a clear workforce need and the responsibility to better meet community demand in rural, regional and remote areas. We wanted more than a “metro-first” model where people train in the city and only do a short rural stint; we needed a rural program with its own agency and purpose. The College’s Rural Roadmap was also a catalyst. Once that work was underway, it helped kick off a chain of events that led us to seek accreditation for a standalone rural training program focused on learning, development, and long-term retention.

What inspires or motivates you to do the work you do?

What motivates me is the reality of the need in the rural services where I live and work, and the opportunity to shift the system so it serves those communities better. I’m inspired by the mindset shift that rural training can be the primary pathway and by what it offers trainees as a richer, more connected training experience. I also stay focused on the evidence that the more people train in the country, the more likely they are to stay, so building training capacity is a practical way to improve retention in the long term.

What outcomes or impacts are you most proud of since establishing RPTWA?

I’m most proud of seeing trainees complete the program and then sign contracts to work with WA Country Health Service because that’s the end goal. We’re already seeing strong retention, with the overwhelming majority of trainees from the program staying in the locations where they trained. I’m also proud of the culture we’ve built: reading trainees’ final reflective reports has highlighted a real sense of belonging and community, even across huge distances.

We’ve invested in connection through regular videoconferencing, monthly whole-of-program “town hall” catch-ups, exam preparation groups, and an annual in-person event called Dandjoo (meaning “connection”) that brings everyone together.

You’re involved in several RANZCP committees and working groups. How has this broader College engagement influenced your work with rural training, and vice versa?

My broader College engagement has been really important because, if I want to be ambitious about changing the rural workforce, I need to lean into the College and help influence the system settings that affect rural training. Being involved in committees and working groups, particularly around issues like remote supervision and alternative ways of meeting mandatory rotation requirements in rural locations lets me contribute to change that then directly supports what we’re doing in WA. At the same time, the relationships I’ve built through College networks (including other Directors of Training, Congress connections, and advisory groups) bring ideas, support and learning back into RPTWA. That experience has also flowed outward: I’m now being asked within my own organisation to advise other medical specialties on how to expand specialty training in rural areas, and we’re building an end-to-end rural pipeline alongside rural clinical schools and rural internships.