Rural background and education boost country doctor numbers, Australia

Increasing the amount of time medical students spend training in rural settings and recruiting more students from rural backgrounds will encourage more to become country doctors, according to research published in the Medical Journal of Australia.

A/Prof Srinivas Kondalsamy-Chennakesavan, Director of Research and Professor Geoff Nicholson, Head at The University of Queensland's Rural Clinical School (UQRCS), led a team of researchers who used data from UQ's longitudinal tracking study of its medical graduates (UQMediCoS).

They sent questionnaires to 1572 UQ medical graduates who graduated between 2002 and 2011. Of the 754 (48.0%) who responded, 236 (31.3%) had a rural background and 276 (36.6%) had attended UQRCS.

Of those who had attended one of UQ's metropolitan clinical schools, 18.8% (90/478) were practicing rurally. For those who spent time at UQRCS that percentage rose to 41.7% (115/276). When compared to students with a metropolitan background who attended a Metropolitan Clinical School, those with a rural background who spent two years at UQRCS were seven times more likely to practice rurally.

"This study strengthens evidence that, after adjusting for multiple confounders, a number of exposures including training in a regional/rural setting and rural background are independent predictors of rural medical practice", the researchers concluded.

"The strong positive interaction between rural background and rural clinical school exposure, and the duration-dependent relationships, could help inform policy changes aimed at enhancing the efficacy of Australia's rural clinical school program", they wrote.

In an editorial in the same issue of the MJA, Prof Nicky Hudson and Dr Jennifer May, both from the University of Newcastle in Tamworth, NSW, said there was now a need to build "regional local postgraduate training networks".

"Start-up funding will help establish the necessary partnerships with postgraduate training providers and colleges for regionally based postgraduate education", they wrote. Recruiting Commonwealth-supported place students from rural and lower socioeconomic backgrounds should also be influential in increasing rural doctor numbers, they said.

"Better targeting of incentives should provide a synergistic strategy and, when used in conjunction with key strategies associated with rural background, rural education and rural service obligations, should increase the number of doctors working in rural locations."