To the Editor: We report that the internship location choices of the second cohort of medical students to graduate from James Cook University (JCU) are very similar to those of the first cohort.1 Of the 75 students who graduated in the second cohort in 2006, 65 (87%) are working in Queensland; 42 (56%) in North Queensland (roughly the area north of Mackay). Fifty-three (71%) are in non-metropolitan hospitals, including three of the 10 graduates who moved or returned interstate.

These proportions reflect the cohort’s geographic origins. As in the first cohort, a small number of students (13; 17%) of North Queensland origin moved away and a similar number (14; 19%) from elsewhere stayed in North Queensland. Further, a majority of the first cohort have remained where they undertook internship: 24 of 29 (83%) have remained in North Queensland and one commenced remote practice, consistent with the group’s stated intentions to work in regional locations.2 Hence, JCU’s first two graduating cohorts had a combined effect of strong recruitment to non-metropolitan hospitals, particularly in Queensland, some of which have experienced difficulty in recruiting junior staff.

These results have two implications. First, they contribute to the debate on selection into medicine.3 JCU gives weight to rural schooling, with about two-thirds of each cohort having a rural background, and a similar proportion coming from North Queensland.4

Second, there are workforce policy implications. The growth in medical school numbers over the past 3 years has not evenly reflected workforce needs or availability of postgraduate training places. As some urban areas become oversupplied with junior doctors, it will be important not to neglect areas of maldistribution that are drivers of growth. Regional training pathways for specialist and generalist careers need urgent definition; graduates in Queensland are expected to increase from 300 in 2007 to 727 in 2014, so vocational training places will need to more than double.5 An impact on the Australian medical workforce shortage will only be felt when a number of cohorts have graduated from JCU and other regional schools, and bottlenecks to subsequent training are removed.

It will take another decade to obtain a clear picture of postgraduate career outcomes for this group, but the investment in regional medical education in North Queensland appears at this stage to be having the desired effect. If this effect is sustained and replicated in other new regional medical schools, Australia may soon have an adequate supply of medical graduates who both understand and choose to live and work in regional Australia.