Review Article
Sexual assault medical and forensic examiners in regional and rural NSW, Australia: a qualitative study of experiences impacting workforce participation
AUTHORS
Tatum Faber1 MD, Medical Officer
Sam Sperring2 PhD, Researcher
Ellie Freedman3 FAChSHM, Staff Specialist, Medical Forensic Portfolio
Rosalie Power2 PhD, Associate Research Fellow
Samantha Ryan2 PhD, Associate Research Fellow
Natalie Edmiston4 FAChSHM, Senior Lecturer, Rural Research * 
AFFILIATIONS
1 South Eastern Sydney Local Health District, Taren Point, NSW 2229, Australia
2 Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
3 NSW Health Education Centre Against Violence (ECAV), Western Sydney Local Health District, North Parramatta, NSW 2151, Australia
4 University Centre for Rural Health, Western Sydney University, Lismore, NSW 2480, Australia
ACCEPTED: 8 September 2026
Early Abstract:
Introduction: People who have experienced sexual assault have many acute needs requiring timely attention. In New South Wales (NSW), Australia, reported sexual assault rates have been increasing over the past decade, with reported rates increasing at a higher rate outside metropolitan areas. These areas experience chronic shortages of medical and forensic examiners able to deliver timely care. The aim of this study was to identify the motivations, barriers and facilitators affecting the recruitment and retention of examiners in regional and rural NSW, Australia.
Methods: Doctors and sexual assault nurse examiners who have worked as examiners for NSW sexual assault services in a non-metropolitan area were recruited to participate in a semi-structured interview. Written informed consent was obtained, and interviews were recorded and transcribed. Data was coded using a combination of deductive and inductive approaches. Themes were developed according to Braun and Clarke’s thematic analysis approach.
Results: A total of 13 participants were interviewed, of which 11 were female and 2 were male; 9 were doctors and 4 were nurses Five key themes were identified: (1) structural challenges of rural service delivery, (2) near invisibility in the health system, (3) isolation and missed connections with colleagues, (4) inability to thrive, and (5) sense of duty to colleagues and community.
Whilst motivated by obligation to colleagues and community, barriers of travel time over large geographic areas and insufficient examinations to maintain skills were present. Potential facilitators such as peer support, contributing to policy and funded training opportunities were considered to be lacking.
Conclusion: To ensure the sustainability of rural sexual assault medical workforces, change addressing isolation and invisibility is needed. Future changes to services should be considered from a rural lens, as rural examiners face unique barriers to workforce participation and are essential to service delivery.
Keywords: forensic medicine, medical examiners, rural health services, sex offences, workforce.