Rural longitudinal integrated clerkships and medical workforce outcomes: A scoping review

Abstract

Introduction

Internationally the medical workforce is suffering from a persistent geographic and specialist maldistribution. Longitudinal models of rural medical education such as longitudinal integrated clerkships (LIC) have been one of the strategies employed to redress this issue.

Aim

To map and synthesise the evidence on the medical workforce outcomes of rural LIC graduates, identifying gaps in the literature to inform future research.

Methods

This review followed Arksey and O’Malley’s methodological steps. Databases searched included Medline, CINAHL Complete (EBSCOhost), Scopus, Embase (Elsevier), and ISI Web of Science.

Results

A total of 9045 non-duplicate articles were located, 112 underwent a full review, with 25 articles meeting the inclusion criteria. Studies were commonly cohort-based (84%), with data collected by database tracking and data linkage (52%). Five themes were identified to summarise the studies: (i) Overall geographic workforce outcomes (ii) influence of non-LIC medical training, (iii) remaining in region and level of rurality, (iv) medical speciality choice and rurality, and (v) selection and preferences.

Conclusion

Synthesis of the evidence related to workforce outcomes of rural LIC graduates provides directions for future rural medical workforce planning and research. While rural LIC graduates were found to be more likely to work rurally and in primary care specialities compared to graduates from other training pathways there is evidence to suggest this can be enhanced by strategically aligning selection and training factors.

Keywords:

• Longitudinal integrated clerkships
• rural medical education
• rural workforce

Acknowledgements

We acknowledge the contribution of Deakin University librarian Julie Higgins in providing guidance on the development of the initial search strategy and the use of academic databases and information sources.

Disclosure statement

The authors report there are no competing interests to declare.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Jessica Beattie

Jessica Beattie, MHHSM, Deakin University, School of Medicine, Rural Community Clinical School, Geelong, Victoria, Australia.

Marley Binder

Dr Marley Binder, PhD, Deakin University, School of Medicine, University Department of Rural Health, Warrnambool, Victoria, Australia.

Lara Fuller

Associate Professor Lara Fuller, FRACGP, Deakin University, School of Medicine, Rural Community Clinical School, Geelong, Victoria, Australia.