“[It’s] more than just medicine”: The value and sustainability of mandatory, non-clinical, short-term rural placements in a Western Australian medical school

Abstract

Introduction: In 2005, the University of Notre Dame School of Medicine (Western Australia) established a mandatory, non-clinical rural and remote (hereafter termed rural) health placement program delivered in 2 weeks over 2 years, largely resourced by voluntary human capital. Our study investigated whether the program: (1) encouraged medical graduates to seek rural employment; (2) enhanced their ability to meet rural people’s health needs; and (3) was sustainable.

Methods: A qualitative descriptive study collected data using semi-structured, in-depth interviews with graduates and placement hosts. Data were transcribed, coded and analysed using Framework Analysis to identify key themes.

Results: Twenty-eight medical graduates and 15 community hosts participated. The program validated pre-existing interest in, or positively influenced graduates’ attitudes towards, rural practice, and enabled empathy and responsiveness when caring for rural patients in urban, as well as rural, health services. Placement hosts unanimously supported the program and contributed social capital, to ensure its sustainability.

Discussion: The program influenced a broad spectrum of students over 15 years and reflects a socially-accountable approach to medical education.

Conclusions: This study demonstrates the sustainability and value of mandatory short-term community-based placements in improving medical graduates’ responsiveness to the health needs of rural Australians.

Keywords:

• Community-oriented
• medicine
• methods
• medical education research
• ethics/attitudes

Note

Acknowledgments

The authors thank the Shires, communities and placement hosts whose support and participation are the key to this Program’s sustainability and positive influence on Australia’s future doctors.

Disclosure statement

ST and DLV report no declarations of interest. DBM is the instigator and academic coordinator of the Program.

Notes

1 Rural Clinical School is an Australian government funded program in which 25% of medical students undertake the penultimate year of their medical degree in a rural location. These students voluntarily apply for Rural Clinical School and are selected by their medical school in a competitive process.

Additional information

Funding

The Program is funded by the Australian Government’s Rural Health Multidisciplinary Training Program. This study was partly funded by the Australian Government’s Office of Learning and Teaching through an award for Programs that Enhance Leaning.

Notes on contributors

Daniel L. Vujcich

Daniel L. Vujcich holds a doctorate in Population Health from the University of Oxford, is a research Fellow at Curtin University and adjunct academic at Notre Dame and the University of Western Australia. He has experience working in public and Aboriginal health in government and within Aboriginal community-controlled organisations.

Sandy Toussaint

Sandy Toussaint, PhD, MA, BA (hons.), is professor of anthropology and adjunct academic at Notre Dame’s School of Medicine and Nulungu Research Institute. She has published widely, including five books, and undertaken cross-disciplinary cultural research in the Kimberley and elsewhere on health, legal and heritage issues, cultural ethics and material culture.

Donna B. Mak

Donna B. Mak, MBBS, MPH, FACRRM, FAFPHM, was a general practitioner and public health physician in the Kimberley region of Western Australia (WA) for 11 years before chairing the Population and Preventive Health Domain in Notre Dame School of Medicine’s MD curriculum and joining the WA Department of Health’s Communicable Disease Control Directorate.