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

Abstract

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.

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

“…Flexible training options, supportive team practices with sufficient staff relief, salaried employment options, female-tailored continuing professional development topics, and robust social and professional network opportunities may be important strategies to attracting more females to this workforce [ 44 , 46 , 47 ]. Previous research has demonstrated the linkage between female GPs having children and relocations to more urban settings, with the same effect on males only occurring when the children are of secondary school age [ 48 ]. There appears to be a strong scope for rural faculties to play a role in accommodating the tailored employment and family needs of doctors.…”

Choices of Specialties and Training Sites among Taiwanese Physicians Graduating from Polish Medical Schools

“…However, P-IMGs seemed to be more likely to join these specialties and fill the critical gaps, as with those in the US [ 45 ]. We found papers stating that IMGs in the US tend to practice in primary care specialties [ 46 , 47 , 48 ], as did foreign medical graduates in Australia [ 4 ]. Another paper found that IMGs practiced more in four specialties: internal medicine, neurology, psychiatry, and pediatrics [ 49 ].…”

“…The term “international medical graduates” (IMGs) is generally understood to denote a physician who is awarded their medical degree in a country other than the one where they intend to practice medicine [ 1 , 2 , 3 ]. Over recent decades, IMGs have played a significant and expanding role in medical practice in many developed countries throughout the world, constituting approximately 31% of physicians in the United Kingdom, 25% in the United States, 17% in Australia, and 23% in Canada [ 1 , 4 ]. The wave of globalization, an aging population with increasing demands for medical care, and the pursuit of a better quality of life could all be reasons for this phenomenon [ 5 , 6 , 7 ].…”

Exploring preference for, and uptake of, rural medical internships, a key issue for supporting rural training pathways

“…The latter example are perhaps more likely to work long-term in rural Victoria if given the opportunity to return to Victoria and take up a rural internship. International graduates in comparison are less likely to have any connection to rural areas they are applying to undertake an internship in, as the government-funded rural training opportunities during medical school (Rural Clinical School training immersion) is largely reserved for domestic students [ 25 , 26 ]. They are also unlikely to have spent childhood periods in rural Victoria.…”

“…Australia's key regulatory policy since 1996 has required overseas trained doctors and international students graduating from Australian medical schools to work in Districts of Workforce Shortages (DWS) (mainly in rural areas) for up to 10 years after they enter the medical workforce, in order to gain a provider number for access to Medicare billing. This policy's 'success' is strongly associated with Australia's current high reliance on OTDs to supply its rural medical workforce [24,25]. As such, growing the number of domestic graduates who enter and remain in Australia's rural workforce remains a key priority.…”