Local and regional workforce return on investment from sponsoring rural generalist-based training for medical students

Abstract

The objective of this case study was to examine and evaluate the retention of medical graduates for a hospital and health service partnering with a university to deliver a rural medical program. Eight cohorts of the Griffith Rural Medical Longlook program were followed for workforce outcomes, including both rural and local workforce outcomes for the Darling Downs Hospital and Health Service (DDHHS) and the region. The DDHHS partnered with Griffith Health for capital investment in the region, creating three main campuses in rural generalist hospitals and augmented resources in other rural health facilities. Most (60%) medical graduates placed for a year or more on the Longlook program chose regional internships in Queensland, including 31% who chose internship in the DDHHS. Students spending 2 years on the program in the DDHHS were more likely to remain for local internship (odds ratio (OR) 5.7) and to be practicing locally after internship (OR 3.3). Local retention of medical graduates from the partnership between the Faculty of Health at Griffith University and the DDHHS to establish and conduct the Rural Medical Longlook Program includes resourcing and utilisation of spare training capacity in rural generalist hospitals and in addressing junior medical workforce recruitment. What is known about the topic?Rural medical programs improve choice of regional centres for early career placements. Rural longitudinal integrated clerkships (LICs) are effective in influencing regional choices for early medical career placements. What does this paper add?This was a case study on the local retention of medical graduates for health services sponsoring rural medical programs. LICs are sustainable in rural generalist hospitals to increase clinical training capacity. There is evidence for longer rural placements improving rural retention, specific for rural LICs. Longer LICs are more effective in influencing regional internship choices and regional retention, as well as local internship choice and local retention. What are the implications for practitioners?Investment in increasing clinical training capacity in rural generalist health facilities can produce significant retention of medical graduates for the junior medical workforce. Retaining students in the regional health service for longer periods increases the likelihood of retention upon graduation.

Approaches Used to Describe, Measure, and Analyze Place of Practice in Dentistry, Medical, Nursing, and Allied Health Rural Graduate Workforce Research in Australia: A Systematic Scoping Review

“…However, it was identified that this rural work was not always sustained [42] and that graduates had limited prior contact with the rural areas in which they were working [50]. Other models of rural training included a partnership between a university and a health service to deliver a rural training program, with research finding that graduates who had participated in the program were more likely to remain local for an internship, as well as following an internship [44]. Overall, rural training was supported as a predictor of rural practice [65][66][67]78,81,89].…”

“…Medicine: Gupta et al, 2019 [42], Herd et al, 2017 [43], Kitchener 2021 [44], Kwan et al, 2017 [45] [68] Nursing and allied health: Playford, Moran and Thompson 2020 [69] Acknowledgments: We thank Deakin University librarians, Jill Stephens, and Fiona Russell, for their assistance in reviewing the search strategies used for this review.…”