- Title
- Association between rural exposure/experience and practice location 10 years postgraduation, stratified by specialty: evidence from a cohort study of graduates from nine Australian universities
- Creator
- Seal, Alexa; McGrail, Matthew R.; Bain-Donohue, Suzanne; Fuller, Lara; Kirke, Andrew; Garne, David; Luscombe, Georgina; Allen, Penny; Wright, Julian; Burrows, Julie M.
- Relation
- BMJ Open Vol. 14, Issue 6, no. e086850
- Publisher Link
- http://dx.doi.org/10.1136/bmjopen-2024-086850
- Publisher
- BMJ Group
- Resource Type
- journal article
- Date
- 2024
- Description
- Objective: This study aims to determine the associations between specialty type and practice location at postgraduate year 10 (PGY10), matched with PGY5 and PGY8 work locations, and earlier rural exposure/experience. Design and setting: A cohort study of medicine graduates from nine Australian universities. Participants: 1220 domestic medicine graduates from the class of 2011. Outcome measures: Practice location recorded by the Australian Health Practitioner Regulation Agency in PGY10; matched graduate movement between PGYs 5, 8 and 10 as classified by the Modified Monash Model, stratified by specialty type (predominantly grouped as general practitioner (GP) or non-GP). Results: At PGY10, two-thirds (820/1220) had achieved fellowship. GPs were 2.8 times more likely to be in non-metropolitan practice (28% vs 12%; 95% CI 2.0 to 4.0, p<0.001) than graduates with non-GP (all other) specialist qualifications. More than 70% (71.4%) of GPs who were in non-metropolitan practice in PGY5 remained there in both PGY8 and PGY10 versus 29.0% of non-GP specialists and 36.4% of non-fellowed graduates (p<0.001). The proportion of fellowed graduates observed in non-metropolitan practice was 14.9% at PGY5, 16.1% at PGY8 and 19.0% at PGY10, with this growth predominantly from non-GP specialists moving into non-metropolitan locations, following completion of metropolitan-based vocational training. Conclusions: There are strong differences in practice location patterns between specialty types, with few non-GP specialists remaining in non-metropolitan practice between PGY5 and PGY10. Our study reinforces the importance of rural training pathways to longer-term work location outcomes and the need to expand specialist vocational training which supports more rural training opportunities for trainees outside general practice.
- Subject
- health services accessibility; health workforce; medical education & training; General Practioners; SDG 3; SDG 4; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1506503
- Identifier
- uon:55893
- Identifier
- ISSN:2044-6055
- Rights
- x
- Language
- eng
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