Harvey Will, Ali Zahra, Van Schaik Lachlan, Develyn Tamekha, Wright Julian
Department of Rural Health, The University of Melbourne, Shepparton, VIC, Australia.
Front Med (Lausanne). 2025 Jul 23;12:1587912. doi: 10.3389/fmed.2025.1587912. eCollection 2025.
Addressing rural healthcare workforce shortages requires evidence-based strategies in medical education. Extended rural immersion programs offer a potential solution, but the optimal duration for fostering long-term regional and rural practice remains unclear.
This retrospective study evaluates the impact of one-year versus three-year rural immersion experiences at the University of Melbourne's Rural Clinical School (RCS) on graduate clinical practice locations of the 2016-2023 graduating cohorts. Using logistic regression analysis, we assessed key predictors of regional and rural practice, including rural immersion duration and intent to practice regionally or rurally.
Graduates who completed the three-year rural immersion program were significantly more likely to practice in Modified Monash Model (MMM) 2-7 areas than those with only one year of rural immersion. Intent to practice regionally or rurally and completing a regional/rural internship emerged as strong predictors of regional/rural practice. However, regional/rural intent did not appear to be a strong indicator for students who only completed 1-year of rural immersion. This highlights the importance of the duration of immersion.
The study demonstrates the effectiveness of extended rural immersion in increasing regional and rural workforce retention. Findings support further investment in rural medical education, including end-to-end rural training models, which integrates rural exposure across the entire medical education journey. Future research should examine long-term workforce retention and strategies for sustaining rural career pathways.
解决农村医疗劳动力短缺问题需要医学教育中基于证据的策略。延长农村实习项目提供了一个潜在的解决方案，但培养长期区域和农村医疗实践的最佳时长仍不明确。
这项回顾性研究评估了墨尔本大学农村临床学院（RCS）为期一年和三年的农村实习经历对2016 - 2023届毕业生临床实习地点的影响。我们使用逻辑回归分析评估了区域和农村医疗实践的关键预测因素，包括农村实习时长以及在区域或农村地区执业的意愿。
完成三年农村实习项目的毕业生在莫纳什改良模型（MMM）2 - 7区域执业的可能性显著高于仅参加一年农村实习的毕业生。在区域或农村地区执业的意愿以及完成区域/农村实习成为区域/农村医疗实践的有力预测因素。然而，对于仅完成一年农村实习的学生来说，区域/农村执业意愿似乎并不是一个强有力的指标。这凸显了实习时长的重要性。
该研究证明了延长农村实习在增加区域和农村劳动力留存方面的有效性。研究结果支持对农村医学教育的进一步投资，包括端到端的农村培训模式，即在整个医学教育过程中融入农村实习经历。未来的研究应考察长期劳动力留存情况以及维持农村职业发展路径的策略。
