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Results

A total of 234 questionnaires were sent and 137 replies were received, a response rate of 59%. (Twenty-two of those surveyed were either no longer at the stated address or had retired.)

Demographics
 Specialty: Almost all the surgeons (127/137; 93%) were general surgeons. Six were orthopaedic surgeons, and the remaining four specialised in urology, gynaecology, ear nose and throat, and ophthalmology.
M:F sex ratio: 134:3.
Age: The surgeons' mean age was 52 years. Almost half (49%) were aged 50-59 years, and 15% were over 60 years.
Qualifications: 84% of rural surgeons had obtained their specialist qualification in Australia, and a further 9.5% in the United Kingdom only.
Rural upbringing (before tertiary education): 41% of surgeons spent all or part of their upbringing in a rural area.

Age of surgeons (years)
30-3913 (9.5%)
40-4935 (25%)
50-5967 (49%)
60-6920 (15%)
>701 (0.7%)
Surgeons' qualifications
FRACS only59 (43%)
FRACS, FRCS (London and/or Edinburgh)56 (41%)
FRCS19 (14%)
Qualifications in addition to FRACS/FRCS13 (9.5%)
Not stated3 (2%)
Rural upbringing
0-10 years20 (15%)
10-20 years36 (26%)
No rural upbringing54 (39%)
Upbringing in another country27 (20%)

Practice profile
Hours worked: 86% of the surgeons worked an average of more than 50 hours per week.
On-call frequency: More than half the surgeons were on-call 1:3 or more often (1:1 means on-call every night, 1:2 means on-call every second night, etc).
Hospitals visited: Two-thirds of the surgeons visited more than one hospital.
Locum cover: More than half the surgeons experienced great difficulty in finding locum cover.
Years in same location: Half the surgeons had been in their current location for at least 15 years, and most will remain there until retirement.

Average number of hours worked
<404 (3%)
40-5013 (9.5%)
50-6039 (28%)
60-7045 (33%)
>7034 (25%)
Not answered2 (1%)
On-call frequency
1:134 (25%)
1:225 (18%)
1:332 (23%)
1:422 (16%)
Less frequently24 (18%)
Size of the main hospital
<50 beds14 (10%)
50-100 beds51 (37%)
100-150 beds35 (25%)
150-200 beds21 (15%)
>200 beds16 (12%)
Other hospitals visited
None41 (30%)
One34 (25%)
Two35 (26%)
Three24 (18%)
>Three3 (2%)
Difficulty in finding locum cover
No difficulty31 (23%)
Some difficulty28 (20%)
Great difficulty75 (55%)
Years in same location (range)
0-524 (18%)
5-1022 (16%)
10-1520 (15%)
15-2023 (17%)
20-2525 (18%)
25-3016 (12%)
>307 (5%)
Number of years envisaged remaining at current location, by age group in years
Years
Age group
0-5
5-10
10-15
>15
Total
30-35
-
-
-
2
2
35-40
-
1
1
8
10
40-45
2
-
3
6
11
45-50
3
7
9
5
24
50-55
8
14
10
2
34
55-60
10
18
5
-
33
>60
18
3
-
-
21

Family issues
Marital status: A high proportion (122/137; 89%) of the surgeons were married and 126 (92%) had children. Half of the surgeons had all or some of their children still at school. Half the surgeons sent or had sent their children to boarding school, rather than local schools.
Employment of spouse/partner: 106 surgeons (86%) had spouses/partners who were employed, and 23 (19%) who were not. Of those who were employed, 70 (66%) had jobs connected with the practice, 22 (21%) were working in the medical/nursing field, and in 14 (13%) their employment was unrelated to healthcare. Sixty-six (54%) spouses/partners were working in their chosen profession.

Social issues
Recreation leave: 38% of surgeons had had fewer than three weeks' leave in the past 12 months.

Recreation leave in the past 12 months
<2 weeks24 (18%)
2-3 weeks28 (20%)
3-4 weeks37 (27%)
4-5 weeks21 (15%)
5-6 weeks23 (17%)
Not answered4 (3%)

Positive and negative aspects of rural practice
Positive aspectsNo. of surgeons
Range of cases encountered
115
Lifestyle
110
Professional autonomy
93
Income
47
Negative aspects
Continual on-call work
85
Peer isolation
74
Children's schooling
62
Lack of privacy
38
Income
25
Spouse employment opportunities
15

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