Preferences and pathways of the next generation of rural doctors

Paynter, Jessica A; O’Sullivan, Belinda

doi:10.1111/ajr.12629

Cited by 4 publications

(6 citation statements)

References 2 publications

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“…This will only lead to recruitment if all the desired job attributes are embedded through organisational commitment, and partner and childcare/schooling options have been considered. 45 This is feasible to implement if there is greater awareness and engagement with these attractors as part of every rural marketing and recruitment campaign.…”

Section: Discussionmentioning

confidence: 99%

Responsive policies needed to secure rural supply from increasing female doctors: A perspective

O’Sullivan

McGrail

May³

2021

Health Planning & Management

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Around the world, the supply of rural health services to address population health needs continues to be a wicked problem. Adding to this, an increasing proportion of female doctors is graduating from medical courses but gender is not accounted for within rural workforce policy and planning. This threatens the future capacity of rural medical services. This perspective draws together the latest evidence, to make the case for industry and government action on responsive policy and planning to attract females to rural medicine.We find that the factors that attract female doctors to rural practice are not the same as males. We identify female-tailored policies require a re-visioning of rural recruitment, use of employment arrangements that attract females and re-thinking issues of rural training and specialty choice. We conceptualise a roadmap that includes co-designing rural jobs within supportive teams, allowing for capped hours which align with childcare along with boosting of female peer support and mentorship. There is also a need to enhance flexible rural postgraduate training options in a range of specialties (at a time when many women are establishing families) and to consider viable partner employment (including for female doctors with university trained partners) and advertising specific rural attractors to women, including the chance to connect with communities and make a difference.

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Section: Discussionmentioning

confidence: 99%

Responsive policies needed to secure rural supply from increasing female doctors: A perspective

O’Sullivan

McGrail

May³

2021

Health Planning & Management

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“…This focus is increasingly seeing medical graduates pursue specific technical skills including pursuing research publications, which may be more challenging to achieve in rural locations [55]. A recent snapshot survey of the broad intentions of the next generation of rural doctors (current undergraduates attending a rural conference) suggested they had rural generalist career intentions but were wedded to doing part of their postgraduate training in metropolitan areas [56]. Linking this group with rural internship positions (and beyond) as part of a continuous and secure regional postgraduate training programs with a line of sight to specialist college selection, may be important to increase the attractiveness of rural internships for this group, but this needs to be clarified with further research.…”

Section: Discussionmentioning

confidence: 99%

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

McGrail

O’Sullivan

Russell

et al. 2020

BMC Health Serv Res

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Background Improved medical care access for rural populations continues to be a major concern. There remains little published evidence about postgraduate rural pathways of junior doctors, which may have strong implications for a long-term skilled rural workforce. This exploratory study describes and compares preferences for, and uptake of, rural internships by new domestic and international graduates of Victorian medical schools during a period of rural internship position expansion. Methods We used administrative data of all new Victorian medical graduates’ location preference and accepted location of internship positions for 2013–16. Associations between preferred internship location and accepted internship position were explored including by rurality and year. Moreover, data were stratified between ‘domestic graduates’ (Australian and New Zealand citizens or permanent residents) and ‘international graduates’ (temporary residents who graduated from an Australian university). Results Across 2013–16, there were 4562 applicants who filled 3130 internship positions (46% oversubscribed). Domestic graduates filled most (69.7%, 457/656) rural internship positions, but significantly less than metropolitan positions (92.2%, p < 0.001). Only 20.1% (551/2737) included a rural location in their top five preferences, less than for international graduates (34.4%, p < 0.001). A greater proportion of rural compared with metropolitan interns accepted a position not in their top five preferences (36.1% versus 7.4%, p < 0.001). The proportion nominating a rural location in their preference list increased across 2013–2016. Conclusions The preferences for, and uptake of, rural internship positions by domestic graduates is sub-optimal for growing a rural workforce from local graduates. Current actions that have increased the number of rural positions are unlikely to be sufficient as a stand-alone intervention, thus regional areas must rely on international graduates. Strategies are needed to increase the attractiveness of rural internships for domestic students so that more graduates from rural undergraduate medical training are retained rurally. Further research could explore whether the uptake of rural internships is facilitated by aligning these positions with protected opportunities to continue vocational training in regionally-based or metropolitan fellowships. Increased understanding is needed of the factors impacting work location decisions of junior doctors, particularly those with some rural career intent.

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“…[44][45][46][47] This is dependent on their confidence and comfort with performing these auxiliary procedures, which is largely dictated by their surgical training. 48 For example, neurosurgical operative confidence among general surgeons increases with distance from a neurosurgical centre. 23,49,50 Over seven years, rural general surgeons from Hamilton, Victoria, did 114 emergency neck of femur fracture operations locally, with outcomes consistent with national guidelines.…”

Section: Extended and Broad Scope Of Practicementioning

confidence: 99%

The provision of general surgery in rural Australia: a narrative review

Paynter,

Qin,

Brennan

et al. 2024

Medical Journal of Australia

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Summary Rural surgery is most commonly provided by general surgeons to the 29% of people (7 million) living in rural Australia. The provision of rural general surgery to enable equitable and safe surgical care for rural Australians is a multifaceted issue concerning recruitment, training, retention, surgical procedures and surgical outcomes. Sustaining the rural general surgical workforce will be dependent upon growing an increased number of resident rural general surgeons, as well as changed models of care, with a need for ongoing review to track the outcomes of these changes. To increase recruitment, rural general surgical training must improve to be less stressful for trainees and to be incorporated alongside a rural‐facing generalist curriculum. Rural general surgical outcomes (excluding some oncology conditions) achieve comparable results to metropolitan centres. Access to, and outcomes of, surgical oncology services continues to be inequitable for rural Australians and should be a major focus for improved service delivery.

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Preferences and pathways of the next generation of rural doctors

Cited by 4 publications

References 2 publications

Responsive policies needed to secure rural supply from increasing female doctors: A perspective

Responsive policies needed to secure rural supply from increasing female doctors: A perspective

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

The provision of general surgery in rural Australia: a narrative review

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