Effects of a regional–rural immersion program in Northland, New Zealand, on returning to work in that region

Abstract

Introduction It is well established that rural workforce outcomes are more likely among medical graduates who spend time training in non‐urban areas; however, fewer studies have assessed whether graduates are more likely to return to the specific area where they undertook rural training. Objective This study aimed to determine whether graduates who had undertaken a regional–rural immersion program in Northland, NZ, were more likely to have returned to work in Northland as of mid‐2021, relative to peers who did not participate. Design This prospective cohort study used longitudinal tracking survey responses, medical school administrative data and workforce outcome information. A multinomial model, accounting for other covariates, was built to determine the association between graduates practising in Northland (population ⟨ 100 000), which encompasses both rural (population ⟨ 25 000) and regional (25 000 ⟩ population ⟨ 100 000) areas, and having participated in a Northland‐based immersion program during medical school. The study population was University of Auckland domestic medical students graduating between 2009 and 2018, inclusive. Immersion program participants who responded to longitudinal career tracking surveys were included in the study sample. Findings The final sample size was 1320 students (80% of population of interest). Graduates who undertook the Northland immersion program (n = 169) were more likely than non‐participants (n = 1151) to be working in Northland as of 2020–2021 (relative risk: 3.2). Discussion and Conclusion Regional–rural immersion programs might preferentially build workforces in that specific region; however, further research is required to understand whether these findings are generalizable, and the main reasons for this effect.

Royal Australasian College of Surgeons Rural Health Equity Strategic Action Plan: excellence through equity

“…We start with rural populations of 29% in Australia and 38% in Aotearoa New Zealand. In Australia, 25% of medical students are of rural origin 16 and both Aotearoa New Zealand Medical Schools have rural selection initiatives. 17 On exit from medical school, Medical Deans of Australia and New Zealand 18 reports 35% of Australian graduates and 37% of Aotearoa New Zealand graduates intend to practice rurally.…”

“…Multiple sequential actions across the whole career cycle are most powerful. The evidence has been applied in Australia for over 20 years, via the Australian Government Rural Health Multidisciplinary Training Program 16 that mandates a quarter of all students selected to medical school are of rural origin and a quarter of students spend at least 1 year at a Rural Clinical School. Seal and others reported the program's success in 2021 27 : rural origin plus one-year rural clinical school experience increased rural working at 8 years postgraduation 4.8 times.…”