A dedicated Coonabarabran doctor who is in her final year of training to become a Rural Generalist – and who also plays representative rugby union – was last week recognsed for her significant work in rural health advocacy and ‘flying the flag’ for rural junior doctors everywhere.

Dr Jean Littlewood was announced as the recipient of the Rural Doctors Association of Australia’s (RDAA) Rural Doctor in Training of the Year Award 2025, at the Rural Medicine Australia (RMA25) Conference Dinner in Perth on Friday night.

Jean was raised on a small farm between Tamworth and Gunnedah, and attended the local primary school of about 30 children in Somerton.

“My parents were both teachers, so I heard a lot about the characters they came across in rural towns – it really highlighted to me how interesting living and working in a rural town could be” she said.

“I always knew I wanted to do something in healthcare, but didn’t think I was bright enough to get into Medicine.

"What really cemented my passion for it was spending some time at the local general practice in Manilla, where the doctor was a really kind and knowledgeable Rural Generalist who had been working in the community for 30 years.

“He had a labrador who loved hanging around the practice, he sat on a gym ball when he was consulting, and the way he interacted with his patients was something I really admired.

“I loved talking to his patients and hearing their wonderful stories, and felt that a career in Rural Medicine would enable me to do that too."

Dr Littlewood didn’t get into Medicine on her first attempt.

So she tackled a Degree in Medical Science first and was then accepted into Medicine the following year.

"The privilege wasn’t lost on me when I got there," she said.

She spent time studying and training in Sydney and Port Macquarie, before moving back inland to Dubbo to undertake her early years.

"There were a lot of fantastic doctors and health staff at the Dubbo Hospital whom I learnt a lot from, before making the move to general practice in Wellington to continue my training.

"This was with the legendary Dr Ian Spencer, who has been there for 50 years.

"You couldn’t train under a better doctor - he taught me so much about Medicine and about being a good person.

“I’m now continuing my training in Coonabarabran with another icon of Rural Medicine, Dr Aniello Ianuzzi – who is not only a great doctor, but also an excellent wine and pasta maker."

“I’ve always been interested in people and their backgrounds, and working as a Rural Generalist trainee enables me to meet and treat all these incredible people from all walks of life.

"I love Rural Generalist Medicine because I can look after my patients in an holistic way – I can treat the person as well as the pathology, and I can look after my community both in the general practice and also at the hospital. To me, that makes for a very rewarding career!” she said.

Dr Littlewood said it is critical to ensure that more junior doctors are able to undertake placements in rural general practice, and to then also feel supported as a young rural GP or RG Registrar.

“As JMOs, a lot of our day is geared towards the hospital environment, rather than general practice – so it is critical that if we want to encourage more junior doctors to consider a career in general practice or Rural Generalist Medicine, we make it easier for them to sample those fields of Medicine and see how rewarding they are.

“We also need to ensure that, once someone does decide to move to a rural area as a GP or RG, they feel supported there.

"Junior doctors and registrars nowadays are looking outside traditional rural doctor work models – they may want to work part-time, they may want to work in a rural community for a couple of years but potentially move to another community or elsewhere after that; and many just want to work as a rural doctor and don’t want to have to buy into a practice."

She says these are all factors that have to be taken into account in order to make the path to Rural Medicine the most enticing it can be for the next generation of doctors.

“It also seems paradoxical that while junior doctors are being encouraged to ‘go rural’ and be a Rural GP or an RG, rural hospitals and local health services in numerous states continue to be downgraded.

"In some states things seem to be getting a bit better, but there’s still a long way to go!” She said.

Country rugby is like rural medicine 

Outside Medicine, Dr Littlewood has a passion for playing rugby union which took flight when she was undertaking her medical studies.

She has since gone on to play rugby union at a high level in NSW, including on the NSW Country Rugby Union (Corellas) Representative team and zone representative teams for the Central West, Central North and Mid North Coast – as well as on the local teams in Gunnedah, Port Macquarie and Dubbo.

“To me, a game of country rugby is the same as Rural Medicine.

We are all different shapes and sizes and we have different skills, but we are all working together for the same thing” she said.

“I’m always hopeful, however, that an opponent I tackled on the field on Saturday isn’t someone who presents with an injury that I need to treat on Monday!”

In congratulating Dr Littlewood, RDAA President Dr Sarah Chalmers said, “Jean is an absolute dynamo – her advocacy efforts so early in her career have already left an enormous legacy that will benefit countless junior doctors who want to ‘go rural’ in the future… as well as the rural and remote communities in which they will work.

“Throughout her medical training, she has demonstrated an unwavering commitment to rural health and pursuing a career as a Rural Generalist doctor.

“While she undertook her first years of medical studies at the Sydney campus of the University of New South Wales, she then moved to the University’s Port Macquarie Rural Clinical School to complete her medical degree," Dr Chalmers said.

“After that, it was rural all the way.

"“Despite being incredibly busy working as a junior doctor and studying to complete her RG Registrar training, Jean has been very active in the advocacy space."

She said Jean has been an active member of RDA NSW and taken on roles on other boards, advisory groups and foundations.

“One of her most impactful contributions while on the RDA NSW Management Committee was the part she played in gaining a fairer deal for rurally-based Junior Medical Officers (JMOs) in NSW when they undertake training rotations in metropolitan hospitals.

“While metropolitan-based JMOs in NSW had been automatically receiving additional pay increments from NSW Health when working and training in rotations at rural hospitals, rurally-based JMOs were not receiving equivalent pay and conditions when undertaking rotations in metropolitan hospitals.

Rurally-based JMOs also faced a much more difficult process in receiving accommodation support and other supports while on city placements."

Jean and the RDA NSW Committee fought against this, not just on grounds of fairness but also for how it made rurally-based JMO training positions much less appealing to junior doctors.

“This advocacy was rewarded with a change to the policy that now provides the same remuneration to all NSW JMOs, regardless of whether they are metro-based or rurally-based."

Jean has also played a lead role in co-ordinating orientation week (O-Week) sessions and #DestinationRural events for junior doctors across NSW to help show the wide variety of career paths that Rural Medicine offers and speaks at rural medical careers forums to inspire high school and medical students to consider becoming a rural doctor.

“Jean exemplifies the passion, leadership and commitment to service that defines an outstanding Doctor in Training," Dr Chalmers said.

"Her contributions have had a lasting impact on rural health in NSW, and she is highly deserving of this year’s Award.”