Dedicated rural health professional programmes are getting doctors into rural areas, but they need to expand to address New Zealand's rural doctor shortage, University of Otago – Ōtākou Whakaihu Waka research has found.
Lead author Dr Katelyn Costello, of the Centre for Rural Health, says the study set out to find what factors increased the likelihood of medical graduates choosing careers in rural medicine.
Dr Katelyn Costello
"Attention is currently on students with rural backgrounds and those expressing early career intentions of working rural. Although they are incredibly important, they shouldn't be the sole focus – more medical students need opportunities to be exposed to rural medicine as we've found those working in rural practice come from all walks of life," she says.
The study, published in BMJ Open, included more than 3,290 New Zealand doctors and is the first in the world to link medical school data with workforce outcomes at a national level.
"We now have information about what doctors are actually doing, not just their intentions."
The research combined data from the longitudinal Medical School Outcomes Database with workforce location data of all doctors who graduated from New Zealand medical schools from 2011 to 2019.
Independent predictors of entering rural practice included being of rural origin, being older than 25 when entering medical school, and participating in an extended rural medical school placement, such as Otago's Rural Medical Immersion Programme (RMIP). Students who participated in RMIP were six times as likely to be working as rural doctors compared with the rest of the cohort.
"We found New Zealand is on the right track with dedicated rural programmes, but currently only a minority of students are participating in these. We need to be doing more if we want to overcome rural doctor shortages. However, for rural initiatives to be successful, there needs to be both sufficient and targeted government funding," Dr Costello says.
Interestingly, students of urban origin and those with no rural career intentions at the start of medical school still make up more than half of the early career rural medical workforce.
"Interests and career paths change throughout life – it's important to provide opportunities and supports for more students and doctors to practice rural medicine regardless of where they come from or where they think they might end up working in the future.
"It's really important to know we are training doctors for all of New Zealand, not just the cities. Rural communities deserve to flourish – providing high-quality and cost-effective healthcare close to home is part of that."
*The researchers acknowledge rural healthcare is not just about doctors but an entire healthcare team. This research focused on doctors as the Medical School Outcomes Database enables them to be followed from when they first enter medical school.
Publication:
Predictors of rural medical practice in Aotearoa New Zealand: a national outcomes prospective cohort study
Katelyn Costello, Garry Nixon, Tim Stokes, Chris Frampton, Janine Lander, Tim Wilkinson
BMJ Open
https://bmjopen.bmj.com/content/bmjopen/16/3/e114478.full.pdf
