Dhupelia Dilip, Van Erp Ansmarie, Collins James, Sen Gupta Tarun
Darling Downs Health, Queensland Country Practice, Brisbane, QLD, 4001, Australia.
College of Medicine & Dentistry, James Cook University, DOUGLAS, Queensland, 4811, Australia.
MedEdPublish (2016). 2024 Feb 19;14:6. doi: 10.12688/mep.20025.1. eCollection 2024.
International workforce shortages have prompted many initiatives to recruit, train and retain rural doctors, including Australia's emerging National Rural Generalist Pathway. This project explored an important component of retention, rural doctors' post-Fellowship support needs, to develop and validate a post-Fellowship support framework. There has been considerable international attention on social accountability in medical education and how medical schools and other institutions can address the needs of the communities they serve. The recognition that rural and remote communities globally are underserved has prompted numerous educational approaches including rurally focused recruitment, selection, and training. Less attention has been paid to the support needs of rural doctors and how they can be retained in rural practice once recruited.
The project team reviewed international and Australian rural workforce and medical education literature and relevant policy documents to develop a set of guiding principles for a post-Fellowship support framework. This project utilised a mixed methods approach involving quantitative and qualitative methodologies. A range of rural doctors, administrators, and clinicians, working in primary and secondary care, across multiple rural locations in Queensland were invited to participate in interviews. Thematic analysis was undertaken.
The interviews validated ten interconnected guiding principles which enabled development of a grounded, contextually relevant approach to post-Fellowship support. This framework provides a blueprint for a retention strategy aiming to build a strong, skilled, and sustainable medical workforce capable of meeting community needs.
The ten principles were designed in the real-world context of a mature Queensland Rural Generalist Pathway. Four themes emerged from the inductive thematic analysis: connecting primary and secondary care; valuing a rural career; supporting training and education; and valuing rural general practice. These themes will be used as a basis for engagement and consultation with rural stakeholders to develop appropriate retention and support strategies.
国际劳动力短缺促使许多国家采取举措招募、培训和留住乡村医生，其中包括澳大利亚新出现的全国乡村全科医生培养途径。本项目探讨了留住乡村医生的一个重要组成部分，即乡村医生获得 Fellowship 后的支持需求，以制定并验证一个 Fellowship 后支持框架。医学教育中的社会问责以及医学院校和其他机构如何满足其所服务社区的需求已受到国际上的广泛关注。全球农村和偏远社区医疗服务不足这一认识促使人们采取了多种教育方法，包括以农村为重点的招聘、选拔和培训。然而，对于乡村医生的支持需求以及招募后如何让他们留在农村行医的关注较少。
项目团队查阅了国际和澳大利亚农村劳动力及医学教育文献以及相关政策文件，以制定 Fellowship 后支持框架的一套指导原则。本项目采用了混合方法，包括定量和定性方法。邀请了昆士兰州多个农村地区从事初级和二级医疗服务的一系列乡村医生、管理人员和临床医生参与访谈，并进行了主题分析。
访谈验证了十条相互关联的指导原则，这些原则有助于制定一个基于实际情况且与背景相关的 Fellowship 后支持方法。该框架为留住人才战略提供了蓝图，旨在打造一支强大、有技能且可持续的医疗队伍，以满足社区需求。
这十条原则是在昆士兰州成熟的乡村全科医生培养途径的实际背景下设计的。归纳主题分析得出了四个主题：连接初级和二级医疗服务；重视乡村职业生涯；支持培训与教育；重视乡村全科医疗。这些主题将作为与农村利益相关者进行交流和协商的基础，以制定适当的留住人才和支持战略。
