General practice training in regional and rural Australia: A cross-sectional analysis of the Registrar Clinical Encounters in Training study.

Abstract

We aimed to investigate registrar, practice and consultation characteristics associated with varying degrees of GP registrars' practice rurality. A cross-sectional analysis of 12 rounds of data collection (2010-2015) from the longitudinal Registrar Clinical Encounters in Training study, an ongoing, cohort study of Australian GP registrars. The principal analysis used was a generalised ordered logistic regression. GP registrars in training practices within five of 17 GP regional training providers in five Australian states. Degree of rurality of the practice in which the registrar undertook training terms was calculated from the practice postcode using the Australian Standard Classification-Remoteness Area classification. A total of 1161 registrars contributed data for 166 998 patient consultations (response rate 95.5%). Of these, 56.9% were in major city practices (ASGC-RA1), 25.7% were in inner-regional practices (ASGC-RA2) and 17.4% were in outer-regional/rural practices (ASGC-RA3-5). Several statistically significant associations (P = < .001) were found within regional/rural practices (ASGC-RA2-5), when compared with major city practices (ASGC-RA1). These included registrar characteristics such as being in Term 1, being medically trained overseas, and having worked at the practice previously; patient characteristics such as the patient being an existing patient, being older and being Aboriginal or Torres Strait Islander; and consultation characteristics such as performance of procedures. Our findings suggest that registrars are undertaking rural practice early in their GP training and are being exposed to a rich and challenging mix of clinical and educational practice.