Two decades of building capacity in rural health education, training and research in Australia: University Departments of Rural Health and Rural Clinical Schools David Lyle, MBBS, PhD, FAFPHM, 1 and Jennene Greenhill, PhD, MSocPlan&Dev, BA, GradDipAppSc, RMN, RN 2 1 Broken Hill University Department of Rural Health, University of Sydney, Broken Hill, New South Wales, and 2 Rural Clinical School, Flinders University, Renmark, South Australia, Australia Abstract This review article reports on the contribution of uni- versity Departments of Rural Health and Rural Clini- cal Schools to the development of rural health and the rural health workforce and is set at the Australian Government’s university Departments of Rural Health and Rural Clinical Training and Support Programs. The main outcome measures include educational infrastructure, clinical academic workforce, student numbers, community engagement, research outputs, rural health and workforce outcomes. As a result, uni- versity Departments of Rural Health and Rural Clini- cal Schools have established a substantial geographical footprint covering most of the rural and remote popu- lations and regions across Australia. They have a large distributed rural clinical academic workforce that exceeds 1300. Medical student numbers on long-term placements have increased threefold from inception to 1200 annually. Allied health and nursing numbers doubled over 10 years to 4000 in 2013 and are pro- jected to double again by 2018. In 2013, they pub- lished 363 peer-reviewed papers – half of which specifically addressed rural and/or remote health issues. High levels of intention to practise rurally and uptake of rural and remote practice following expo- sure to rural training have been reported, especially for medicine. Thus, university Departments of Rural Health and Rural Clinical Schools constitute a national network of academic units that deliver aca- demically enriched clinical education and training for medical, nursing and allied health students and fulfil an essential academic role for the health system in rural and remote Australia. Community engagement and accountability to region are hallmarks of the pro- gram. Early evidence of the uptake of rural and remote practice following exposure to rural training has set expectations for the Rural Health Multidisci- plinary Training Program. KEY WORDS: program evaluation, rural health academic centres, rural health education and train- ing, rural health workforce development. Introduction The viability of rural and remote communities depends on access to quality health services, which, in turn, relies on being able to attract a highly trained, sustain- able health workforce. During the 1990s and 2000s, university Departments of Rural Health (UDRHs) and Rural Clinical Schools (RCSs) were established with a view to ensuring a suitably trained rural health work- force and were instigated as a key initiative of the coalition government’s Rural Workforce Strategy at the 1996 federal election. Multidisciplinary UDRHs and RCSs that focused on medical student training were designed to provide teaching and learning facili- ties in non-metropolitan centres across Australia. These programs aimed to attract medical, nursing and allied health professionals to reside and practise in rural and remote communities. The declining social and economic circumstances in rural Australia in the latter part of the 20th century were accompanied by significant rural health work- force shortages and health service problems 1 which had garnered community support and attracted gov- ernmental attention. As a result, the National Rural Health Alliance and the Rural Doctors Association of Australia, together with other rural professional groups, had advocated addressing the shortage of rural Correspondence: David Lyle, Broken Hill University Depart- ment of Rural Health, PO BOX 457, Broken Hill, New South Wales 2880, Australia. Email: david.lyle@health.nsw.gov.au Disclosure: The authors declare the following possible com- peting interests. Accepted for publication 4 August 2018. doi: 10.1111/ajr.12470 © 2018 National Rural Health Alliance Ltd. Aust. J. Rural Health (2018) 26, 314–322