Connect
MJA
MJA

Impact of the Rural Clinical School of Western Australia on work location of medical graduates

Denese E Playford, Sharon F Evans, David N Atkinson, Kirsten A Auret and Geoffrey J Riley
Med J Aust 2014; 200 (2): 104-107. || doi: 10.5694/mja13.11082

Summary

Objective: To determine whether completing a year of the Rural Clinical School of Western Australia (RCSWA) program is associated with entering the rural medical workforce.

Design and setting: Cohort study of graduates from the University of Western Australia who completed Year 5 of medical school between 2002 and 2009, comparing work location (identified from the Australian Health Practitioner Regulation Agency database in March–June 2013) between those who participated in the RCSWA (RCSWA graduates) and those who did not (controls).

Main outcome measure: Rural or urban work location of graduates.

Results: Of 1116 eligible graduates, 1017 (91.1%) could be traced and were included in the study. Of 258 RCSWA graduates, 42 (16.3%) were working rurally compared with 36 of 759 controls (4.7%). Of 195 RCSWA graduates from urban backgrounds, 29 (14.9%) were working rurally compared with 26 of 691 urban-background controls (3.8%). Of 63 rural-background RCSWA graduates, 13 (20.6%) were working rurally, compared with 10 of 68 rural-background controls (14.7%). Using logistic regression, RCSWA participation had a strong relationship with working rurally (rural-background RCSWA graduates: odds ratio [OR], 7.5; 95% CI, 3.5–15.8; urban-background RCSWA graduates: OR, 5.1; 95% CI, 2.9–9.1). Rural background without RCSWA participation (OR, 4.2; 95% CI, 1.8–9.2) and older age (age in 2012, 30–39 years: OR, 2.2; 95% CI, 1.3–3.7 v ≥ 40 years: OR, 6.6; 95% CI, 2.8–15.0) were also significant factors for working rurally.

Conclusions: Participation in the RCSWA is strongly associated with greater likelihood of working rurally. Graduates from urban backgrounds who participated in the RCSWA were much more likely to work in rural areas than those who did not. These data substantiate the RCSWA as an effective rural workforce strategy.

  • Denese E Playford1
  • Sharon F Evans1
  • David N Atkinson2
  • Kirsten A Auret3
  • Geoffrey J Riley3

  • 1 Rural Clinical School of Western Australia, University of Western Australia, Perth, WA.
  • 2 Rural Clinical School of Western Australia, University of Western Australia, Broome, WA.
  • 3 Rural Clinical School of Western Australia, University of Western Australia, Albany, WA.


Competing interests:

No relevant disclosures.

  • 1. Joyce C, Wolfe R. Geographic distribution of the Australian primary health workforce in 1996 and 2001. Aust N Z J Public Health 2005; 29: 129-135.
  • 2. Rabinowitz HK, Diamond JJ, Markham FW, Santana AJ. The relationship between entering medical students’ backgrounds and career plans and their rural practice outcomes three decades later. Acad Med 2012; 87: 493-497.
  • 3. Rabinowitz HK, Diamond JJ, Markham FW, Wortman JR. Medical school programs to increase the rural physician supply: a systematic review and projected impact of widespread replication. Acad Med 2008; 83: 235-243.
  • 4. Ramsey PG, Coombs JB, Hunt DD, et al. From concept to culture: the WWAMI program at the University of Washington School of Medicine. Acad Med 2001; 76: 765-775.
  • 5. Zink T, Center B, Finstad D, et al. Efforts to graduate more primary care physicians and physicians who will practice in rural areas: examining outcomes from the University of Minnesota–Duluth and the Rural Physician Associate Program. Acad Med 2010; 85: 599-604.
  • 6. 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. <MJA full text>
  • 7. McDonnel Smedts A, Lowe MP. Efficiency of clinical training at the Northern Territory Clinical School: placement length and rate or return for internship. Med J Aust 2008; 189: 166-168. <MJA full text>
  • 8. Playford DE, Denz-Penhey H, Skinner L, Murdoch JC. Will Australian rural clinical schools be an effective workforce strategy? Early indications of their positive effect on intern choice and rural career interest [letter]. Med J Aust 2008; 188: 190. <MJA full text>
  • 9. Worley P, Martin A, Prideaux D, et al. Vocational career paths of graduate entry medical students at Flinders University: a comparison of rural, remote and tertiary tracks. Med J Aust 2008; 188: 177-178. <MJA full text>
  • 10. Eley DS, Synnott R, Baker PG, Chater AB. A decade of Australian Rural Clinical School graduates – where are they and why? Rural Remote Health 2012; 12: 1937.
  • 11. Australian Government Department of Health. Australian Standard Geographical Classification – Remoteness Area (ASGC-RA). http://www.health. gov.au/internet/otd/Publishing.nsf/Content/RA-intro (accessed Dec 2013).
  • 12. Playford D, Power P, Boothroyd A, et al. Is the National Registration website (Australian Health Practitioner Regulation Agency) effective in tracking Australian medical graduates’ rural work? Aust J Rural Health 2013; 21: 249-253.
  • 13. Deloitte Access Economics. Review of the rural medical workforce distribution programs and policies. Canberra: Department of Health and Ageing, 2011.
  • 14. Laven G, Wilkinson D. Rural doctors and rural backgrounds: how strong is the evidence? A systematic review. Aust J Rural Health 2003; 11: 277-284.
  • 15. Carter RG. The relation between personal charateristics of physicians and practice location in Manitoba. CMAJ 1987; 136: 366-368.
  • 16. Wilkinson D, Laven G, Pratt N, Beilby J. Impact of undergraduate and postgraduate rural training, and medical school entry criteria on rural practice among Australian general practitioners: national study of 2414 doctors. Med Educ 2003; 37: 809-814.
  • 17. Rabinowitz HK, Diamond JJ, Markham FW, Hazelwood CE. A program to increase the number of family physicians in rural and underserved areas: impact after 22 years. JAMA 1999; 281: 255-260.
  • 18. Rourke JT, Incitti F, Rourke LL, Kennard M. Relationship between practice location of Ontario family physicians and their rural background or amount of rural medical education experience. Can J Rural Med 2005; 10: 231-240.
  • 19. Laven GA, Beilby JJ, Wilkinson D, McElroy HJ. Factors associated with rural practice among Australian-trained general practitioners. Med J Aust 2003; 179: 75-79. <MJA full text>

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.