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Human Resources for Health
Published in: Human Resources for Health 1/2023

Open Access 01-12-2023 | Research

Rural medical workforce pathways: exploring the importance of postgraduation rural training time

Authors: Matthew R. McGrail, Tiana Gurney, Jordan Fox, Priya Martin, Diann Eley, Bushra Nasir, Srinivas Kondalsamy-Chennakesavan

Published in: Human Resources for Health | Issue 1/2023

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Abstract

Background

Inadequate distribution of the medical workforce in rural regions remains a key global challenge. Evidence of the importance of postgraduation (after medical school) rural immersion time and subsequent rural practice, particularly after accounting for other key factors, remains limited. This study investigated the combined impact of three key training pathway factors: (1) rural background, (2) medical school rural immersion, and (3) postgraduation rural immersion, and duration time of each immersion factor on working rurally.

Methods

Data from a cross-sectional national survey and a single university survey of Australian doctors who graduated between 2000 to 2018, were utilised. Key pathway factors were similarly measured. Postgraduation rural training time was both broad (first 10 years after medical school, national study) and specific (prevocational period, single university). This was firstly tested as the dependent variable (stage 1), then matched against rural practice (stage 2) amongst consultant doctors (national study, n = 1651) or vocational training doctors with consultants (single university, n = 478).

Results

Stage 1 modelling found rural background, > 1 year medical school rural training, being rural bonded, male and later choosing general practice were associated with spending a higher proportion (> 40%) of their postgraduation training time in a rural location. Stage 2 modelling revealed the dominant impact of postgraduation rural time on subsequent rural work for both General Practitioners (GPs) (OR 45, 95% CI 24 to 84) and other specialists (OR 11, 95% CI 5–22) based on the national dataset. Similar trends for both GPs (OR 3.8, 95% CI 1.6–9.1) and other specialists (OR 2.8, 95% CI 1.3–6.4) were observed based on prevocational time only (single university).

Conclusions

This study provides new evidence of the importance of postgraduation rural training time on subsequent rural practice, after accounting for key factors across the entire training pathway. It highlights that developing rural doctors aligns with two distinct career periods; stage 1—up to completing medical school; stage 2—after medical school. This evidence supports the need for strengthened rural training pathways after medical school, given its strong association with longer-term decisions to work rurally.
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Metadata
Title
Rural medical workforce pathways: exploring the importance of postgraduation rural training time
Authors
Matthew R. McGrail
Tiana Gurney
Jordan Fox
Priya Martin
Diann Eley
Bushra Nasir
Srinivas Kondalsamy-Chennakesavan
Publication date
01-12-2023
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2023
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-023-00819-3

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