Woolley Torres
College of Medicine & Dentistry, James Cook University, Townsville, Queensland, Australia.
Aust J Rural Health. 2019 Oct;27(5):412-418. doi: 10.1111/ajr.12546. Epub 2019 Jul 23.
Geographic mal-distribution towards urban over rural medical practice exists worldwide. The James Cook University medical school has focused its selection and curriculum on selecting and training students to address medical workforce needs for local regional, rural and remote areas. This study investigates final-year James Cook University medical students' intended rural practice modality and association with rurality of upbringing.
DESIGN, SETTING & PARTICIPANTS: Cross-sectional survey of final-year James Cook University medical students in 2018 (n = 147; response rate = 76%).
Association between students' rurality of hometown at entry to medical school and self-reported intentions for rural practice.
Overall, final-year students' preferred rural practice modality was "for a specific number of years" (38, 25%), followed by "periodic short-term locum" (33, 23%), "permanently based" (26, 18%), "orbiting" (21, 14%), "none" (14, 10%), "long-term shared position" (9, 6%) and "specialist outreach clinics" (6, 4%). Urban hometown at entry to medical school was associated with students preferring periodic rural practice, with rural-origin students contrastingly preferring more permanent rural practice.
Only 10% of James Cook University medical students did not want a rural career in any form, suggesting the majority, regardless of urban or rural hometown, are open to some type of rural practice. Urban-origin medical students around Australia might be a significant, untapped resource for periodic and more permanent rural practice if they can be provided with extended, immersive rural placements experiences. Government funding models should provide increased funding for immersive rural placements, and promotion of orbiting and longer-term job share practice modalities.
全球范围内存在城市医疗实践优于农村的地理分布不均衡现象。詹姆斯·库克大学医学院在招生和课程设置上注重选拔和培养学生，以满足当地地区、农村和偏远地区的医疗劳动力需求。本研究调查了詹姆斯·库克大学医学专业最后一年学生的农村执业意向模式及其与成长地农村程度的关联。
设计、地点与参与者：对2018年詹姆斯·库克大学医学专业最后一年学生进行横断面调查（n = 147；回复率 = 76%）。
医学院入学时学生家乡的农村程度与自我报告的农村执业意向之间的关联。
总体而言，最后一年学生首选的农村执业模式是“特定年限”（38人，25%），其次是“定期短期临时代理”（33人，23%）、“长期驻留”（26人，18%）、“巡回”（21人，14%）、“无”（14人，10%）、“长期共享职位”（9人，6%）和“专科医生外展诊所”（6人，4%）。医学院入学时家乡在城市的学生更倾向于定期农村执业，而农村出身的学生则相反，更倾向于长期农村执业。
詹姆斯·库克大学只有10%的医学专业学生不希望从事任何形式的农村医疗工作，这表明无论家乡是城市还是农村，大多数学生都愿意接受某种类型的农村执业。如果能为澳大利亚城市出身的医学生提供更长时间、更深入的农村实习经历，他们可能会成为定期和更长期农村执业的重要未开发资源。政府资助模式应增加对沉浸式农村实习的资助，并推广巡回和长期工作分担的执业模式。
