Continuity of service and longer term retention of doctors training as general practitioners in the Remote Vocational Training Scheme

Abstract

Objective: To explore continuity of service and longer term retention outcomes of participants of the Remote Vocational Training Scheme (RVTS). Design, setting, participants: Retrospective cohort study of all doctors who participated in the RVTS from 2000 to 2023, many of whom are international medical graduates and are expected to work in the same community for three to four years in remote (Modified Monash Model [MMM] categories 4–7) or rural Aboriginal Medical Services (AMS) streams while undertaking training towards general practice fellowship. Main outcome measures: Continuity of service was measured in the pre-program period (period working in same practice before commencing) and during-program period (period completing the RVTS program in same practice as worked in before commencing the program). Retention was measured firstly within two years, and secondly beyond two years (up to 20 post-completion years) based on: working in the same community (relevant to both streams); working in the same region (Remote Stream only); working in any MMM4–7 community (Remote Stream only); or working anywhere rurally (both streams). Results: From 506 enrolled participants, 373 (73.7%) were international medical graduates. The approximate mean service continuity in the same practice was 1.6 years (standard deviation [SD], 2.2 years) for the pre-program period and 3.6 years (SD, 1.4 years) for the during-program period (mean total, 5.2 years). Two years after completion, 21 out of 43 Remote Stream doctors (49%) and four out of five AMS Stream doctors (80%) remained in the same community. Over the long term, retention in the same community stabilised to 44 out of 242 Remote Stream doctors (18.2%) and seven out of 27 AMS Stream doctors (26%); 72 Remote Stream doctors (29.8%) remained in the same region, 70 Remote Stream doctors (28.9%) were in an MMM4–7 community, and 11 AMS Stream doctors (41%) were in a rural (MMM2–7) community. Conclusion: Strong service continuity outcomes have been achieved by the RVTS, which supports mostly international medical graduates in locations typified by the highest workforce turnover. This suggests that continuity of service could be improved for remote and First Nations communities through place-based retention-focused programs like the RVTS. © 2024 The Author(s). Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.

Keywords

Author Keywords

Not provided

Index Keywords

training adult female human male Humans Article Vocational education Australia education general practice general practitioner General Practitioners controlled study physician patient care major clinical study workforce aged cohort analysis Turnover rate rural health care Rural Health Services indigenous people medical service retrospective study Retrospective Studies First Nation foreign medical graduate Continuity of Patient Care Foreign Medical Graduates

Author Affiliations

Rural Clinical School, The University of Queensland, Brisbane, QLD, Australia

Rural Clinical School, The University of Queensland, Brisbane, QLD, Australia, School of Rural Health, Monash University, Melbourne, VIC, Australia

Remote Vocational Training Scheme, Albury, NSW, Australia, University of New South Wales, Rural Clinical School, Wagga Wagga, NSW, Australia

Funding & Acknowledgements

Australian National University, ANU

The Remote Vocational Training Scheme is supported by funding from the Australian Government. Executive and senior leaders at the Rural Doctors Association of Australia, Australian College of Rural and Remote Medicine, Royal Australian College of General Practitioners, General Practice Supervision Australia, General Practice Registrars Australia, NSW Rural Doctors Network and individuals including Jenny May (University of Newcastle) and Susan Wearne (Australian National University) contributed insights through a stakeholder advisory group. Others including Ronda Gurney, Clara Smith, Tony Trevaskis, Marlene Drysdale, Veeraja Uppal (all Remote Vocational Training Scheme management team) and Tiana Gurney (The University of Queensland) contributed to data collection and interpretation of the findings.

Australian Government

The Remote Vocational Training Scheme is supported by funding from the Australian Government. Executive and senior leaders at the Rural Doctors Association of Australia, Australian College of Rural and Remote Medicine, Royal Australian College of General Practitioners, General Practice Supervision Australia, General Practice Registrars Australia, NSW Rural Doctors Network and individuals including Jenny May (University of Newcastle) and Susan Wearne (Australian National University) contributed insights through a stakeholder advisory group. Others including Ronda Gurney, Clara Smith, Tony Trevaskis, Marlene Drysdale, Veeraja Uppal (all Remote Vocational Training Scheme management team) and Tiana Gurney (The University of Queensland) contributed to data collection and interpretation of the findings.

University of Newcastle Australia, UON

The Remote Vocational Training Scheme is supported by funding from the Australian Government. Executive and senior leaders at the Rural Doctors Association of Australia, Australian College of Rural and Remote Medicine, Royal Australian College of General Practitioners, General Practice Supervision Australia, General Practice Registrars Australia, NSW Rural Doctors Network and individuals including Jenny May (University of Newcastle) and Susan Wearne (Australian National University) contributed insights through a stakeholder advisory group. Others including Ronda Gurney, Clara Smith, Tony Trevaskis, Marlene Drysdale, Veeraja Uppal (all Remote Vocational Training Scheme management team) and Tiana Gurney (The University of Queensland) contributed to data collection and interpretation of the findings.

NSW Rural Doctors Network, RDN

The Remote Vocational Training Scheme is supported by funding from the Australian Government. Executive and senior leaders at the Rural Doctors Association of Australia, Australian College of Rural and Remote Medicine, Royal Australian College of General Practitioners, General Practice Supervision Australia, General Practice Registrars Australia, NSW Rural Doctors Network and individuals including Jenny May (University of Newcastle) and Susan Wearne (Australian National University) contributed insights through a stakeholder advisory group. Others including Ronda Gurney, Clara Smith, Tony Trevaskis, Marlene Drysdale, Veeraja Uppal (all Remote Vocational Training Scheme management team) and Tiana Gurney (The University of Queensland) contributed to data collection and interpretation of the findings.

University of Queensland, UQ

The Remote Vocational Training Scheme is supported by funding from the Australian Government. Executive and senior leaders at the Rural Doctors Association of Australia, Australian College of Rural and Remote Medicine, Royal Australian College of General Practitioners, General Practice Supervision Australia, General Practice Registrars Australia, NSW Rural Doctors Network and individuals including Jenny May (University of Newcastle) and Susan Wearne (Australian National University) contributed insights through a stakeholder advisory group. Others including Ronda Gurney, Clara Smith, Tony Trevaskis, Marlene Drysdale, Veeraja Uppal (all Remote Vocational Training Scheme management team) and Tiana Gurney (The University of Queensland) contributed to data collection and interpretation of the findings.

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Continuity of service and longer term retention of doctors training as general practitioners in the Remote Vocational Training Scheme

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