The rural pipeline to longer-term rural practice: general practitioners and specialists

Kwan, Marcella M. S., Kondalsamy Chennakes, Srinivas, Ranmuthugala, Geetha, Toombs, Maree R. and Nicholson, Geoffrey C. (2017) The rural pipeline to longer-term rural practice: general practitioners and specialists. PLoS One, 12 7: e0180394-e0180394. doi:10.1371/journal.pone.0180394


 
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Author Kwan, Marcella M. S.
Kondalsamy Chennakes, Srinivas
Ranmuthugala, Geetha
Toombs, Maree R.
Nicholson, Geoffrey C.
Title The rural pipeline to longer-term rural practice: general practitioners and specialists
Journal name PLoS One   Check publisher's open access policy
ISSN 1932-6203
Publication date 2017-07-07
Sub-type Article (original research)
DOI 10.1371/journal.pone.0180394
Open Access Status DOI
Volume 12
Issue 7
Start page e0180394
End page e0180394
Total pages 15
Place of publication San Francisco, CA, United States
Publisher Public Library of Science
Language eng
Abstract Rural medical workforce shortage contributes to health disadvantage experienced by rural communities worldwide. This study aimed to determine the regional results of an Australian Government sponsored national program to enhance the Australian rural medical workforce by recruiting rural background students and establishing rural clinical schools (RCS). In particular, we wished to determine predictors of graduates' longer-term rural practice and whether the predictors differ between general practitioners (GPs) and specialists.
Formatted abstract
Background: Rural medical workforce shortage contributes to health disadvantage experienced by rural communities worldwide. This study aimed to determine the regional results of an Australian Government sponsored national program to enhance the Australian rural medical workforce by recruiting rural background students and establishing rural clinical schools (RCS). In particular, we wished to determine predictors of graduates’ longer-term rural practice and whether the predictors differ between general practitioners (GPs) and specialists.

Methods: A cross-sectional cohort study, conducted in 2012, of 729 medical graduates of The University of Queensland 2002–2011. The outcome of interest was primary place of graduates’ practice categorised as rural for at least 50% of time since graduation (‘Longer-term Rural Practice’, LTRP) among GPs and medical specialists. The main exposures were rural background (RB) or metropolitan background (MB), and attendance at a metropolitan clinical school (MCS) or the Rural Clinical School for one year (RCS-1) or two years (RCS-2).

Results: Independent predictors of LTRP (odds ratio [95% confidence interval]) were RB (2.10 [1.37–3.20]), RCS-1 (2.85 [1.77–4.58]), RCS-2 (5.38 [3.15–9.20]), GP (3.40 [2.13–5.43]), and bonded scholarship (2.11 [1.19–3.76]). Compared to being single, having a metropolitan background partner was a negative predictor (0.34 [0.21–0.57]). The effects of RB and RCS were additive—compared to MB and MCS (Reference group): RB and RCS-1 (6.58 [3.32–13.04]), RB and RCS-2 (10.36[4.89–21.93]). Although specialists were less likely than GPs to be in LTRP, the pattern of the effects of rural exposures was similar, although some significant differences in the effects of the duration of RCS attendance, bonded scholarships and partner’s background were apparent.

Conclusions: Among both specialists and GPs, rural background and rural clinical school attendance are independent, duration-dependent, and additive, predictors of longer-term rural practice. Metropolitan-based medical schools can enhance both specialist and GP rural medical workforce by enrolling rural background medical students and providing them with long-term rural undergraduate clinical training. Policy settings to achieve optimum rural workforce outcomes may differ between specialists and GPs.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
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Created: Thu, 20 Jul 2017, 15:09:47 EST by Marcella Kwan on behalf of Rural Clinical School