The Australian Rural Clinical School (RCS) program supports rural medical workforce

Evidence from a crosssectional study of 12 RCSs

Joe McGirr, Alexa Seal, Amanda Barnard, Colleen Cheek, David Garne, Jennene Greenhill, Srinivas Kondalsamy-Chennakesavan, Georgina M. Luscombe, Jenny May, Janet Mc Leod, Belinda O'Sullivan, Denese Playford, Julian Wright

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)

Abstract

Introduction: Many strategies have been implemented to address the shortage of medical practitioners in rural areas. One such strategy, the Rural Clinical School Program supporting 18 rural clinical schools (RCSs), represents a substantial financial investment by the Australian Government. This is the first collaborative RCS study summarising the rural work outcomes of multiple RCSs. The aim of this study was to combine data from all RCSs' 2011 graduating classes to determine the association between rural location of practice in 2017 and (i) extended rural clinical placement during medical school (at least 12 months training in a rural area) and (ii) having a rural background. Methods: All medical schools funded under the RCS Program were contacted by email about participation in this study. Deidentified data were supplied for domestic students about their gender, origin (rural background defined as having lived in an Australian Standard Geographic Classification-Remoteness Area (ASGC-RA) 2-5 area for at least 5 years since beginning primary school) and participation in extended rural clinical placement (attended an RCS for at least 1 year of their clinical training). The postcode of their practice location according to the publicly available Australian Health Practitioner Regulation Agency (AHPRA) register was collected (February to August 2017) and classified into rural and metropolitan areas using the ASGC 2006 and the more recent Modified Monash Model (MMM). The main outcome measure was whether graduates were working in a 'rural' area (ASGC categories RA2-5 or MMM categories 3-7) or 'metropolitan' area. Pearson's χ 2 test was used to detect differences in gender, rural background and extended placement at an RCS between rural and metropolitan practice locations. Binary logistic regression was used to determine odds of rural practice and 95% confidence intervals (CIs) were calculated. Results: Although data were received from 14 universities, two universities had not started collecting origin data at this point so were excluded from the analysis. The proportion of students with a rural background had a range of 12.3-76.6% and the proportion who had participated in extended RCS placement had a range of 13.7-74.6%. Almost 17% (16.6%) had a principal practice postcode in a rural area (according to ASGC), range 5.8-55.6%, and 8.3% had a principal practice postcode in rural areas (according to MMM 3-7), range 4.5-29.9%. After controlling for rural background, it was found that students who attended an RCS were 1.5 times more likely to be in rural practice (95%CI 1.2-2.1, p=0.004) using ASGC criteria. Using the MMM 3-7 criteria, students who participated in extended RCS placement were 2.6 times as likely to be practising in a rural location (95%CI 1.8-3.8, p < 0.001) after controlling for rural background. Regardless of geographic classification system (ASGC, MMM) used for location of practice and of student background (metropolitan or rural), those students with an extended RCS had an increased chance of working rurally. Conclusion: Based on the combined data from three-quarters (12/16) of the Australian medical schools who had a graduating class in 2011, this suggests that the RCS initiative as a whole is having a significant positive effect on the regional medical workforce at 5 years post-graduation.

Original languageEnglish
Article number4971
Number of pages9
JournalRural and Remote Health
Volume19
Issue number1
DOIs
Publication statusPublished - 4 Mar 2019

Keywords

  • Australia
  • Graduate
  • Medical education
  • Rural background
  • Rural clinical school
  • Rural workforce

