Gippsland Medical School, Monash University, Northways Road, Churchill, VIC 3842, Australia.
Health Policy. 2012 Dec;108(2-3):133-9. doi: 10.1016/j.healthpol.2012.10.003. Epub 2012 Oct 30.
Rural communities worldwide are increasingly reliant on international medical graduates (IMGs) to provide health care access, with many countries utilising health policies which mandate IMGs to practise only in rural designated areas of (medical) workforce shortage for many years. The objective of this study is to analyse the satisfaction of IMGs in their current work location, particularly in relation to the effect of mandating IMGs to small rural communities.
We used data of 3502 general practitioners (GPs) from Wave 2 of the Medicine in Australia: Balancing Employment and Life (MABEL) longitudinal study of Australian doctors. The main outcome measures were the level of professional and non-professional satisfaction expressed by GPs with respect to various job and social aspects.
We found that non-professional satisfaction of mandated IMGs was significantly lower across all social aspects, whilst professional satisfaction was also significantly lower for most job aspects relating to their professional autonomy. In contrast, non-mandated IMGs were similarly satisfied compared to Australian trained GPs.
Mandated IMGs are currently filling a critical shortage in rural areas of Australia. However, long-term success of this policy is problematic unless outstanding issues affecting their significantly reduced professional and non-professional satisfaction can be addressed.
世界范围内的农村社区越来越依赖国际医学毕业生（IMGs）来提供医疗服务，许多国家多年来一直利用卫生政策，要求 IMGs 只能在农村指定的医疗人员短缺地区执业。本研究的目的是分析 IMGs 在当前工作地点的满意度，特别是与要求 IMGs 到小型农村社区执业的影响有关。
我们使用了来自澳大利亚医生纵向研究《医学：平衡就业与生活》（MABEL）第 2 波的 3502 名全科医生的数据。主要观察指标是全科医生对各种工作和社会方面表示的专业和非专业满意度水平。
我们发现，在所有社会方面，受强制要求的 IMGs 的非专业满意度显著降低，而与他们的专业自主权有关的大多数工作方面的专业满意度也显著降低。相比之下，非强制要求的 IMGs 与澳大利亚培训的全科医生相比满意度相似。
受强制要求的 IMGs 目前正在填补澳大利亚农村地区的关键短缺。然而，除非能够解决影响他们专业和非专业满意度显著降低的突出问题，否则该政策的长期成功是有问题的。
