NSW & ACT Research and Evaluation Unit, GP Synergy, Regional Training Organisation (RTO), Mayfield West, New South Wales, Australia.
School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.
BMJ Open. 2022 Apr 26;12(4):e058892. doi: 10.1136/bmjopen-2021-058892.
To: (1) establish the prevalence of urban, regional, rural and remote practice location of early-career general practitioners (GPs); and (2) examine demographic and training-related characteristics associated with working in regional, rural or remote areas post attainment of vocational general practice qualifications.
Cross-sectional, questionnaire-based study, combined with contemporaneously collected data from participants' prior vocational training.
Australian general practice.
Newly vocationally qualified GPs (ie, within 6 months-2 years post fellowship) who had completed vocational training with regional training organisations in New South Wales, Australian Capital Territory, eastern Victoria, and Tasmania between January 2016 and July 2018.
Rurality of post-fellowship practice location, as defined by Modified Monash Model (MMM) geographical classifications, based on current practice postcode. Prevalence of regional/rural/remote ('rural') practice was described using frequencies, and associations of rural practice were established using multivariable logistic regression, considering a range of demographic factors and training characteristics as independent variables.
A total of 354 participants completed the questionnaire (response rate 28%) with 319 providing information for their current practice location. Of these, 100 (31.4%) reported currently practising in a rural area (MMM2-7). Factors most strongly associated with practising in a rural area included having undertaken vocational GP training in a rural location OR 16.0 (95% CI 6.79 to 37.9); p<0.001; and undertaking schooling in rural area prior to university OR 4.21 (1.98, 8.94); p<0.001.
The findings suggest that vocational training experience may have a role in rural general practice location post fellowship, attenuating the previously demonstrated 'leakage' from the rural practice pipeline.
（1）确定早期职业全科医生（GP）的城市、地区、农村和偏远地区执业地点的流行情况；（2）检查与获得职业全科医生资格后在地区、农村或偏远地区工作相关的人口统计学和培训相关特征。
横断面、基于问卷的研究，结合参与者之前职业培训期间的同期收集数据。
澳大利亚全科医学。
新获得职业资格的全科医生（即在 fellowship 后 6 个月至 2 年内），他们在 2016 年 1 月至 2018 年 7 月期间在新南威尔士州、澳大利亚首都领地、维多利亚州东部和塔斯马尼亚州的地区培训组织完成了职业培训。
根据当前实践邮政编码，使用改良 Monash 模型（MMM）地理分类法定义的 fellowship 后实践地点的农村程度。使用频率描述农村实践的流行情况，并使用多变量逻辑回归确定农村实践的关联，考虑一系列人口统计学因素和培训特征作为自变量。
共有 354 名参与者完成了问卷（响应率 28%），其中 319 名参与者提供了其当前实践地点的信息。在这些参与者中，有 100 名（31.4%）报告目前在农村地区执业（MMM2-7）。与在农村地区执业最密切相关的因素包括在农村地区接受职业 GP 培训或 16.0（95%CI 6.79 至 37.9）；p<0.001；和在大学之前在农村地区接受学校教育或 4.21（1.98，8.94）；p<0.001。
研究结果表明，职业培训经验可能在 fellowship 后农村全科医学执业地点中发挥作用，减弱了先前从农村实践管道中出现的“泄漏”。