Cite this

McGirr, Joe ; Seal, Alexa ; Barnard, Amanda ; Cheek, Colleen ; Garne, David ; Greenhill, Jennene ; Kondalsamy-Chennakesavan, Srinivas ; Luscombe, Georgina M. ; May, Jenny ; Leod, Janet Mc ; O'Sullivan, Belinda ; Playford, Denese ; Wright, Julian. / The Australian Rural Clinical School (RCS) program supports rural medical workforce : Evidence from a crosssectional study of 12 RCSs. In: Rural and Remote Health. 2019 ; Vol. 19, No. 1.
@article{497020ad549546fe8d9f92752da8a2a3,
title = "The Australian Rural Clinical School (RCS) program supports rural medical workforce: Evidence from a crosssectional study of 12 RCSs",
abstract = "Introduction: Many strategies have been implemented to address the shortage of medical practitioners in rural areas. One such strategy, the Rural Clinical School Program supporting 18 rural clinical schools (RCSs), represents a substantial financial investment by the Australian Government. This is the first collaborative RCS study summarising the rural work outcomes of multiple RCSs. The aim of this study was to combine data from all RCSs' 2011 graduating classes to determine the association between rural location of practice in 2017 and (i) extended rural clinical placement during medical school (at least 12 months training in a rural area) and (ii) having a rural background. Methods: All medical schools funded under the RCS Program were contacted by email about participation in this study. Deidentified data were supplied for domestic students about their gender, origin (rural background defined as having lived in an Australian Standard Geographic Classification-Remoteness Area (ASGC-RA) 2-5 area for at least 5 years since beginning primary school) and participation in extended rural clinical placement (attended an RCS for at least 1 year of their clinical training). The postcode of their practice location according to the publicly available Australian Health Practitioner Regulation Agency (AHPRA) register was collected (February to August 2017) and classified into rural and metropolitan areas using the ASGC 2006 and the more recent Modified Monash Model (MMM). The main outcome measure was whether graduates were working in a 'rural' area (ASGC categories RA2-5 or MMM categories 3-7) or 'metropolitan' area. Pearson's χ 2 test was used to detect differences in gender, rural background and extended placement at an RCS between rural and metropolitan practice locations. Binary logistic regression was used to determine odds of rural practice and 95{\%} confidence intervals (CIs) were calculated. Results: Although data were received from 14 universities, two universities had not started collecting origin data at this point so were excluded from the analysis. The proportion of students with a rural background had a range of 12.3-76.6{\%} and the proportion who had participated in extended RCS placement had a range of 13.7-74.6{\%}. Almost 17{\%} (16.6{\%}) had a principal practice postcode in a rural area (according to ASGC), range 5.8-55.6{\%}, and 8.3{\%} had a principal practice postcode in rural areas (according to MMM 3-7), range 4.5-29.9{\%}. After controlling for rural background, it was found that students who attended an RCS were 1.5 times more likely to be in rural practice (95{\%}CI 1.2-2.1, p=0.004) using ASGC criteria. Using the MMM 3-7 criteria, students who participated in extended RCS placement were 2.6 times as likely to be practising in a rural location (95{\%}CI 1.8-3.8, p < 0.001) after controlling for rural background. Regardless of geographic classification system (ASGC, MMM) used for location of practice and of student background (metropolitan or rural), those students with an extended RCS had an increased chance of working rurally. Conclusion: Based on the combined data from three-quarters (12/16) of the Australian medical schools who had a graduating class in 2011, this suggests that the RCS initiative as a whole is having a significant positive effect on the regional medical workforce at 5 years post-graduation.",
keywords = "Australia, Graduate, Medical education, Rural background, Rural clinical school, Rural workforce",
author = "Joe McGirr and Alexa Seal and Amanda Barnard and Colleen Cheek and David Garne and Jennene Greenhill and Srinivas Kondalsamy-Chennakesavan and Luscombe, {Georgina M.} and Jenny May and Leod, {Janet Mc} and Belinda O'Sullivan and Denese Playford and Julian Wright",
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McGirr, J, Seal, A, Barnard, A, Cheek, C, Garne, D, Greenhill, J, Kondalsamy-Chennakesavan, S, Luscombe, GM, May, J, Leod, JM, O'Sullivan, B, Playford, D & Wright, J 2019, 'The Australian Rural Clinical School (RCS) program supports rural medical workforce: Evidence from a crosssectional study of 12 RCSs', Rural and Remote Health, vol. 19, no. 1, 4971. https://doi.org/10.22605/RRH4971

The Australian Rural Clinical School (RCS) program supports rural medical workforce : Evidence from a crosssectional study of 12 RCSs. / McGirr, Joe; Seal, Alexa; Barnard, Amanda; Cheek, Colleen; Garne, David; Greenhill, Jennene; Kondalsamy-Chennakesavan, Srinivas; Luscombe, Georgina M.; May, Jenny; Leod, Janet Mc; O'Sullivan, Belinda; Playford, Denese; Wright, Julian.

In: Rural and Remote Health, Vol. 19, No. 1, 4971, 04.03.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The Australian Rural Clinical School (RCS) program supports rural medical workforce

T2 - Evidence from a crosssectional study of 12 RCSs

AU - McGirr, Joe

AU - Seal, Alexa

AU - Barnard, Amanda

AU - Cheek, Colleen

AU - Garne, David

AU - Greenhill, Jennene

AU - Kondalsamy-Chennakesavan, Srinivas

AU - Luscombe, Georgina M.

