Abstract
BackgroundLimited evidence exists about the extent to which doctors are returning to rural region(s) where they had previously trained. This study aims to investigate the rate at which medical students who have trained for 12 months or more in a rural region return to practice in that same region in their early medical career. A secondary aim is to investigate whether there is an independent or additional association with the effect of longer duration of rural exposure in a region (18–24 months) and for those completing both schooling and training in the same rural region.MethodsThe outcome was rural region of work, based on postcode of work location in 2017 for graduates spanning 1–9 years post-graduation, for one large medical program in Victoria, Australia. Region of rural training, combined with region of secondary schooling and duration of rural training, was explored for its association with region of practice. A multinomial logistic regression model, accounting for other covariates, measured the strength of association with practising in the same rural region as where they had trained.ResultsOverall, 357/2451 (15%) graduates were working rurally, with 90/357 (25%) working in the same rural region as where they did rural training. Similarly, 41/170 (24%) were working in the same region as where they completed schooling. Longer duration (18–24 vs 12 months) of rural training (relative risk ratio, RRR, 3.37, 1.89–5.98) and completing both schooling and training in the same rural region (RRR: 4.47, 2.14–9.36) were associated with returning to practice in the same rural region after training.ConclusionsMedical graduates practising rurally in their early career (1–9 years post-graduation) are likely to have previous connections to the region, through either their basic medical training, their secondary schooling, or both. Social accountability of medical schools and rural medical workforce outcomes could be improved by policies that enable preferential selection and training of prospective medical students from rural regions that need more doctors, and further enhanced by longer duration of within-region training.
Highlights
Limited evidence exists about the extent to which doctors are returning to rural region(s) where they had previously trained
There remains limited evidence about the extent to which domestically trained doctors are returning to the same rural region(s) where they have spent time training as a medical student or, instead, whether they are choosing other work locations
This study aims to investigate the rate at which medical graduates with 12 months or more of rural training in a region return to practice in that same region in their early medical career
Summary
Limited evidence exists about the extent to which doctors are returning to rural region(s) where they had previously trained. This study aims to investigate the rate at which medical students who have trained for 12 months or more in a rural region return to practice in that same region in their early medical career. Doctors with a childhood rural-origin are known to have a stronger propensity to work in rural areas compared to those with a childhood metropolitan-origin; policies that increase selection of such students into medical schools are vital [1, 8, 9]. There remains limited evidence about the extent to which domestically trained doctors are returning to the same rural region(s) where they have spent time training as a medical student (or during their earlier schooling) or, instead, whether they are choosing other work locations
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