JCU medical graduates: positive rural workforce impacts from the first seven cohorts

Resumo

Introdução: The regionally-based James Cook University (JCU) School of Medicine seeks to address the health needs of northern Australia by combining selection and curriculum strategies shown to increase rural career recruitment outcomes. The School has graduated 536 students in its first seven cohorts from 2005 to 2011.

Objetivos: This presentation describes the early career practice locations of these cohorts, and the association between later practice location with both hometown at application and internship location.

Metodologia ou descrição da experiência: ‘Hometown at application’ data for JCU medical graduates was retrieved from administrative databases held by the university, while postgraduate location data was obtained either from personal contact via email, telephone, FacebookTM or electronically from the Australian Health Practitioner Regulation Authority website. Data is 99% complete for the primary practice location of 536 JCU MBBS graduates across postgraduate years (PGY) 1 to 7. These were compared with equivalent data from other medical schools held in the national Medical Schools Outcome Database.

Resultados: 65% of JCU graduates undertook non-metropolitan internships compared to 1 in 6 of other graduates (OR=10) and half in outer-regional or remote areas as against 1 in 20 from elsewhere (OR=17). For the internship year, ‘non-metropolitan-origin’ JCU graduates predominantly worked in rural locations, while ‘metropolitan origin’ graduates were more likely to work in major cities. Data to PGY 7 show two-thirds are practising outside of major cities and that a combination of non-metropolitan origin / non-metropolitan internship is highly predictive of subsequently working outside metropolitan areas. 46% of the first 4 cohorts are training in general practice, one third as Rural Generalists.

Conclusões ou hipóteses: This data provides the first real evidence from one of Australia’s new medical schools on actual postgraduate practice location, as compared to ‘intent to practice’. This early evidence supports the JCU model of distributed non-metropolitan medical education, and suggests more regionally-located internship and specialty training places are needed to address rural Australia’s workforce needs.