This study strengthens evidence that, after adjusting for multiple confounders, a number of exposures are independent predictors of rural medical practice. The strong positive interaction between rural background and rural clinical school exposure, and the duration-dependent relationships, could help inform policy changes aimed at enhancing the efficacy of Australia's rural clinical school program.
The critical shortage of the rural medical workforce in Australia continues.
There is pressure on medical schools to produce not only more doctors, but to supply them in geographical areas of need.
The latest policy to tackle these problems will increase medical student numbers while the supply of clinical teachers and patients for teaching remains static.
This challenges the traditional apprenticeship model for learning medicine.
Coupled with this is the requirement of medical schools to provide compulsory rural clinical placements for all students.
The success of rural clinical schools and University Departments of Rural Health (UDRH) is increasingly apparent, but they must find new strategies to maintain a quality clinical experience and exposure to rural lifestyle for all medical students.
The dilemma is providing this quality rural experience to all medical students in the immediate future.
We suggest approaches to meet this challenge at a policy, organisational, student and teaching level.
The problems associated with rural and remote health have been widely recognised by health workers, rural communities and health professions for some time. Yet it has only been in the past decade that any concerted effort has been made to address rural health issues. Today the state of health in rural Australia remains less than optimal. The tenth anniversary of the Australian Journal of Rural Health provides the opportunity to reflect on what progress has been achieved over the past decade, to recognise those factors that have contributed most to the implementation of policies designed to address the health needs of rural and remote Australians, and to discuss outstanding impediments and barriers to resolving rural health issues.
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