Responses to post-graduation surveys do not accurately reflect the workforce

Burkitt, Tessa; Playford, Denese

doi:10.1080/0142159x.2017.1324143

“…These data appear to be more encouraging than the data reported by Playford, Qi-ng and Burkitt (2016) [18] who state that only 7% of graduates spent 75-100% of their of post-graduating time working in a rural area, while the majority spent up to 30% of their postgraduate training in a rural location [18]. However the Kwan et al (2017) paper only reports on the 29% of all domestic medical graduates who responded to their survey and who therefore may represent alumni who are biased towards rural work [19].…”

Section: Introductionmentioning

confidence: 92%

“…Of the remaining 190 graduates, 56 had one missing data point and 82 had two missing data points with 52 having three or more missing data points. There were 88 graduates from post-graduate years three to eight with all missing data points throughout the study who were conservatively coded as in urban practice, as those who did not respond to the surveys were more likely to be in urban work [19].…”

Section: Description Of Study Samplementioning

confidence: 99%

Survival analysis of Rural Clinical School of Western Australia graduates: the long-term work of building a long-term rural medical workforce

Gupta

¹

,

Ngo

²

,

Burkitt

³

et al. 2019

BMC Health Serv Res

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Background Deficits in the rural medical workforce is an international issue. In Australia, The Rural Clinical School intervention is effective for initial recruitment of rural doctors. However, the extent of survival is not yet established. This paper summarises rural survival over a 10-year period. Methods Rural Clinical School graduates of Western Australia were surveyed annually, 2006–2015, and post Graduate Years (PGY) 3–12 included. Survival was described as “tours of service”, where a tour was either a period of ≥1 year, or a period of ≥2 weeks, working rurally. A tour ended with a rural work gap of ≥52 weeks. Considering each exit from urban as an event, semi-parametric repeated measures survival models were fitted. Results Of 468 graduates, using the ≥2 weeks definition, 239 PGY3–12 graduates spent at least one tour rurally (average 61.1, CI 52.5–69.7 weeks), and a total length of 14,607 weeks. Based on the tour definition of ≥1 year, 120 graduates completed at least one tour (average 1.89, 1.69–2.10 years), and a total of 227 years’ rural work. For both definitions, the number of tours increased from one to four by PGY10/11, giving 17,786 total weeks (342 years) across all PGYs for the ≥2 weeks tour definition, and 256 years total for ≥1 year. Significantly more graduates exited from urban work for the 2007–09 middle cohort compared with 2010–11 (HR 1.876, p = 0.022), but no significant difference between 2002 and 06 and 2010–11. Rural origin, age and gender were not statistically significant. Conclusions PGY3–12 RCS graduates contributed substantially to the rural workforce: 51% did so by short rotations, while 26% contributed whole years of service. There was an apparent peak in entry and survival for the middle cohort and decline thereafter, likely attributable to lack of advanced/specialist vocational training. These data indicate a real commitment to rural practice by RCS graduates, and the need for rural vocational training as a key element of a successful rural survival strategy.

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“…There were 88 graduates from post-graduate years three to eight with all missing data points throughout the study who were conservatively coded as in urban practice, as those who did not respond to the surveys were more likely to be in urban work. 19 At the commencement of their rural clinical school the majority of participants were female (64%) and aged less than 25 years (71%) ( Table 1). One-fifth (99) of graduates had a rural background.…”

Section: Description Of Study Samplementioning

confidence: 99%

“…18 However the Kwan et al (2017) paper only reports on the 29% of all domestic medical graduates who responded to their survey and who therefore may represent alumni who are biased towards rural work. 19 Since both Kwan et al (2017) and Playford et al (2016) follow whole cohorts collectively (i.e., they did not follow individual graduates over time), they only partially contribute to the quantification of survival. These studies also did not take time since graduation into account.…”

Section: Introductionmentioning

confidence: 99%

Survival analysis of Rural Clinical School of Western Australia graduates: the long-term work of building a long-term rural medical workforce

