Rural work outcomes of medical students participating in a contracted Extended Rural Cohort (ERC) program by course-entry preference

Abstract

This paper evaluates rural work location outcomes of an Extended Rural Cohort (ERC) program in medical school. Students nominate a preference and are contracted to the program at entry to the medical course, involving 2–3 years continuous rural training. Data included 2412 graduates from a large university medical school cohort study. Regression modeling compared 2017 work location of ERC participants, by their level of preference for the ERC and students who had other (similar or shorter duration) rural training with a metropolitan-only trained group. Students who entered medicine with ERC as their first preference commonly had rural background (95.5%) compared with second or lower preferences (61.5% and 40.4%, respectively). Multivariate regression modeling identified ERC participants were more likely to work rurally (OR: 2.69–3.27, compared with metropolitan-trained), though higher odds were associated with lower preference for ERC. However, non-ERC students undertaking a similar duration rural training by opting for this “year by year” after course entry, had the strongest odds of rural work (OR: 4.62, 95%CI: 3.00–7.13) and work in smaller rural towns (RRR: 4.08, 95%CI: 2.36–7.06). The ERC attracts rural background students and increases rural work outcomes. However, students choosing a rural training path of equivalent duration after course entry may be more effective and improve rural workforce distribution.

Acknowledgments

We acknowledge the Monash University students now practicing as doctors, whose data contributed to this study. We acknowledge the staff and students involved in the Extended Rural Cohort program.

Disclosure statement

The authors report no conflicts of interest. The views and opinions expressed in this article are those of the authors.

Glossary

Years postgraduation: Years counted after finished the medical course, with 1 being the first year of clinical practice under provisional registration, known as internship.

NA: Not applicable.

Additional information

Funding

This work was supported by the Australia Government Department of Health with funding from the Rural Health Multi-disciplinary Training Fund.

Notes on contributors

Belinda O’Sullivan

Dr Belinda O’Sullivan, PhD, School of Rural Health, Monash University, Bendigo, Victoria, Australia.

Matthew McGrail

Dr Matthew McGrail, PhD, Rural Clinical School, University of Queensland, Rockhampton, Queensland, Australia.

Laura Major

Ms Laura Major, School of Rural Health, Monash University, Clayton, Victoria, Australia.

Mark Woodfield

Mr Mark Woodfield, School of Rural Health, Monash University, Clayton, Victoria, Australia.

Christian Holmes

A/Prof Christian Holmes, MBBS FRACP Grad Cert PHE, School of Rural Health, Monash University, Bendigo, Victoria, Australia.