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

IF 6.7 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medical Journal of Australia Pub Date : 2024-10-06 DOI:10.5694/mja2.52448

Matthew R McGrail, Belinda G O'Sullivan, Patrick Giddings

{"title":"Continuity of service and longer term retention of doctors training as general practitioners in the Remote Vocational Training Scheme","authors":"Matthew R McGrail, Belinda G O'Sullivan, Patrick Giddings","doi":"10.5694/mja2.52448","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>To explore continuity of service and longer term retention outcomes of participants of the Remote Vocational Training Scheme (RVTS).</p>\n </section>\n \n <section>\n \n <h3> Design, setting, participants</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Main outcome measures</h3>\n \n <p>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).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"221 S7","pages":"S9-S15"},"PeriodicalIF":6.7000,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.52448","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Journal of Australia","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.5694/mja2.52448","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}

引用次数: 0

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.

查看原文本刊更多论文

在远程职业培训计划中接受全科医生培训的医生的持续服务和长期留用。

目的探讨偏远地区职业培训计划（RVTS）参与者的服务连续性和长期留用结果：他们中的许多人都是国际医学毕业生，预计将在同一社区的偏远地区（经修改的莫纳什模式[MMM]类别4-7）或农村原住民医疗服务（AMS）分流工作三至四年，同时接受全科医师资格培训：主要结果测量指标：服务的连续性在项目开始前（项目开始前在同一诊所工作的时间）和项目期间（在项目开始前在同一诊所完成 RVTS 项目的时间）进行测量。留任率的衡量标准首先是两年内的留任率，其次是两年后的留任率（最多为结业后 20 年），衡量标准包括：在同一社区工作（与两个流派相关）；在同一地区工作（仅限偏远地区流派）；在任何 MMM4-7 社区工作（仅限偏远地区流派）；或在任何偏远地区工作（两个流派）：在 506 名注册参与者中，有 373 人（73.7%）是国际医学毕业生。计划前在同一诊所工作的平均持续时间为 1.6 年（标准差为 2.2 年），计划期间为 3.6 年（标准差为 1.4 年）（平均总时间为 5.2 年）。结业两年后，43 名远程流医生中的 21 人（49%）和 5 名 AMS 流医生中的 4 人（80%）仍留在同一社区。从长远来看，242 名远程流医生中有 44 名（18.2%）和 27 名 AMS 流医生中有 7 名（26%）留在同一社区；72 名远程流医生（29.8%）留在同一地区，70 名远程流医生（28.9%）在 MMM4-7 社区，11 名 AMS 流医生（41%）在农村（MMM2-7）社区：结论："区域医疗服务流 "取得了很好的服务连续性成果。这表明，可以通过以地方为基础、以留住人才为重点的计划（如 RVTS）来改善偏远社区和原住民社区的服务连续性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Medical Journal of Australia 医学-医学：内科

CiteScore

9.40

自引率

5.30%

发文量

410

审稿时长

3-8 weeks

期刊介绍： The Medical Journal of Australia (MJA) stands as Australia's foremost general medical journal, leading the dissemination of high-quality research and commentary to shape health policy and influence medical practices within the country. Under the leadership of Professor Virginia Barbour, the expert editorial team at MJA is dedicated to providing authors with a constructive and collaborative peer-review and publication process. Established in 1914, the MJA has evolved into a modern journal that upholds its founding values, maintaining a commitment to supporting the medical profession by delivering high-quality and pertinent information essential to medical practice.