Faculties to Support General Practitioners Working Rurally at Broader Scope: A National Cross-Sectional Study of Their Value

Abstract

<jats:p>Strategies are urgently needed to foster rural general practitioners (GPs) with the skills and professional support required to adequately address healthcare needs in smaller, often isolated communities. Australia has uniquely developed two national-scale faculties that target rural practice: the Fellowship in Advanced Rural General Practice (FARGP) and the Fellowship of the Australian College of Rural and Remote Medicine (FACRRM). This study evaluates the benefit of rural faculties for supporting GPs practicing rurally and at a broader scope. Data came from an annual national survey of Australian doctors from 2008 and 2017, providing a cross-sectional design. Work location (rurality) and scope of practice were compared between FACRRM and FARGP members, as well as standard non-members. FACRRMs mostly worked rurally (75–84%, odds ratio (OR) 8.7, 5.8–13.1), including in smaller rural communities (&lt;15,000 population) (41–54%, OR 3.5, 2.3–5.3). FARGPs also mostly worked in rural communities (56–67%, OR 4.2, 2.2–7.8), but fewer in smaller communities (25–41%, OR 1.1, 0.5–2.5). Both FACRRMs and FARGPs were more likely to use advanced skills, especially procedural skills. GPs with fellowship of a rural faculty were associated with significantly improved geographic distribution and expanded scope, compared with standard GPs. Given their strong outcomes, expanding rural faculties is likely to be a critical strategy to building and sustaining a general practice workforce that meets the needs of rural communities.</jats:p>

New Zealand's Rural Hospital Medicine training program at 10 years: Locality and career choice of the first graduate cohort

“…The findings add to international evidence that dedicated rural postgraduate training is strongly associated with entering rural practice 2‐5 . Study findings compare favourably with rural workforce outcomes of other postgraduate rural programs 4,5 .…”

“…The findings add to international evidence that dedicated rural postgraduate training is strongly associated with entering rural practice. [2][3][4][5] Study findings compare favourably with rural workforce outcomes of other postgraduate rural programs. 4,5 Further analysis of study data being undertaken will consider the effectiveness of the RHMTP in meeting the needs of NZ's diverse rural communities.…”

“…[2][3][4][5] Study findings compare favourably with rural workforce outcomes of other postgraduate rural programs. 4,5 Further analysis of study data being undertaken will consider the effectiveness of the RHMTP in meeting the needs of NZ's diverse rural communities. Ongoing studies will be needed to assess the retention of RHM graduates in their later career.…”

A Realist Evaluation of Theory about Triggers for Doctors Choosing a Generalist or Specialist Medical Career

“…Many countries are training more doctors than ever before, but a major goal is achieving enough generalists working in fields like general practice (GP) and public health compared with narrow specialty fields [ 1 ]. Achieving a critical mass of generalists is important as they support delivery of integrated, preventative and primary care services across a wide range of community needs, at lower cost, for increased life expectancy [ 2 , 3 , 4 , 5 ]. Although preventive and primary care services are universally needed, many countries are facing declining general practice numbers [ 6 , 7 ].…”

The Future Health Workforce: Integrated Solutions and Models of Care

“…The next paper in this special issue reports a national cross-sectional study of faculties supporting general medical practitioners (GPs) [ 5 ]. Matthew McGrail and Belinda O’Sullivan report data obtained from an annual national cross-sectional survey of doctors in Australia conducted between 2008 and 2017.…”