Graduate rural work outcomes of the first 8years of a medical school: What can we learn about student selection and clinical school training pathways?

Abstract

To determine the student characteristics and clinical school training pathways that are associated with postgraduate rural practice. A cross-sectional observational study. Deakin University's School of Medicine, encompassing 3 rural and 2 metropolitan clinical schools, including a rural longitudinal integrated clerkship (LIC) year. A total of 948 School of Medicine medical graduates (2011-2018) who had an Australian Health Practitioners Regulation Agency registered work location in Australia (September 2019). Graduates' work locations were linked with admission and clinical school training data and analysed for significant associations. Graduates completing a rural LIC year and a regional rural clinical school year were 7 times more likely to be working rurally than metropolitan trainees. A small number of rural background (RB) students completed a rural LIC and rural clinical school year, 66.7% of whom were practising rurally. Further associations with rural practice were attending a rural clinical school for 2years or a rural LIC for 1year, student having a RB, rurally bonded course placement and being an international student. The significant influence of a rural LIC year on graduate rural work location is noteworthy, especially when undertaken by students from a RB in combination with a second regional rural clinical school year. These findings support the strategic alignment of rural student selection with rural clinical school training pathways to achieve the greatest impact on rural graduate workforce outcomes.