Does undertaking rural placements add to place of origin as a predictor of where health graduates work?

Abstract

Objective: To determine the work location (metropolitan, regional, rural and remote) of graduates in nursing, allied health and oral health disciplines who complete their professional training, end-to-end training, in a regional or rural area noting the potential inclusion of a metropolitan-based placement for speciality practice not available in rural or regional Victoria. Methods:We tracked the place of employment from the Australian Health Practitioners Regulation Agency (AHPRA) of all graduates from a regional/rural tertiary education provider. The student home address at enrolment, locations where they undertook all placements and their current place of work were described using an objective geographical model of access, the Modified Monash Model.Results: Seventy-five per cent of 5506 graduates were located in the AHPRA database. About one third of graduates were working in metropolitan areas, 1/3 in regional cities and 1/3 in rural areas. Students' origin accounted for 1/3 of variance in current workplace location. The more placement days students completed in regional/ rural areas was also a significant predictor of working in a regional or rural area. Conclusion:End-to-end training in regional/rural areas is an effective approach to retaining a regional/rural workforce. Student origin is a strong predictor of working rural or regionally, as is undertaking placements in rural areas. This suggests that priority for rural/ regional student placements should be given to students in end-to-end regional/ rural programs and students from a regional/ rural background.

Ten years of graduates: A cross-sectional study of the practice location of doctors trained at a socially accountable medical school

“…Published in 2021, a cross-sectional study of Australian doctors found a strong positive predictive relationship among having the same rural region for their hometown, rural region training location during part of their UG, and rural region of practice in 2017 [ 49 ].There was a consistent dose-response effect between years in rural hometown and practice in the same rural region as well as between training duration in a rural region and practice in the same rural region. Other recent work supports the positive association among hometown, training and practice location [ 50 ].…”

Rural health careers for rural students: The entry‐level degree stepping‐stone challenge

“…Thoughtful and determined effort will be needed to maintain and grow the number of rural‐origin students ready to commence courses that lead to health professional qualifications. There is good evidence about the importance of rural origin and rural training in increasing the likelihood of health professionals practising rurally, particularly in the field of medicine 1–5 . In order to address health workforce maldistribution, many universities have established selection and admission streams for individuals from rural backgrounds into professional‐entry degrees in medicine, nursing and some allied health fields.…”

“…The path through education and training also needs to include the flexibility for students to undertake all (or most) of their training in rural areas. This is preferable as research indicates that rural‐origin plus long periods of rural training, together have a multiplier effect that increases the likelihood of rural practice 1–5 …”

“…There is good evidence about the importance of rural origin and rural training in increasing the likelihood of health professionals practising rurally, particularly in the field of medicine. [1][2][3][4][5] In order to address health workforce maldistribution, many universities have established selection and admission streams for individuals from rural backgrounds into professional-entry degrees in medicine, nursing and some allied health fields. These rural streams are valuable and need to continue, along with opportunities for long periods of rural training during such courses.…”

“…This is preferable as research indicates that rural-origin plus long periods of rural training, together have a multiplier effect that increases the likelihood of rural practice. [1][2][3][4][5] On the flip side, the more time rural background students spend in metropolitan environments, the higher the likelihood of their rural connection becoming weaker. Their intention to practise rurally may wane or be overtaken by life events.…”