Mid-career graduate practice outcomes of the James Cook University medical school: key insights from the first 20 years

Introduction: Previous studies have demonstrated early-career James Cook University (JCU) medical graduates are more likely to practise in regional, rural and remote areas than other Australian medical practitioners. This study investigates whether these non-metropolitan practice location outcome...

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Autores principales:	Torres Woolley, Tarun Sen Gupta, Kath Paton
Formato:	article
Lenguaje:	EN
Publicado:	James Cook University 2021
Materias:	Australia medical postgraduate workforce. Special situations and conditions RC952-1245 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/33acd688ab624df28e2de8a7db881d07
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id	oai:doaj.org-article:33acd688ab624df28e2de8a7db881d07
record_format	dspace
institution	DOAJ
collection	DOAJ
language	EN
topic	Australia medical postgraduate workforce. Special situations and conditions RC952-1245 Public aspects of medicine RA1-1270
spellingShingle	Australia medical postgraduate workforce. Special situations and conditions RC952-1245 Public aspects of medicine RA1-1270 Torres Woolley Tarun Sen Gupta Kath Paton Mid-career graduate practice outcomes of the James Cook University medical school: key insights from the first 20 years
description	Introduction: Previous studies have demonstrated early-career James Cook University (JCU) medical graduates are more likely to practise in regional, rural and remote areas than other Australian medical practitioners. This study investigates whether these non-metropolitan practice location outcomes continue into mid-career, and identifies the key underlying demographic, selection process, curriculum and postgraduate training factors associated with JCU graduates choosing to currently practise in regional, rural and remote areas of Australia. Methods: This study used the JCU medical school's graduate tracking database to identify 2019 Australian practice location data for 931 JCU medical graduates across postgraduate years (PGY) 5-14. This data was sourced primarily from the Australian Health Practitioner Regulation Agency, and then categorised into Modified Monash Model (MMM) rurality classifications using the Department of Health's DoctorConnect website. For these mid-career (PGY5-14) cohorts, multinominal logistic regression was undertaken to identify specific demographic, selection process, undergraduate training and postgraduate career variables found to be associated with a 2019 practice location in a regional city (MMM2), large to small rural town (MMM3-5) or remote community (MMM6-7). Additional multinominal logistic regression analysis was then used to determine the key independent predictors of mid-career JCU medical graduates working in regional cities (MMM2), rural towns (MMM3-5) and remote communities (MMM6-7) in 2019. Results: Around one-third of mid-career (PGY5-14) JCU medical graduates were working in regional cities during 2019, mostly in North Queensland, with a further 14% in rural towns and 3% in remote communities. These first 10 cohorts were undertaking careers in general practice (n=300, 33%), as subspecialists (n=217, 24%), rural generalists (n=96, 11%), generalist specialists (n=87, 10%) or hospital non-specialists (n=200, 22%). Key statistically significant, independent predictors of JCU MBBS graduates practising in MMM3-5 and MMM6-7 locations in 2019 were, respectively, being awarded a rurally bonded Australian Government undergraduate Medical Rural Bonded Scholarship (MRBS) (p=0.004, prevalence odds ratio (POR)=3.5; p=0.017, POR=7.3); graduation from the JCU postgraduate general practice training program, JCU General Practice Training (p=0.001, POR=3.9; p<0.001, POR=20.1) and internship training in a hospital located in a regional city (p=0.003, POR=2.4; p=0.049, POR=4.3) or in a rural or remote town (p=0.033, POR=5.0; p=0.002, POR=54.6). JCU MBBS graduates practising in MMM3-5 locations was also predicted by a rural hometown at application to the medical school (p=0.021, POR=2.5) and choosing a career in general practice (p<0.010, POR=4.4) or in rural generalism (p<0.001, POR=26.4), while JCU MBBS graduates practising in MMM6-7 locations was also predicted by undertaking an extended 20- or 35-week undergraduate rural placement during year 6 (p=0.014, POR=8.9). Conclusion: The findings show positive outcomes from the first 10 cohorts of JCU medical graduates for regional Queensland cities, with a significantly higher proportion of mid-career graduates practising in regional areas of Queensland than the percentage of the overall Queensland population. The proportion of JCU medical graduates practising in smaller regional and remote towns is similar to the overall Queensland population. The recent establishment of the postgraduate JCU General Practice Training program for vocational generalist medicine training and the Northern Queensland Regional Training Hubs for building local specialist training pathways should further strengthen the retention and recruitment of JCU and other medical graduates across the northern Australia region.
format	article
author	Torres Woolley Tarun Sen Gupta Kath Paton
author_facet	Torres Woolley Tarun Sen Gupta Kath Paton
author_sort	Torres Woolley
title	Mid-career graduate practice outcomes of the James Cook University medical school: key insights from the first 20 years
title_short	Mid-career graduate practice outcomes of the James Cook University medical school: key insights from the first 20 years
