Volume 188 - Issue 3
Will Australian rural clinical schools be an effective workforce strategy? Early indications of their positive effect on intern choice and rural career interest
Authors: Denese E Playford, Harriet Denz-Penhey, Lesley Skinner and J Campbell Murdoch
Med J Aust 2008; 188 (3): 190. || doi: 10.5694/j.1326-5377.2008.tb01576.x
Published online: 4 February 2008
Published online: 4 February 2008
To the Editor: The academic success of the rural clinical schools (RCS) program is clear: community-based clinical placements in rural Australia are able to produce graduates that are academically indistinguishable from tertiary hospital-trained peers.1,2
The effect of the RCS program on the workforce is yet to be established. Eley and Baker recently identified early career choices by Queensland RCS graduates.3 Western Australian RCS students spend an entire academic year in the country. Here, we provide the first data on the return of WA RCS graduates to rural internship positions relative to the intern year cohort as a whole.
Based on two cohorts entering postgraduate year 1 (PGY1) positions in 2004 and 2005, 14 of 28 WA RCS graduates have requested and completed the one rural rotation that is permitted during their intern year. Given the limited rural rotations available in WA, some sought rural experience as far afield as Queensland and New South Wales.
The substantive uptake of rural experience by RCS interns is in contrast to the intern cohort as a whole (Box).
In 2004 and 2005, the three WA tertiary allocation centres placed 135 and 131 interns, respectively. As WA has no whole-year rural internships, a subset of the urban allocation included a 3-month rural rotation.
The distribution of graduates of the RCS was different to that of graduates from other programs (χ2 = 7.0693; df = 1; P = 0.008). RCS students were more likely than other graduates to take a rural rotation (odds ratio, 3.1).
Furthermore, ongoing postgraduate contact with the RCS cohort has identified that 23 of 28 graduates have chosen to undertake at least some time in the country during their PGY1–3 years. There is also early indication that graduates will sign up for a rural vocational training pathway (3/28). Interestingly, only a small proportion of these graduates are from a rural background (5/28).
Our data suggest that rural practice is seen as highly desirable postgraduate clinical experience by WA RCS graduates. These results provide initial evidence that the WA RCS program will increase the rural workforce.
Aggregate of 2004 and 2005 rural clinical school (RCS) interns versus non-RCS interns: comparison of postgraduate year 1 (PGY1) intern location choices
Expected tertiary allocation centre PGY1 internships (statistically even distribution) |
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Actual tertiary allocation centre PGY1 internships (actual distribution) |
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References
- Worley P, Silagy C, Prideaux D, et al. The parallel rural community curriculum: an integrated clinical curriculum based on rural general practise. Med Educ 2000; 34: 558-565.
- Maley M, Denz-Penhey H, Lockyer-Stevens V, Murdoch JC. Tuning medical education for rural-ready practice: designing and resourcing optimally. Med Teach 2006; 28: 345-350.
- Eley DS, Baker PG. Will Australian rural clinical schools be an effective workforce strategy? Early indications of their positive effect on intern choice and rural career interest. Med J Aust 2007; 187: 166-167.