AU - May, Jenny

AU - Leod, Janet Mc

AU - O'Sullivan, Belinda

AU - Playford, Denese

AU - Wright, Julian

PY - 2019/3/4

Y1 - 2019/3/4

N2 - Introduction: Many strategies have been implemented to address the shortage of medical practitioners in rural areas. One such strategy, the Rural Clinical School Program supporting 18 rural clinical schools (RCSs), represents a substantial financial investment by the Australian Government. This is the first collaborative RCS study summarising the rural work outcomes of multiple RCSs. The aim of this study was to combine data from all RCSs' 2011 graduating classes to determine the association between rural location of practice in 2017 and (i) extended rural clinical placement during medical school (at least 12 months training in a rural area) and (ii) having a rural background. Methods: All medical schools funded under the RCS Program were contacted by email about participation in this study. Deidentified data were supplied for domestic students about their gender, origin (rural background defined as having lived in an Australian Standard Geographic Classification-Remoteness Area (ASGC-RA) 2-5 area for at least 5 years since beginning primary school) and participation in extended rural clinical placement (attended an RCS for at least 1 year of their clinical training). The postcode of their practice location according to the publicly available Australian Health Practitioner Regulation Agency (AHPRA) register was collected (February to August 2017) and classified into rural and metropolitan areas using the ASGC 2006 and the more recent Modified Monash Model (MMM). The main outcome measure was whether graduates were working in a 'rural' area (ASGC categories RA2-5 or MMM categories 3-7) or 'metropolitan' area. Pearson's χ 2 test was used to detect differences in gender, rural background and extended placement at an RCS between rural and metropolitan practice locations. Binary logistic regression was used to determine odds of rural practice and 95% confidence intervals (CIs) were calculated. Results: Although data were received from 14 universities, two universities had not started collecting origin data at this point so were excluded from the analysis. The proportion of students with a rural background had a range of 12.3-76.6% and the proportion who had participated in extended RCS placement had a range of 13.7-74.6%. Almost 17% (16.6%) had a principal practice postcode in a rural area (according to ASGC), range 5.8-55.6%, and 8.3% had a principal practice postcode in rural areas (according to MMM 3-7), range 4.5-29.9%. After controlling for rural background, it was found that students who attended an RCS were 1.5 times more likely to be in rural practice (95%CI 1.2-2.1, p=0.004) using ASGC criteria. Using the MMM 3-7 criteria, students who participated in extended RCS placement were 2.6 times as likely to be practising in a rural location (95%CI 1.8-3.8, p < 0.001) after controlling for rural background. Regardless of geographic classification system (ASGC, MMM) used for location of practice and of student background (metropolitan or rural), those students with an extended RCS had an increased chance of working rurally. Conclusion: Based on the combined data from three-quarters (12/16) of the Australian medical schools who had a graduating class in 2011, this suggests that the RCS initiative as a whole is having a significant positive effect on the regional medical workforce at 5 years post-graduation.

AB - Introduction: Many strategies have been implemented to address the shortage of medical practitioners in rural areas. One such strategy, the Rural Clinical School Program supporting 18 rural clinical schools (RCSs), represents a substantial financial investment by the Australian Government. This is the first collaborative RCS study summarising the rural work outcomes of multiple RCSs. The aim of this study was to combine data from all RCSs' 2011 graduating classes to determine the association between rural location of practice in 2017 and (i) extended rural clinical placement during medical school (at least 12 months training in a rural area) and (ii) having a rural background. Methods: All medical schools funded under the RCS Program were contacted by email about participation in this study. Deidentified data were supplied for domestic students about their gender, origin (rural background defined as having lived in an Australian Standard Geographic Classification-Remoteness Area (ASGC-RA) 2-5 area for at least 5 years since beginning primary school) and participation in extended rural clinical placement (attended an RCS for at least 1 year of their clinical training). The postcode of their practice location according to the publicly available Australian Health Practitioner Regulation Agency (AHPRA) register was collected (February to August 2017) and classified into rural and metropolitan areas using the ASGC 2006 and the more recent Modified Monash Model (MMM). The main outcome measure was whether graduates were working in a 'rural' area (ASGC categories RA2-5 or MMM categories 3-7) or 'metropolitan' area. Pearson's χ 2 test was used to detect differences in gender, rural background and extended placement at an RCS between rural and metropolitan practice locations. Binary logistic regression was used to determine odds of rural practice and 95% confidence intervals (CIs) were calculated. Results: Although data were received from 14 universities, two universities had not started collecting origin data at this point so were excluded from the analysis. The proportion of students with a rural background had a range of 12.3-76.6% and the proportion who had participated in extended RCS placement had a range of 13.7-74.6%. Almost 17% (16.6%) had a principal practice postcode in a rural area (according to ASGC), range 5.8-55.6%, and 8.3% had a principal practice postcode in rural areas (according to MMM 3-7), range 4.5-29.9%. After controlling for rural background, it was found that students who attended an RCS were 1.5 times more likely to be in rural practice (95%CI 1.2-2.1, p=0.004) using ASGC criteria. Using the MMM 3-7 criteria, students who participated in extended RCS placement were 2.6 times as likely to be practising in a rural location (95%CI 1.8-3.8, p < 0.001) after controlling for rural background. Regardless of geographic classification system (ASGC, MMM) used for location of practice and of student background (metropolitan or rural), those students with an extended RCS had an increased chance of working rurally. Conclusion: Based on the combined data from three-quarters (12/16) of the Australian medical schools who had a graduating class in 2011, this suggests that the RCS initiative as a whole is having a significant positive effect on the regional medical workforce at 5 years post-graduation.

KW - Australia

KW - Graduate

KW - Medical education

KW - Rural background

KW - Rural clinical school

KW - Rural workforce

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JO - Rural and Remote Health

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SN - 1445-6354

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