Duration and setting of rural immersion during the medical degree relates to rural work outcomes

O’Sullivan, Belinda; McGrail, Matthew Richard; Russell, Deborah; Walker, Judi; Chambers, Helen Phyllis; Major, Laura; Langham, Robyn G

doi:10.1111/medu.13578

Cited by 55 publications

(97 citation statements)

References 17 publications

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“…International evidence points to the need for rural workforce retention strategies to be multi-faceted, targeting education (selection and training), personal and professional support and financial support in addition to regulatory approaches [22]. A substantial body of research, for example, suggests that strategies such as training medical students and young doctors in rural areas is effective and delivery of curriculum through longitudinal integrated clerkships combined with training in regional hospitals is associated with both rural and generalist practice [20]. However, current rural training policies in Australia systematically exclude FGAMS from participating in Rural Clinical Schools (undergraduate training) and instead target Commonwealth-supported (DMG) students only.…”

Section: Discussionmentioning

confidence: 99%

“…[19] However, no Tasmanian or other comparison data were applied to this study. Evidence from Victoria found that FGAMS had an odds ratio of 5.8 (95% CI 4.0-8.4) for working rurally 1-9 years post-graduation, compared to DMGs [20]. A study of GPs suggested FGAMS had a lower probability of training on a rural pathway, though their definition of FGAMS was problematic as it included doctors born overseas but who were Australian citizens when they entered medical school, and thus would be classified as DMGs by the Australian government [21].…”

Section: Year Of Graduationmentioning

confidence: 99%

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Rural Work and Specialty Choices of International Students Graduating from Australian Medical Schools: Implications for Policy

McGrail

O’Sullivan

Russell

2019

IJERPH

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Almost 500 international students graduate from Australian medical schools annually, with around 70% commencing medical work in Australia. If these Foreign Graduates of Accredited Medical Schools (FGAMS) wish to access Medicare benefits, they must initially work in Distribution Priority Areas (mainly rural). This study describes and compares the geographic and specialty distribution of FGAMS. Participants were 18,093 doctors responding to Medicine in Australia: Balancing Employment and Life national annual surveys, 2012-2017. Multiple logistic regression models explored location and specialty outcomes for three training groups (FGAMS; other Australian-trained (domestic) medical graduates (DMGs); and overseas-trained doctors (OTDs)). Only 19% of FGAMS worked rurally, whereas 29% of Australia's population lives rurally. FGAMS had similar odds of working rurally as DMGs (OR 0.93, 0.77-1.13) and about half the odds of OTDs (OR 0.48, 0.39-0.59). FGAMS were more likely than DMGs to work as general practitioners (GPs) (OR 1.27, 1.03-1.57), but less likely than OTDs (OR 0.74, 0.59-0.92). The distribution of FGAMS, particularly geographically, is sub-optimal for improving Australia's national medical workforce goals of adequate rural and generalist distribution. Opportunities remain for policy makers to expand current policies and develop a more comprehensive set of levers to promote rural and GP distribution from this group.

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Section: Discussionmentioning

confidence: 99%

Section: Year Of Graduationmentioning

confidence: 99%

Rural Work and Specialty Choices of International Students Graduating from Australian Medical Schools: Implications for Policy

McGrail

O’Sullivan

Russell

2019

IJERPH

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“…Medical workforce shortages in Scotland (see Table 1). Though workforce shortages apply across all specialties, they are particularly marked in general practice and even more so in rural and remote areas, and LICs are known to improve recruitment to community based careers [2,5]. 2.…”

Section: The Driversmentioning

confidence: 99%

“…Supporting medical students to learn by contributing to the care of patients and living in their communities was predicted to encourage their return to these underserved areas after graduation. International literature increasingly demonstrates positive outcomes for medical students, teaching clinicians, patients and recruitment to community careers [2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Dundee’s Longitudinal Integrated Clerkship: drivers, implementation and early evaluation

Bartlett

Dowell

Graham

et al. 2019

Education for Primary Care

123

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Results Students reported positive learning experiences though access to secondary care learning linked to their patients was sometimes problematic. GP tutors were positive and enthusiastic about the programme and could see the potential benefits on recruitment to GP careers. Pre-existing workload pressures were a challenge. Summative assessment results were encouraging. Conclusion The Dundee LIC is successful in delivering Dundee's year 4 curriculum. Ongoing development has been focused on improving awareness of the programme in secondary care services.

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“…To be specific, a wide range of research on the career trajectory of health professionals after graduation has explored how different factors [11][12][13] (e.g. gender, family background, indebtedness and academic performance) affect medical students' choices of work location (urban or rural) [14][15], work status (full-time or part-time) [16], profession (surgeon, physician, general practitioner, etc.) [17], career success and drop-out rates [18].…”

mentioning

confidence: 99%

Medical career expectations of academically talented high school students: A nationwide cross-sectional study in China

Pei

et al. 2020

Preprint

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Background: Academically talented high school students (ATHSSs), an exceptional cohort, are not well studied for their career expectations, especially for those with medical career expectation (MCE). Nowadays, the public perception of the medical profession is changing in China. The purpose of this study was to answer questions about ‘is medicine attractive for ATHSSs and ‘what factors affect medical career expectations (MCE) for ATHSSs’ in China. Methods: A total of 16,479 representative ATHSSs in senior three completed a questionnaire and four different academic tests. Frequency statistics showed the proportion of ATHSSs with MCE. Unpaired t-tests were performed to find out the differences in demographics, family background, and academic performance between students with and without MCE. The logit models analysis were applied to explore the potential factors that affected the MCE of this exceptional group of students. Results: ATHSSs with MCE accounted for 20.6% (ranking 7/18) of the respondents. They were more likely to be female, came from relatively poorer families, lived in a rural area, and performed significantly worse in all academic tests except for mathematics, compared with those without MCE. In addition, the results revealed that gender (β=-0.436, p<0.01), region of hometown (β=-103, p<0.1), mother’s years of schooling (β=-0.019, p<0.05), and father’s occupational status (β=-0.005, p<0.01) contributed significantly to the MCE of academically talented students. Better performance in mathematics affected the MCE of ATHSSs taking the liberal arts and science tests differently. Conclusions: We found the medical career is becoming unattractive to academically talented students and the medical career may be loosing their aura in China. Students who have medical career expectations are likely to be females and to have a weak family background. We discuss implications for medical education.

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Duration and setting of rural immersion during the medical degree relates to rural work outcomes

Abstract: These findings inform medical schools about effective rural immersion programmes. Longer rural immersion and immersion in both regional hospitals and rural general practices are likely to increase rural work and rural distribution of early career doctors.

Cited by 55 publications

References 17 publications

Rural Work and Specialty Choices of International Students Graduating from Australian Medical Schools: Implications for Policy

Rural Work and Specialty Choices of International Students Graduating from Australian Medical Schools: Implications for Policy

Dundee’s Longitudinal Integrated Clerkship: drivers, implementation and early evaluation

Medical career expectations of academically talented high school students: A nationwide cross-sectional study in China

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