In-Place Training: Optimizing Rural Health Workforce Outcomes through Rural-Based Education in Australia

Jennifer May,Julie Burrows,Leanne Brown

doi:10.3390/educsci8010020

Abstract

The medical workforce shortfall in rural areas is a major issue influencing the nature of undergraduate medical education in Australia. Exposing undergraduates to rural life through rural clinical school (RCS) placements is seen as a key strategy to address workforce imbalances. We investigated the influence of an extended RCS placement and rural origin on the rural principal place of practice (PPP) of the first 3 graduate cohorts (2012–2014) from a Joint Medical Program offered by two universities based in northern New South Wales. Data was available for 426 eligible graduates. Participation in an extended RCS placement (odds ratio (OR), 6.075, 95% confidence interval (CI) 2.716–13.591), rural background (OR 3.613, 95% CI 1.752–7.450) and being 25 years or older at completion of a medical degree (OR 2.550, 95% CI 1.252–5.194) were all independently associated with rural PPP. Being bonded into a program to practice rurally was not associated with rural PPP. Participation in an extended RCS placement is strongly associated with rural practice in the first 3 to 5 years of practice for graduates from both rural and metropolitan backgrounds. This finding indicates that strategies to improve the rural workforce should focus on the promotion of rural placements, in addition to rural background.

Highlights

Most developed countries are wrestling with the challenges of delivering cost-effective primary care
Given that access to affordable health care is considered an important value within Australian society, successive governments have introduced policies aimed at improving recruitment and retention in a number of health professional workforces
Records were found for 428 graduates (98%), 426 of whom were registered as practicing in Australia

Summary

Introduction

Most developed countries are wrestling with the challenges of delivering cost-effective primary care. In the face of rapidly aging populations, with the challenging advent of chronic non-communicable diseases and technological innovations in diagnosis and management [1], Australia is facing rapidly increasing demands on both primary and secondary care sectors like many other countries. These demands intensify in underserved areas where health workforce disparities exist, while rural localities face additional service challenges. Given that access to affordable health care is considered an important value within Australian society, successive governments have introduced policies aimed at improving recruitment and retention in a number of health professional workforces

Objectives

Results

Discussion

Conclusion