As part of a broader investigation into the training needs of rural doctors, the reasoning behind decisions of graduates to enter rural practice in North Queensland was explored. North Queensland is a growing and diverse region that is home to 500 000 people but has had no local production of medical graduates. While prior rural exposure was found to be a powerful influence on the decision of some, a small number of those interviewed entered rural practice almost by chance, liked it and stayed. Should this finding be confirmed in more formal investigation, workforce planners would need to continue initiatives to recruit graduates who have no prior connection to rural life.
Objective To identify requirements for vocational training and continuing education programs in rural general practice. Design A questionnaire was sent to all 487 rural doctors and 140 metropolitan and 140 provincial city general practitioners (GPs) in Queensland. A sample of medical educators, health professional and consumer representatives and rural doctors was also interviewed. Res‐ponses were compared by geographical area, practice characteristics and level of postgraduate training. Results There are significant differences between rural and urban practice profiles. Rural doctors have to practise a range of clinical skills in an environment with restricted access to health professional support, although the need for advanced training in procedural or other skills depends on the type of rural practice. Rural and urban doctors want more influence in determining continuing medical education (CME) programs. Interactive learning methods were rated as the most effective education methods by both rural and urban GPs. Rural doctors were less likely to consider that they spent enough time on CME. Conclusion Vocational training programs should accommodate various rural career objectives, including those requiring advanced levels of procedural work. There is a significant unmet demand for CME tailored to the needs of individual doctors, both rural and urban, but distance and isolation may make this more critical in rural practice. These issues need to be addressed as training opportunities can contribute to improved retention of the rural medical workforce.
: The relative shortage of both general practitioners and specialists providing medical services to rural areas disadvantages people living in the country. This maldistribution of the medical workforce is due in part to the medical education system. The selection and socialisation of medical students, the adequacy of training for rural practice and the continuing support of rural doctors must all be addressed. While progress is being made in vocational training and continuing support of rural practice, aspects of undergraduate education continue to contribute to the shortage of rural practitioners. The school and home addresses of 1991 school leavers in the 1992 intake into first year medicine at the University of Queensland were analysed and compared with those previously reported. Results indicated that students from rural backgrounds remain underrepresented despite previous recommendations to redress the disproportionately low number of rural students entering medical school. Changes to the selection of medical students aimed at increasing the number of rural students entering the course are discussed. This issue needs to be addressed in conjunction with many other factors contributing to the maldistribution of general practitioners if the shortage of rural medical practitioners is to be ultimately corrected.
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