Abstract
BackgroundThe diverse rural medical education initiatives that have been developed in Australia to address the medical workforce maldistribution have been less successful in many smaller and remote communities. This study explored the factors that attract and retain GP registrars and supervisors and the impact that localised training (i.e., rural and remote workplace-based training and support) has on both GP registrars and supervisors, and the GP workforce in rural and remote underserved areas.MethodsA purposive sample of 79 GP registrars, supervisors, practice managers, health services staff and community representatives living and working in areas of low GP workforce in rural and remote Australia were invited to participate in semi-structured interviews and one focus group divided over two phases. Thematic analysis was used to explore themes within the data.FindingsAttractors and barriers to rural and remote practice were identified as the main themes. Attractors include family and community lifestyle factors, individual intrinsic motivators, and remote medicine experiences. In contrast, barriers include work related, location, or family factors. Further, localised GP training was reported to specifically influence GP registrars and supervisors through education, social and financial factors.ConclusionThe current study has provided a contemporary overview of the issues encountered in expanding GP training capacity in rural and remote communities to improve the alignment of training opportunities with community and workforce needs. Strategies including matching scope of practice to registrar interests have been implemented to promote the attractors and lessen the barriers associated with rural and remote practice.
Highlights
The diverse rural medical education initiatives that have been developed in Australia to address the medical workforce maldistribution have been less successful in many smaller and remote communities
The current study has provided a contemporary overview of the issues encountered in expanding general practitioners (GPs) training capacity in rural and remote communities to improve the alignment of training opportunities with community and workforce needs
The current study explored the factors that attract and retain GP registrars and supervisors to rural and remote underserved areas and the impact that localised training has on the GP workforce within rural and remote areas
Summary
The diverse rural medical education initiatives that have been developed in Australia to address the medical workforce maldistribution have been less successful in many smaller and remote communities. Despite over 20 years of rural medical education initiatives in Australia, success in addressing the medical workforce maldistribution remains mixed. Australia has invested heavily in initiatives during medical school and improving links to specialty training programs. These initiatives increase interest and intention to consider rural careers [5]. Some factors that influence the decision to practise in rural and remote communities include an increased workload; staffing issues; difficulty accessing professional development; and geographical, social and professional isolation [7, 8]. Previous research has identified that GPs reported the positive aspects to working in rural and remote areas included a wide scope of practice, professional autonomy and the rural lifestyle [10]
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