Short Communication

Distributed learning as a means of delivering socially accountable medical training

AUTHORS

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Steven Lillis
1 (New Zealand European) PhD, Associate Professor * ORCID logo

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Rawiri Keenan
1 Associate Professor ORCID logo

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Joseph Scott-Jones
1,2 General Practitioner and Honorary Associate Professor

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David McCormack
1 MBBS, Professor, Interim Dean of Medicine ORCID logo

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Ross Lawrenson
1 MBBS, Professor ORCID logo

AFFILIATIONS

1 Te Huataki Waiora School of Health, Waikato University, Hamilton, New Zealand

2 Pinnacle – Opotiki, Ohope, New Zealand

ACCEPTED: 28 January 2026


Early Abstract:

Aotearoa New Zealand faces an ongoing shortage of general practitioners (family physicians), disproportionately affecting rural and underserved communities. Although this issue is global, solutions must be context-specific. Traditional medical education pathways in New Zealand have not produced a workforce representative of or committed to serving these populations. This has created a situation where primary health care is increasingly difficult to access, particularly for rural and marginalised communities, with inevitable consequences of poor health outcomes and increased secondary care utilisation. Social accountability as a basic principle of undergraduate medical training has been suggested since to 1990s as a method of solving some of these issues. Distributed learning with a significant portion of experience and training in rural and provincial community primary care practices as well as utilisation of rural and provincial hospitals, embedded within a socially accountable framework, offers an innovative model of medical training. This short communication outlines the rationale for and structure of a proposed new graduate-entry, four-year medical program in Aotearoa New Zealand that emphasises rural and provincial community-based training. We argue that this model is both urgently needed and potentially generalisable to other nations grappling with similar workforce inequities.
Keywords: Aotearoa New Zealand, distributed learning, general practice, medical education, social accountability.