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Human Resources for Health
Published in: Human Resources for Health 1/2018

Open Access 01-12-2018 | Review

A review of characteristics and outcomes of Australia’s undergraduate medical education rural immersion programs

Authors: Belinda G. O’Sullivan, Matthew R. McGrail, Deborah Russell, Helen Chambers, Laura Major

Published in: Human Resources for Health | Issue 1/2018

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Abstract

Background

A key strategy for increasing the supply of rural doctors is rurally located medical education. In 2000, Australia introduced a national policy to increase rural immersion for undergraduate medical students. This study aims to describe the characteristics and outcomes of the rural immersion programs that were implemented in Australian medical schools.

Methods

Information about 19 immersion programs was sourced in 2016 via the grey and published literature. A scoping review of the published peer-reviewed studies via Ovid MEDLINE and Informit (2000–2016) and direct journal searching included studies that focused on outcomes of undergraduate rural immersion in Australian medical schools from 2000 to 2016.

Results

Programs varied widely by selection criteria and program design, offering between 1- and 6-year immersion. Based on 26 studies from 10 medical schools, rural immersion was positively associated with rural practice in the first postgraduate year (internship) and early career (first 10 years post-qualifying). Having a rural background increased the effects of rural immersion. Evidence suggested that longer duration of immersion also increases the uptake of rural work, including by metropolitan-background students, though overall there was limited evidence about the influence of different program designs.
Most evidence was based on relatively weak, predominantly cross-sectional research designs and single-institution studies. Many had flaws including small sample sizes, studying internship outcomes only, inadequately controlling for confounding variables, not using metropolitan-trained controls and providing limited justification as to the postgraduate stage at which rural practice outcomes were measured.

Conclusions

Australia’s immersion programs are moderately associated with an increased rural supply of early career doctors although metropolitan-trained students contribute equal numbers to overall rural workforce capacity. More research is needed about the influence of student interest in rural practice and the duration and setting of immersion on rural work uptake and working more remotely. Research needs to be more nationally balanced and scaled-up to inform national policy development. Critically, the quality of research could be strengthened through longer-term follow-up studies, adjusting for known confounders, accounting for postgraduate stages and using appropriate controls to test the relative effects of student characteristics and program designs.
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Metadata
Title
A review of characteristics and outcomes of Australia’s undergraduate medical education rural immersion programs
Authors
Belinda G. O’Sullivan
Matthew R. McGrail
Deborah Russell
Helen Chambers
Laura Major
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2018
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-018-0271-2

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