Schauer Anna, Woolley Torres, Sen Gupta Tarun
School of Medicine & Dentistry, James Cook University, Townsville, Queensland, Australia.
Aust J Rural Health. 2014 Apr;22(2):56-62. doi: 10.1111/ajr.12080.
To identify the main reason James Cook University (JCU) Bachelor of Medicine, Bachelor of Surgery graduates chose their internship location and first four practice relocations.
DESIGN & PARTICIPANTS: This cross-sectional study invited 261 JCU medical graduates to participate in an email or telephone survey.
Graduates' main reason for choosing internship location and up to four subsequent relocations, post-graduate specialty training undertaken and practice location (either metropolitan or non-metropolitan) for graduates' internship year and current practice year (2012).
Respondents (n=175; response rate=67%) reported personal factors as the primary driver for choosing their internship location, with 33% returning to 'near their family/home town', and 21% staying in the town they were based in Years 5 and 6. Professional reasons dominated for subsequent relocations, particularly 'long-term career ambitions'. Fifty-nine of the 175 (34%) JCU graduates had undertaken their internship in a metropolitan location (Australian Standard Geographical Classification Remoteness Area 1), while 80 (46%) currently (in 2012) practised in a metropolitan location. Internship location was not associated with later specialty training, but current metropolitan practice was associated with Surgical or Paediatrics training (P=0.007 and P=0.063, respectively), while current non-metropolitan practice was associated with General Practice and Rural Generalist training (P=0.010 and P=0.001, respectively).
Personal decisions take precedence over professional career decisions for why JCU medical graduates chose their internship location, but subsequent relocations are driven by career ambitions, usually around specialty training requirements. These findings support establishing more post-graduate training opportunities in non-metropolitan settings for Surgical and Paediatric specialties as a retention strategy for a rural medical career.
确定詹姆斯库克大学（JCU）医学学士和外科学士毕业生选择实习地点以及前四次执业地点变动的主要原因。
这项横断面研究邀请了261名JCU医学毕业生参与电子邮件或电话调查。
毕业生选择实习地点以及最多四次后续地点变动的主要原因、所接受的研究生专业培训以及毕业生实习年份和当前执业年份（2012年）的执业地点（大城市或非大城市）。
受访者（n = 175；回复率 = 67%）表示个人因素是选择实习地点的主要驱动因素，33%的人回到“家人/家乡附近”，21%的人留在他们在五年级和六年级所在的城镇。后续地点变动主要出于职业原因，尤其是“长期职业抱负”。175名JCU毕业生中有59人（34%）在大城市地区（澳大利亚标准地理分类偏远地区1）进行实习，而80人（46%）目前（2012年）在大城市地区执业。实习地点与后期专业培训无关，但当前在大城市执业与外科或儿科培训相关（分别为P = 0.007和P = 0.063），而当前在非大城市执业与全科医学和农村全科医生培训相关（分别为P = 0.010和P = 0.001）。
对于JCU医学毕业生选择实习地点的原因，个人决定优先于职业决定，但后续的地点变动由职业抱负驱动，通常围绕专业培训要求。这些发现支持在非大城市地区为外科和儿科专业建立更多研究生培训机会，作为农村医疗职业的留住人才策略。
