Rural Clinical School, University of Queensland, Rockhampton, QLD.
Rural Clinical School, University of Queensland, Toowoomba, QLD.
Med J Aust. 2024 Oct 7;221 Suppl 7:S9-S15. doi: 10.5694/mja2.52448.
To explore continuity of service and longer term retention outcomes of participants of the Remote Vocational Training Scheme (RVTS).
DESIGN, SETTING, PARTICIPANTS: Retrospective cohort study of all doctors who participated in the RVTS from 2000 to 2023, many of whom are international medical graduates and are expected to work in the same community for three to four years in remote (Modified Monash Model [MMM] categories 4-7) or rural Aboriginal Medical Services (AMS) streams while undertaking training towards general practice fellowship.
Continuity of service was measured in the pre-program period (period working in same practice before commencing) and during-program period (period completing the RVTS program in same practice as worked in before commencing the program). Retention was measured firstly within two years, and secondly beyond two years (up to 20 post-completion years) based on: working in the same community (relevant to both streams); working in the same region (Remote Stream only); working in any MMM4-7 community (Remote Stream only); or working anywhere rurally (both streams).
From 506 enrolled participants, 373 (73.7%) were international medical graduates. The approximate mean service continuity in the same practice was 1.6 years (standard deviation [SD], 2.2 years) for the pre-program period and 3.6 years (SD, 1.4 years) for the during-program period (mean total, 5.2 years). Two years after completion, 21 out of 43 Remote Stream doctors (49%) and four out of five AMS Stream doctors (80%) remained in the same community. Over the long term, retention in the same community stabilised to 44 out of 242 Remote Stream doctors (18.2%) and seven out of 27 AMS Stream doctors (26%); 72 Remote Stream doctors (29.8%) remained in the same region, 70 Remote Stream doctors (28.9%) were in an MMM4-7 community, and 11 AMS Stream doctors (41%) were in a rural (MMM2-7) community.
Strong service continuity outcomes have been achieved by the RVTS, which supports mostly international medical graduates in locations typified by the highest workforce turnover. This suggests that continuity of service could be improved for remote and First Nations communities through place-based retention-focused programs like the RVTS.
探讨远程职业培训计划（RVTS）参与者的服务连续性和长期保留结果。
设计、设置、参与者：对 2000 年至 2023 年期间参加 RVTS 的所有医生进行回顾性队列研究，其中许多是国际医学毕业生，预计在偏远地区（修改后的莫纳什模式 [MMM] 4-7 类别）或农村原住民医疗服务（AMS）中从事三到四年的工作社区） streams 在接受全科医师研究员培训的同时。
服务连续性在计划前阶段（开始前在同一实践中工作的阶段）和计划期间进行测量（在同一实践中完成 RVTS 计划的阶段）。保留首先在两年内进行测量，其次在两年后（完成后 20 年）进行测量，依据是：在同一社区工作（与两个流都相关）；在同一地区工作（仅远程流）；在任何 MMM4-7 社区工作（仅远程流）；或在任何农村地区工作（两个流）。
在 506 名入组参与者中，有 373 名（73.7%）是国际医学毕业生。计划前阶段在同一实践中的平均服务连续性约为 1.6 年（标准差 [SD]，2.2 年），计划期间为 3.6 年（SD，1.4 年）（平均总，5.2 年）。完成后两年，43 名远程流医生中有 21 名（49%）和 5 名 AMS 流医生中的 4 名（80%）留在同一社区。从长远来看，242 名远程流医生中有 44 名（18.2%）和 27 名 AMS 流医生中有 7 名（26%）留在同一社区；72 名远程流医生（29.8%）留在同一地区，70 名远程流医生（28.9%）在 MMM4-7 社区，11 名 AMS 流医生（41%）在农村（MMM2-7）社区。
RVTS 取得了强劲的服务连续性成果，为大多数国际医学毕业生在劳动力流失率最高的地区提供支持。这表明，通过像 RVTS 这样基于地点的以保留为重点的计划，可以改善偏远和原住民社区的服务连续性。
