Fuller Lara, Beattie Jessica, Versace Vincent L, Rogers Gary D, McGrail Matthew Richard
School of Medicine, Deakin University, Geelong, VIC, Australia.
Rural Community Clinical School, School of Medicine, Deakin University, Colac, VIC, Australia.
Front Med (Lausanne). 2025 Jun 26;12:1582793. doi: 10.3389/fmed.2025.1582793. eCollection 2025.
To address the maldistribution of medical practitioners within Deakin University's rural training footprint, a place-based Rural Training Stream (RTS) was established (2022). Formal definition of the footprint has enabled priority admission of 30 local students annually. This paper describes graduate workforce outcomes for the footprint, providing a baseline for future evaluation of the RTS.
Graduates' (2011-2022) Principal Places of Practice (2023) were extracted from the Australian Health Practitioner Regulation Agency register and linked with demographic, admission and training data. Descriptive statistics, univariate analysis and multinomial logistic regression were employed to describe associations with practice in three defined rural Tiers (Tier 1: Deakin's rural footprint, Tier 2: other rural Victoria, Tier 3: other rural Australia), with metropolitan practice as the reference group.
120 (39.2%) graduates were working in Tier 1 and 93 (30.4%) in each of Tiers 2 and 3. Significant associations ( < 0.001) with working in the footprint were: post-graduate years 1-3 (OR 7.2), rural longitudinal integrated clerkship and rural clinical school (RCS) pathway (OR 6.8); RCS pathway only (OR 4.1), general practice specialty (OR 4.7) and rural background (OR 3.0).
The differential effect of rural training on graduates working in the rural footprint, compared with other parts of rural Victoria and Australia is noteworthy. Attrition of graduates from the footprint beyond post-graduate year three highlights the urgency of expanding rural specialty training pathways. These baseline data reinforce the place-based design of the RTS and provide a foundation for future evaluation of local workforce outcomes.
为解决迪肯大学农村培训范围内执业医师分布不均的问题，于2022年设立了基于地点的农村培训流（RTS）。该培训范围的正式界定使得每年能够优先录取30名当地学生。本文描述了该培训范围内的毕业生劳动力成果，为未来对农村培训流的评估提供了基线。
从澳大利亚卫生从业人员监管局登记册中提取2011 - 2022年毕业生的主要执业地点（2023年），并将其与人口统计学、录取和培训数据相关联。采用描述性统计、单变量分析和多项逻辑回归来描述与在三个定义的农村层级（第1层级：迪肯大学的农村培训范围，第2层级：维多利亚州其他农村地区，第3层级：澳大利亚其他农村地区）执业的关联，以大都市执业作为参照组。
120名（39.2%）毕业生在第1层级工作，93名（30.4%）毕业生分别在第2层级和第3层级工作。与在该培训范围内工作存在显著关联（<0.001）的因素有：毕业后1 - 3年（优势比7.2）、农村纵向综合实习和农村临床学院（RCS）途径（优势比6.8）；仅RCS途径（优势比4.1）、全科医学专业（优势比4.7）和农村背景（优势比3.0）。
与维多利亚州农村地区和澳大利亚其他地区相比，农村培训对在农村培训范围内工作的毕业生产生的不同影响值得关注。毕业后三年后该培训范围内毕业生的流失凸显了扩大农村专科培训途径的紧迫性。这些基线数据强化了农村培训流基于地点的设计，并为未来评估当地劳动力成果提供了基础。
