Vocational career paths of graduate entry medical students at Flinders University: a comparison of rural, remote and tertiary tracks

Paul Worley, Anne Martin, David Prideaux, Richard Woodman, Elizabeth Worley and Michael Lowe
Med J Aust 2008; 188 (3): 177-178. || doi: 10.5694/j.1326-5377.2008.tb01567.x
Published online: 4 February 2008

In 1996, Flinders University School of Medicine was the first Australian medical school to introduce a 4-year graduate-entry medical program.1 Simultaneously, it piloted two new clinical teaching programs. The first, the Parallel Rural Community Curriculum (PRCC), enabled volunteer students to undertake their entire Year 3 study based in primary care in small rural communities in the Riverland, 250 km from Adelaide.2 The second, the Northern Territory Clinical School (NTCS), enabled volunteer students to undertake their entire Year 3 study in the remote tertiary referral centre at Royal Darwin Hospital, 3000 km from Adelaide.3 All other students undertook the standard Year 3 program based at Flinders Medical Centre (FMC), the urban tertiary teaching hospital affiliated with the university.

The PRCC and NTCS programs were funded with the expectation that the experiences would encourage students to choose careers outside capital cities. The graduates of the first three cohorts are now at least 6 years post-graduation. We aimed to determine the career path trajectories of these three cohorts, particularly in relation to general and rural practice.


We distributed 150 questionnaires. Overall, 74 graduates (49%) returned usable data: 45 of 105 FMC students (43%), 16 of 30 NTCS students (53%), and 13 of 15 PRCC students (87%). The median age of respondents at admission to medical school was 24 years (range, 19–42 years) and 54% were women. These data are consistent with the profile of the non-respondents.


We report, for the first time, vocational career choice data for students undertaking the two most popular forms of rural clinical school attachment — a longitudinal rural community-based year, and a year based in a regional tertiary referral hospital. Our data show that students who chose the PRCC and NTCS programs were more likely to choose a rural career after graduation, even accounting for age at admission and rural background.

Inevitably, small, single institution, cross-sectional studies such as this suffer from significant limitations. Caution should be used in generalising these findings to other institutions. Career choices are made before, during or after undergraduate rotations, and are therefore subject to other influences. As the students were volunteers for both programs, there may have been a selection bias towards students with a prior preference towards rural practice. Our regression analysis accounted for the known influence of rural background.5,6

A further limitation is to what extent this result is generalisable to non-graduate-entry courses. The observation that both rural and general practice choices were positively associated with age suggests that differences between the career choices of graduates from these two course types should be the subject of further research.

Of interest is the finding that 39% of the graduates of the PRCC program and 47% of the NTCS graduates chose specialties other than general practice. This is reassuring, as one requirement of all Australian medical schools is that their graduates are capable of undertaking subsequent specialty training across the breadth of medicine. Previous research has demonstrated the excellent academic performance of students in Flinders University’s rural clinical school programs.7 Although the emphasis on general and rural practice is one key aim of the PRCC and NTCS programs, clearly these graduates are also prepared to pursue careers in urban environments and other specialties. Our study shows that these graduates can contribute to meeting the shortfall that exists across many specialties in rural areas.

  • Paul Worley1
  • Anne Martin1
  • David Prideaux1
  • Richard Woodman1
  • Elizabeth Worley2
  • Michael Lowe3

  • 1 School of Medicine, Flinders University, Adelaide, SA.
  • 2 Healthcare and Education Innovations Pty Ltd, Adelaide, SA.
  • 3 Northern Territory Clinical School, School of Medicine, Flinders University, Darwin, NT.



The PRCC is supported by funding from the Australian Government’s Rural Clinical Schools program. The NTCS is supported by funding from the Northern Territory Government.

Competing interests:

None identified.

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