Effectiveness of regional medical schools in attracting and retaining students for early-career practice in the local area: The James Cook University experience.

Abstract

The regionally based James Cook University medical school in northern Australia has focused its selection processes and curriculum on recruiting, training and graduating doctors to address local workforce needs. This study investigates if James Cook University's regionally based medical school model promotes graduates undertaking internship in local regional hospitals. Cross-sectional survey of final year James Cook University Bachelor of Medicine, Bachelor of Surgery graduates towards the end of the 2016 and 2017 academic years (n=207; response rate=58%). Multivariate (binary outcomes) logistic regression analysis identified the personal and curriculum factors predicting students' choice to do their internship in northern Australia supported by content analysis of free text responses to expand on quantitative associations. Students applied to medicine at James Cook University because there was: "an undergraduate program" (62%); "reputation for a good course/quality graduates" (59%); and "interest in rural medicine or Indigenous health" (39%). Internship in northern Australian hospitals was predicted by: "familiarity with the hospital in Years 5 and 6"; "having a northern Australia hometown at time of application to medical school"; "an interest in rural medicine or Indigenous health"; and "interns have better learning experiences in regional teaching hospitals". The findings suggest regionally based medical schools can promote early-career rural practice by incorporating purposive selection, a rurally focused curriculum supported by quality clinical training experiences in local hospitals and a sufficient number of locally available intern places. However, it is likely regionally based medical schools also require locally available specialty training pathways to support rural practice in the longer term.