More evidence points to benefit of rural training

Matt Woodley

19/08/2022 5:06:05 PM

New research has linked the amount of training time spent outside major cities with better odds of GPs working in rural and remote areas.

Rural GP
The study found a linear gradient between increasing levels of rural exposure in GP general medical training and subsequent rural work.

Junior doctors who train in rural and remote regions are more likely to subsequently decide to work in those areas, new research published in the American Journal of Graduate Medical Education has found.
While other research has previously identified associations between rural training – particularly as a medical student – and subsequent rural practice, the new paper found linked the likelihood of a doctor choosing to practice in regional areas in line with the amount of rural GP training they did.
‘There is a linear gradient between increasing levels of rural exposure in [GP general medical training] and subsequent rural work,’ the authors found.
‘Rural exposure during [GP] residency training is associated with a 5–6-fold increase in subsequent rural practice, with a positive dose effect for greater degrees of exposure.’
As part of the research, the authors identified 15,209 residents who graduated 2008 and 2012, finding that almost half of the family medicine residents who spent more than 50% of their training time in rural areas were working rurally in 2018 (205 of 424).
Conversely, only 12% of graduates with no rural training were practising outside major cities, a slightly lower rate than the 20% of those who had at least some exposure, but still spent less than half of their training rurally.
Even though the study was based in the US, lead author and Menzies Senior Research Fellow Dr Deborah Russell said the findings are relevant for the Australian context as well.
‘The findings suggest that greater investment in rural training programs – especially investments that target current gaps in rural primary care training such as during the prevocational period – could help address forecast shortages in the rural primary care workforce, which in turn could lead to more equitable health outcomes for rural populations,’ she said.
The new research adds to a growing body of work showcasing the potential workforce benefits associated with more rural training for medical doctors.
A 2019 study showed regionally-based junior doctors were 54% more likely to be satisfied in their work than their city counterparts, while separate 2022 and 2020 studies have also shown an association between rural exposure during training and the likelihood of practising outside major cities.
Currently, Federal Government policy mandates that about half of the doctors training to be GPs do their training in rural areas.
However, junior doctors do not enter specialty training pathways (such as GP training) for at least two years after graduating, creating a gap in which they remain in hospitals, largely in metropolitan areas, with limited exposure to rural and remote general practice.
This is despite statistics indicating better healthcare access is needed in these areas.
Recent Australian Institute of Health and Welfare (AIHW) statistics show that the further someone lives from a major city, the more likely they are to die prematurely or from avoidable causes, while in 2018 there were nearly 40 fewer GPs per 100,000 people in very remote areas compared to major cities.
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