Shanmugakumar Sharanyaa, Playford Denese, Burkitt Tessa, Tennant Marc, Bowles Tom
The Rural Clinical School of Western Australia, The University of Western Australia, 35 Stirling Highway, Nedlands, WA 6009, Australia. Email:.
International Research Collaborative - Oral Health and Equity, Department of Anatomy, Physiology and Human Biology, The University of Western Australia, 35 Stirling Highway, Nedlands, WA 6009, Australia. Email.
Aust Health Rev. 2017 Mar;41(1):75-81. doi: 10.1071/AH15084.
Objective Despite public interest in the rural workforce, there are few published data on the geographical distribution of Australia's rural surgeons, their practice skill set, career stage or work-life balance (on-call burden). Similarly, there has not been a peer-reviewed skills audit of rural training opportunities for surgical trainees. The present study undertook this baseline assessment for Western Australia (WA), which has some of the most remote practice areas in Australia. Methods Hospital staff from all WA Country Health Service hospitals with surgical service (20 of 89 rural health services) were contacted by telephone. A total of 18 of 20 provided complete data. The study questionnaire explored hospital and practice locations of practicing rural surgeons, on-call rosters, career stage, practice skill set and the availability of surgical training positions. Data were tabulated in excel and geographic information system geocoded. Descriptive statistics were calculated in Excel. Results Of the seven health regions for rural Western Australia, two (28.6%) were served by resident surgeons at a ratio consistent with Royal Australasian College of Surgeons (RACS) guidelines. General surgery was offered in 16 (89%) hospitals. In total, 16 (89%) hospitals were served by fly-in, fly-out (FIFO) surgical services. Two hospitals with resident surgeons did not use FIFO services, but all hospitals without resident surgeons were served by FIFO surgical specialists. The majority of resident surgeons (62.5%) and FIFO surgeons (43.2%) were perceived to be mid-career by hospital staff members. Three hospitals (16.7%) offered all eight of the identified surgical skill sets, but 16 (89%) offered general surgery. Conclusions Relatively few resident rural surgeons are servicing large areas of WA, assisted by the widespread provision of FIFO surgical services. The present audit demonstrates strength in general surgical skills throughout regional WA, and augers well for the training of general surgeons. What is known about the topic? A paper published in 1998 suggested that Australia's rural surgeons were soon to reach retirement age. However, there have been no published peer-reviewed papers on Australia's surgical workforce since then. More recent workforce statistics released from the RACS suggest that the rural workforce is in crisis. What does this paper add? This paper provides up-to-date whole-of-state information for WA, showing where surgical services are being provided and by whom, giving a precise geographical spread of the workforce. It shows the skill set and on-call rosters of these practitioners. What are the implications for practitioners? The present study provides geographical workforce data, which is important to health planners, the general public and surgeons considering where to practice. In particular, these data are relevant to trainees considering their rural training options.
目的 尽管公众对农村劳动力感兴趣，但关于澳大利亚农村外科医生的地理分布、他们的执业技能组合、职业阶段或工作与生活平衡（随叫随到的负担）的已发表数据却很少。同样，对于外科实习生的农村培训机会也没有经过同行评审的技能评估。本研究对西澳大利亚州（WA）进行了这一基线评估，该州拥有澳大利亚一些最偏远的执业地区。方法 通过电话联系了西澳大利亚州所有提供外科服务的乡村卫生服务医院（89个农村卫生服务机构中的20个）的医院工作人员。20个机构中有18个提供了完整数据。研究问卷探讨了执业农村外科医生的医院和执业地点、随叫随到排班表、职业阶段、执业技能组合以及外科培训职位的可用性。数据在Excel中制成表格并进行地理信息系统地理编码。在Excel中计算描述性统计数据。结果 在西澳大利亚州的七个农村卫生区域中，有两个（28.6%）由常驻外科医生提供服务，比例符合皇家澳大利亚外科学院（RACS）的指导方针。16家（89%）医院提供普通外科服务。总共有16家（89%）医院由飞来飞去（FIFO）外科服务提供支持。有常驻外科医生的两家医院不使用FIFO服务，但所有没有常驻外科医生的医院都由FIFO外科专家提供服务。医院工作人员认为，大多数常驻外科医生（62.5%）和FIFO外科医生（43.2%）处于职业生涯中期。三家医院（16.7%）提供了所有八项已确定的外科技能组合，但16家（89%）提供普通外科服务。结论 在广泛提供FIFO外科服务的协助下，相对较少的常驻农村外科医生为西澳大利亚州的大片地区提供服务。本次评估表明西澳大利亚州各地区的普通外科技能较强，这对普通外科医生的培训是个好兆头。关于该主题已知的情况是什么？1998年发表的一篇论文表明澳大利亚的农村外科医生即将达到退休年龄。然而，从那时起，没有关于澳大利亚外科劳动力的经过同行评审的已发表论文。皇家澳大利亚外科学院发布的最新劳动力统计数据表明农村劳动力处于危机之中。本文补充了什么？本文提供了西澳大利亚州最新的全州信息，显示了外科服务的提供地点和提供者，给出了劳动力的确切地理分布。它展示了这些从业者的技能组合和随叫随到排班表。对从业者有什么影响？本研究提供了地理劳动力数据，这对卫生规划者、普通公众以及考虑在何处执业的外科医生来说很重要。特别是，这些数据与考虑农村培训选择的实习生相关。
