There's some extra considerations we have to take into account when it comes to LGBTIQ patients in rural and remote Australia. For one, patient confidentiality becomes a much bigger priority than in metropolitan centres. In big city hospitals we might be able to casually mention your last patient was thinking of transitioning or that the lady with abdominal pain in ED told you she was a lesbian when you asked about pregnancy risk. We are unlikely to run into the same patient again and confidentiality is not much of an issue and this information is unlikely to reach their family, their friends or their employers. However, in rural, remote and regional services, casually mentioning the last patient you saw was gay to the nurse or receptionist could have big implications. A patient might suffer severe psychological distress, harm to his family relations and could potentially be the target of homophobia and transphobia. It is much easier to inadvertently out a patient to the entire community in a rural setting with quite significant consequences for the patient. As a medical student, the best you can do is educate yourself! Learn about inclusive practice, read up about gender neutral pronouns, know the referral pathways for people seeking gender affirmation. You don't have to do this alone, there's plenty of LGBTIQ organisations who would be happy to engage with you and guide you to the best resources out there. Get familiar with the LGBTIQ organisations in your area and the support available for LGBTIQ people. Your referral could save a life. ore Trees to pay more attention to international medical students Zheng Jie Lim Introduction International medical students make up a significant proportion of medical students in Australia, with an estimated 1 in 5 medical students who train in Australia having a citizenship elsewhere [1]. While Australia faces a lack of doctors in rural and regional areas [2], we are in a perplexing situation where both international and Australian students face a lack of internship in Australia upon graduation which is necessary to register as a medical practitioner. Research into the extent of contribution international medical students have on alleviating the medical workforce shortage have been limited. Hawthorne and Hamilton showed a strong desire of these students to undertake internships in Australia, with most of them wishing to migrate to Australia [3]Do international medical students desire working in Australia? Unlike domestic medical students, international medical students often face the question of whether to return to their home country for postgraduate training. While Australia represents an attractive place to work, attaining an internship is difficult, given the lack of available internships. In 2016, the Australian Medical Students’ Association (AMSA) Rural Health team conducted an online survey of international medical students to understand their interest in rural placements and internships during their time in medical school and post-graduation. The survey was distributed via social media such as Facebook, with emails sent to international medical students. It is important to note that this survey was distributed with web-based links. As such, the reliability and validity of the survey results remain questionable due to non-universal reach of all International students in Australia. Results of the survey A total of 287 responses were recorded from 14 universities across Australia, with all participants identifying as international undergraduate or postgraduate medical students. 231 (80.49%) expressed their interest in practising in Australia, of whom 178 (77.06%) expected to stay in Australia beyond their specialty training. 275 (95.82%) of international students would consider a rural placement if it increased their likelihood of an internship. 239 (83.28%) students expressed interest in working in regional and rural Australia, with 153 saying they were ‘very interested’ and 86 ‘somewhat interested’. However, 94 (32.75%) of international students expressed that their university did not \ | provide rural placements for international students, while opportunities to experience rural health via the John Flynn Placement Program (JFPP) excludes international students. When asked, 213 (74.22%) of students were ‘very interested’ and 41 (14.29%) were ‘somewhat interested’ in participating in the JEP. Discussion The survey shows that a significant number of international medical students are 1 interested in working in Australia after graduation. For many final year international medical students, internship is the first step to permanent residence in Australia. International medical students do all their medical training (4-6 years) in the Australian healthcare system, are well acculturated to Australia, have a good command of English, and graduate with domestically relevant professional training [4]. With a lack of internship positions available in some states, international medical students find it difficult to commence employment as a medical practitioner here in Australia. As a result, many return back to their home country for postgraduate training.4 VA Ve Fe #4 It is unfortunate that many international medical students are not eligible for extended rural placements in their universities despite an overwhelming desire. International students are private, full-fee paying students, where they can be expected to pay over $350,000 in tuition fees alone [5, 6, 7]. Rural placements have been shown to provide valuable experience to medical students, where they were not only given an opportunity to understand rural health care, but to appreciate a rural community as well [8]. Providing rural placements will encourage these students to work and reside in Australia. International medical students are an untapped workforce that can aid in alleviating medical workforce shortages in rural and regional Australia. Australia currently employs International Medical Graduates, many of whom work in a regional and rural area, constituting more than a quarter of the medical workforce [9]. & These graduates often face significant communication, language, professional and cultural _, barriers [10]. Having spent up to 6 years in Australia, international medical students are. ff.) more equipped with the skills and knowledge suited to an Australian healthcare system. » Conclusion Given Australia's ever increasing demand for doctors, it is prudent not to ignore international medical student numbers in medical workforce planning. They are a potential resource with minimal employment barriers and should be considered during internship allocations, Postgraduate training is a requisite to becoming an independent medical practitioner, with a medical degree the initial step in becoming a fully-fledged doctor. 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