Gupta

¹

,

Ngo

²

,

Burkitt

³

et al. 2019

Preprint

Self Cite

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Objective –Deficits in the size of the rural medical workforce is an international issue. In Australia, The Rural Clinical School intervention is effective for initial recruitment of rural doctors. However, the extent of retention is not yet established. This paper summarises rural retention over a 10-year period. Methods –Rural Clinical School graduates of STATE NAME were surveyed annually, 2006-2015, and post Graduate Years (PGY) 3-12 included. Survival was described as “tours of service”, where a tour was either a period of ≥1 year, or a period of at ≥2 weeks, working rurally. A tour ended with a rural work gap of ≥52 weeks. Considering each exit from urban as an event, semi-parametric repeated measures survival models were fitted. Results – Of 468 graduates, using the ≥2 weeks definition, 239 PGY3-12 graduates spent at least one tour rurally (average 61.1, CI 52.5 – 69.7 weeks), and a total length of 14,607 weeks. Based on the tour definition of ≥1 year, 120 graduates completed at least one tour (average 1.89, 1.69 – 2.10 years), and a total of 227 years’ rural work. For both definitions, the number of tours increased from one to four by PGY10/11, giving 17,786 total weeks (342 years) across all PGYs for the ≥2 weeks tour definition, and 256 years total for ≥1 year. Significantly more graduates exited from urban work for the 2007-09 middle cohort compared with 2010-11 (HR 1.876, p=0.022), but no significant difference between 2002-06 and 2010-11. Rural origin, age and gender were not statistically significant. Conclusions – PGY3 – 12 RCS graduates contributed substantially to the rural workforce: 51% did so by short rotations, which have not previously been described, while 26% contributed whole years of service. There was an apparent peak in entry and retention for the middle cohort and decline thereafter, likely attributable to lack of rural advanced/specialist vocational training. These data indicate a real commitment to rural practice by RCS graduates, and the need for rural postgraduate vocational training in the rural context as a key element of a successful rural retention strategy.

show abstract

“…However the Kwan et al (2017) paper only reports on the 29% of all domestic medical graduates who responded to their survey and who therefore may represent alumni who are biased towards rural work. 19 Since both Kwan et al (2017) and Playford et al (2016) follow whole cohorts collectively (i.e., they did not follow individual graduates over time), they only partially contribute to the quantification of survival. These studies also did not take time since graduation into account.…”

Section: Introductionmentioning

confidence: 99%

Survival analysis of Rural Clinical School of Western Australia graduates: the long-term work of building a long-term rural medical workforce

Gupta

¹

,

Ngo

²

,

Burkitt

³

et al. 2019

Preprint

Self Cite

0

View full text Add to dashboard Cite

Objective –Deficits in the size of the rural medical workforce is an international issue. In Australia, The Rural Clinical School intervention is effective for initial recruitment of rural doctors. However, the extent of retention is not yet established. This paper summarises rural retention over a 10-year period. Methods –Rural Clinical School graduates of STATE NAME were surveyed annually, 2006-2015, and post Graduate Years (PGY) 3-12 included. Survival was described as “tours of service”, where a tour was either a period of ≥1 year, or a period of at ≥2 weeks, working rurally. A tour ended with a rural work gap of ≥52 weeks. Considering each exit from urban as an event, semi-parametric repeated measures survival models were fitted. Results – Of 468 graduates, using the ≥2 weeks definition, 239 PGY3-12 graduates spent at least one tour rurally (average 61.1, CI 52.5 – 69.7 weeks), and a total length of 14,607 weeks. Based on the tour definition of ≥1 year, 120 graduates completed at least one tour (average 1.89, 1.69 – 2.10 years), and a total of 227 years’ rural work. For both definitions, the number of tours increased from one to four by PGY10/11, giving 17,786 total weeks (342 years) across all PGYs for the ≥2 weeks tour definition, and 256 years total for ≥1 year. Significantly more graduates exited from urban work for the 2007-09 middle cohort compared with 2010-11 (HR 1.876, p=0.022), but no significant difference between 2002-06 and 2010-11. Rural origin, age and gender were not statistically significant. Conclusions – PGY3 – 12 RCS graduates contributed substantially to the rural workforce: 51% did so by short rotations, which have not previously been described, while 26% contributed whole years of service. There was an apparent peak in entry and retention for the middle cohort and decline thereafter, likely attributable to lack of rural advanced/specialist vocational training. These data indicate a real commitment to rural practice by RCS graduates, and the need for rural postgraduate vocational training in the rural context as a key element of a successful rural retention strategy.

show abstract

Responses to post-graduation surveys do not accurately reflect the workforce

Cited by 4 publications

References 2 publications

Survival analysis of Rural Clinical School of Western Australia graduates: the long-term work of building a long-term rural medical workforce

Survival analysis of Rural Clinical School of Western Australia graduates: the long-term work of building a long-term rural medical workforce

Survival analysis of Rural Clinical School of Western Australia graduates: the long-term work of building a long-term rural medical workforce

Survival analysis of Rural Clinical School of Western Australia graduates: the long-term work of building a long-term rural medical workforce

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