Chong Aaron, Kiroff George
Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
ANZ J Surg. 2015 Mar;85(3):108-12. doi: 10.1111/ans.12880. Epub 2014 Oct 7.
The Royal Australasian College of Surgeons' Rural Surgical Training Program (RSTP) ran from 1996 to 2007. As a formal review of the RSTP had never occurred, it remained unknown whether the RSTP had achieved its objectives of training surgeons for and retaining them in practice in rural Australia.
Sixty-six RSTP fellows and 67 general surgery fellows were asked to complete a survey evaluating factors influencing the decision to pursue a rural surgical career, the influence of the RSTP on subsequent career pathways and the adequacy of the RSTP in preparing its trainees for rural work.
Fifty-one out of 66 RSTP fellows were noted to be in practice in metropolitan Australia, with only 15 in rural Australia. Responses obtained revealed rural surgical rotations during training as a major influence in the decision to perform rural work. Thirty out of 35 RSTP participants stated that the RSTP did not influence their subsequent careers. Six out of 15 RSTP respondents responded positively when asked about the adequacy of the RSTP in preparing its trainees for rural work.
The RSTP largely succeeded in preparing its trainees for rural work, but did not succeed in retaining the majority of its trainees in practice in rural Australia. It appears that targeting doctors at the point of admission to surgical training, in the hope that this would translate into more rural surgeons, did not result in improved retention in rural areas.
澳大利亚皇家外科学院农村外科培训项目(RSTP)于1996年至2007年开展。由于从未对RSTP进行过正式审查,该项目是否实现了为澳大利亚农村地区培训外科医生并使其留在当地执业的目标仍不明确。
66名RSTP学员和67名普通外科住院医生被要求完成一项调查,评估影响从事农村外科职业决策的因素、RSTP对后续职业道路的影响以及RSTP在使学员为农村工作做好准备方面的充分性。
66名RSTP学员中有51名在澳大利亚大城市执业,只有15名在澳大利亚农村地区。调查结果显示,培训期间的农村外科轮转是决定从事农村工作的主要影响因素。35名RSTP参与者中有30人表示RSTP没有影响他们随后的职业生涯。15名RSTP受访者中有6人在被问及RSTP在使学员为农村工作做好准备方面是否充分时给出了肯定回答。
RSTP在很大程度上成功地使学员为农村工作做好了准备,但未能使大多数受训人员留在澳大利亚农村地区执业。看来,在外科培训录取时针对医生,希望这能转化为更多农村外科医生,但这并没有提高农村地区的留用率。