Medical rural generalist training in Queensland, Australia: a five-year evaluation

Resumo

Introdução: Queensland’s Rural Generalist Pathway commenced in 2007 as a strategy to address rural workforce shortages specifically in public hospitals. In the first five years over 160 trainees commenced in the pathway. The pathway was founded on four transformational pillars: recognition of the profession; valuing practice; a supply line/pathway to practice; and workforce redesign.

Objetivos: In 2012/13 Queensland Health commissioned an independent evaluation of the Rural Generalist pathway, by Ernst & Young, a multinational professional services firm. This paper presents the key findings and recommendations of this independent evaluation which was funded by Health Workforce Australia.

Metodologia ou Descrição da Experiência: An independent evaluation by Ernst and Young with multi-stakeholder surveys and analysis of key representative provincial and rural health services engaged in rural generalist training was undertaken in late 2012 and early 2013. The evaluation was asked to: review the current state of the pathway focusing on stakeholder engagement and process efficiency; undertake a comparative cost analysis for a Clinical Services Capability Framework; consider how the pathway met community needs and expectations; undertake a workforce analysis with specific mapping of advanced skills and identified population drivers; and develop a workforce framework for future planning.

Resultados: The evaluation provides positive feedback aligned to the four pillars of the program. Key stakeholders support the establishment of a sustainable and effective pathway, the value of the practice of rural generalist medicine in Queensland, and its contribution to addressing rural medical workforce needs across the state. The evaluation provides 27 recommendations which provide some clear signals for future development of the program. It concludes the training program is: of high quality; operating efficiently but with improvements possible; flexible and responsive; yet to realise its potential to support workforce planning; meets the needs of local communities; and represents value for money.

Conclusão ou Hipóteses: This evaluation indicates the Rural Generalist Pathway made significant steps towards providing a high quality, sustainable solution to training and workforce needs of medical rural generalists in Queensland. It indicates that the program is a cost effective means of delivering the requisite training and workforce. The evaluation provides a range of recommendations to address future challenges.