Tuesday, 24 April 2018

Length and type of rural experience shapes graduate doctor destinations new research shows

When it comes to attracting graduate doctors to the country, new research has found a link between the length of time and place that students undertake rural placement, and their longer-term decision to consider a rural career.

As part of the curriculum across all Australian medical schools, students are required to undertake rural immersion programs designed to steer graduates into the rural workforce. But until now there has been limited research about how the design of these immersion programs affects rural work outcomes.

Monash University research published today in Medical Education has revealed the impact of these programs – showing the longer students spend undertaking rural medical school training, the greater their chances of choosing a rural career. Students who completed up to three years of rural placement were significantly more likely to pursue rural work.

The study also found a positive correlation between student placements in both regional hospitals and rural general practices. More than one years’ immersion in a mix of regional hospitals and rural general practices was associated with the increased likelihood of students going on to rural work.

The study’s lead author, Dr Belinda O’Sullivan, Monash School of Rural Health Bendigo, said a combination of longer rural immersion and experience in both regional hospitals and rural general practice was a good model.

A new study shows a link between students who spend time in both rural or regional hospitals and GP clinics and those who choose a rural or regional career. 

“The evidence suggests that getting students to do longer placements where they gain experience in both regional hospitals and rural general practice has the strongest outcome in terms of graduates going on to work in rural and regional Australia,” Dr O’Sullivan said.

"It might be that diverse clinical, rural and regional exposures over time helps in developing a stronger sense of security in rural practice, giving them the networks and professional mentors they need for effective rural practice.”

Dr O’Sullivan said that findings could inform government in the design and structure of rural immersion programs as it outlines the most effective strategies for encouraging graduating doctors to ‘go rural’.

“We knew that medical students often returned to rural areas given some rural immersion, but we weren’t able to pin down the effects of longer duration and immersion in different settings, or whether these factors affect students working in smaller communities. This study drills down into this nuance and will help universities and government in program design, as it points to the most effective strategies for encouraging graduating doctors to ‘go rural’,” Dr O’Sullivan said.

Head of Monash Rural Health, Professor Robyn Langham, said the findings were highly relevant given that rural medical workforce issues will continue to be a major challenge in the coming decades.

“This study supports the understanding that rural medical school immersion programs play a key role in bolstering doctors for rural and regional communities. By better understanding the variety of pull and push factors influencing medical workforce distribution, including the impact of student rural experience and rural program design, educators and policymakers are in a better position to make informed decisions that bring benefits to all,” Professor Langham said.

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