Evidence map›Paper›PMID 37081430›Full record

ArticleHuman resources for health2023

Rural medical workforce pathways: exploring the importance of postgraduation rural training time.

Matthew R McGrail, Tiana Gurney, Jordan Fox, Priya Martin, Diann Eley, Bushra Nasir, Srinivas Kondalsamy-Chennakesavan

Abstract read
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In one paragraph

Article in Human resources for health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed.

  1. Article
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  4. Learning in a contextually complex rural clinical placement.Advances in health sciences education : theory and practice · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Matthew R McGrailRural Clinical School, The University of Queensland, Rockhampton, QLD, 4700, Australia. m.mcgrail@uq.edu.au.ORCID 0000-0002-6901-8845
Tiana GurneyRural Clinical School, The University of Queensland, Toowoomba, QLD, 4350, Australia.
Jordan FoxRural Clinical School, The University of Queensland, Rockhampton, QLD, 4700, Australia.
Priya MartinRural Clinical School, The University of Queensland, Toowoomba, QLD, 4350, Australia.
Diann EleyAcademy for Medical Education, The University of Queensland, Herston, QLD, 4006, Australia.
Bushra NasirRural Clinical School, The University of Queensland, Toowoomba, QLD, 4350, Australia.
Srinivas Kondalsamy-ChennakesavanRural Clinical School, The University of Queensland, Toowoomba, QLD, 4350, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInadequate distribution of the medical workforce in rural regions remains a key global challenge. Evidence of the importance of postgraduation (after medical school) rural immersion time and subsequent rural practice, particularly after accounting for other key factors, remains limited. This study investigated the combined impact of three key training pathway factors: (1) rural background, (2) medical school rural immersion, and (3) postgraduation rural immersion, and duration time of each immersion factor on working rurally.

methodsData from a cross-sectional national survey and a single university survey of Australian doctors who graduated between 2000 to 2018, were utilised. Key pathway factors were similarly measured. Postgraduation rural training time was both broad (first 10 years after medical school, national study) and specific (prevocational period, single university). This was firstly tested as the dependent variable (stage 1), then matched against rural practice (stage 2) amongst consultant doctors (national study, n = 1651) or vocational training doctors with consultants (single university, n = 478).

resultsStage 1 modelling found rural background, > 1 year medical school rural training, being rural bonded, male and later choosing general practice were associated with spending a higher proportion (> 40%) of their postgraduation training time in a rural location. Stage 2 modelling revealed the dominant impact of postgraduation rural time on subsequent rural work for both General Practitioners (GPs) (OR 45, 95% CI 24 to 84) and other specialists (OR 11, 95% CI 5-22) based on the national dataset. Similar trends for both GPs (OR 3.8, 95% CI 1.6-9.1) and other specialists (OR 2.8, 95% CI 1.3-6.4) were observed based on prevocational time only (single university).

conclusionsThis study provides new evidence of the importance of postgraduation rural training time on subsequent rural practice, after accounting for key factors across the entire training pathway. It highlights that developing rural doctors aligns with two distinct career periods; stage 1-up to completing medical school; stage 2-after medical school. This evidence supports the need for strengthened rural training pathways after medical school, given its strong association with longer-term decisions to work rurally.

Indexed as

General PractitionersRural Health ServicesStudents, MedicalAustraliaCareer ChoiceCross-Sectional StudiesHumansMaleProfessional Practice LocationWorkforceDistributionDoctorsGeneral practiceGraduate medical educationMedical educationPostgraduation trainingRural originRural workforceTraining pathways

Identifiers

PMID37081430
PMCPMC10120195

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.