title_full	Mid-career graduate practice outcomes of the James Cook University medical school: key insights from the first 20 years
title_fullStr	Mid-career graduate practice outcomes of the James Cook University medical school: key insights from the first 20 years
title_full_unstemmed	Mid-career graduate practice outcomes of the James Cook University medical school: key insights from the first 20 years
title_sort	mid-career graduate practice outcomes of the james cook university medical school: key insights from the first 20 years
publisher	James Cook University
publishDate	2021
url	https://doaj.org/article/33acd688ab624df28e2de8a7db881d07
work_keys_str_mv	AT torreswoolley midcareergraduatepracticeoutcomesofthejamescookuniversitymedicalschoolkeyinsightsfromthefirst20years AT tarunsengupta midcareergraduatepracticeoutcomesofthejamescookuniversitymedicalschoolkeyinsightsfromthefirst20years AT kathpaton midcareergraduatepracticeoutcomesofthejamescookuniversitymedicalschoolkeyinsightsfromthefirst20years
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spelling	oai:doaj.org-article:33acd688ab624df28e2de8a7db881d072021-11-16T06:22:24ZMid-career graduate practice outcomes of the James Cook University medical school: key insights from the first 20 years10.22605/RRH66421445-6354https://doaj.org/article/33acd688ab624df28e2de8a7db881d072021-11-01T00:00:00Zhttps://www.rrh.org.au/journal/article/6642/https://doaj.org/toc/1445-6354 Introduction: Previous studies have demonstrated early-career James Cook University (JCU) medical graduates are more likely to practise in regional, rural and remote areas than other Australian medical practitioners. This study investigates whether these non-metropolitan practice location outcomes continue into mid-career, and identifies the key underlying demographic, selection process, curriculum and postgraduate training factors associated with JCU graduates choosing to currently practise in regional, rural and remote areas of Australia. Methods: This study used the JCU medical school's graduate tracking database to identify 2019 Australian practice location data for 931 JCU medical graduates across postgraduate years (PGY) 5-14. This data was sourced primarily from the Australian Health Practitioner Regulation Agency, and then categorised into Modified Monash Model (MMM) rurality classifications using the Department of Health's DoctorConnect website. For these mid-career (PGY5-14) cohorts, multinominal logistic regression was undertaken to identify specific demographic, selection process, undergraduate training and postgraduate career variables found to be associated with a 2019 practice location in a regional city (MMM2), large to small rural town (MMM3-5) or remote community (MMM6-7). Additional multinominal logistic regression analysis was then used to determine the key independent predictors of mid-career JCU medical graduates working in regional cities (MMM2), rural towns (MMM3-5) and remote communities (MMM6-7) in 2019. Results: Around one-third of mid-career (PGY5-14) JCU medical graduates were working in regional cities during 2019, mostly in North Queensland, with a further 14% in rural towns and 3% in remote communities. These first 10 cohorts were undertaking careers in general practice (n=300, 33%), as subspecialists (n=217, 24%), rural generalists (n=96, 11%), generalist specialists (n=87, 10%) or hospital non-specialists (n=200, 22%). Key statistically significant, independent predictors of JCU MBBS graduates practising in MMM3-5 and MMM6-7 locations in 2019 were, respectively, being awarded a rurally bonded Australian Government undergraduate Medical Rural Bonded Scholarship (MRBS) (p=0.004, prevalence odds ratio (POR)=3.5; p=0.017, POR=7.3); graduation from the JCU postgraduate general practice training program, JCU General Practice Training (p=0.001, POR=3.9; p<0.001, POR=20.1) and internship training in a hospital located in a regional city (p=0.003, POR=2.4; p=0.049, POR=4.3) or in a rural or remote town (p=0.033, POR=5.0; p=0.002, POR=54.6). JCU MBBS graduates practising in MMM3-5 locations was also predicted by a rural hometown at application to the medical school (p=0.021, POR=2.5) and choosing a career in general practice (p<0.010, POR=4.4) or in rural generalism (p<0.001, POR=26.4), while JCU MBBS graduates practising in MMM6-7 locations was also predicted by undertaking an extended 20- or 35-week undergraduate rural placement during year 6 (p=0.014, POR=8.9). Conclusion: The findings show positive outcomes from the first 10 cohorts of JCU medical graduates for regional Queensland cities, with a significantly higher proportion of mid-career graduates practising in regional areas of Queensland than the percentage of the overall Queensland population. The proportion of JCU medical graduates practising in smaller regional and remote towns is similar to the overall Queensland population. The recent establishment of the postgraduate JCU General Practice Training program for vocational generalist medicine training and the Northern Queensland Regional Training Hubs for building local specialist training pathways should further strengthen the retention and recruitment of JCU and other medical graduates across the northern Australia region. Torres WoolleyTarun Sen GuptaKath PatonJames Cook UniversityarticleAustraliamedicalpostgraduateworkforce.Special situations and conditionsRC952-1245Public aspects of medicineRA1-1270ENRural and Remote Health, Vol 21 (2021)

Mid-career graduate practice outcomes of the James Cook University medical school: key insights from the first 20 years

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