Rural Work and Specialty Choices of International Students Graduating from Australian Medical Schools: Implications for Policy
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Number of Medical Graduates | Number of Intern Positions | |||||||
---|---|---|---|---|---|---|---|---|
Year of Graduation | International Medical Student Graduates | Australian Citizen Medical Graduates | Total Medical Graduates | % International | Year of Medical Internship | Total Intern Positions Funded | Total Number of FGAMS with Intern Positions * | Approximate Proportion of FGAMS Accepting Intern Positions |
1999–2002 (average) | 143 | 1230 | 1372 | 10.4% | 2000–2003 | n/a | n/a | - |
2003–2007 (average) | 258 | 1350 | 1608 | 15.9% | 2004–2008 (average) | 1746 | n/a | - |
2008 | 401 | 1738 | 2139 | 18.7% | 2009 | 2243 | 320 | 80% |
2009 | 465 | 1915 | 2380 | 19.5% | 2010 | 2394 | 386 | 83% |
2010 | 474 | 2259 | 2733 | 17.3% | 2011 | 2723 | 390 | 82% |
2011 | 457 | 2507 | 2964 | 15.4% | 2012 | 2950 | 351 | 77% |
2012 | 507 | 2777 | 3284 | 15.4% | 2013 | 3118 | 312 | 62% |
2013 | 497 | 2944 | 3441 | 14.4% | 2014 | 3287 | 353 | 71% |
2014 | 469 | 2968 | 3437 | 13.6% | 2015 | 3305 | 331 | 71% |
2015 | 492 | 3055 | 3547 | 13.9% | 2016 | 3420 | 335 | 68% |
2016 | 484 | 3085 | 3569 | 13.6% | 2017 | 3466 | 356 | 74% |
Variable | Characteristics | Wave 5 (2012) | Wave 10 (2017) | Aggregate Wave 5–Wave 10 |
---|---|---|---|---|
Independents | ||||
Doctor type | DMG | 7361 (72.9%) | 6700 (78.6%) | 40,682 (76.8%) |
FGAMS | 414 (4.1%) | 344 (4.0%) | 2191 (4.1%) | |
OTD | 2326 (23.0%) | 1476 (17.3%) | 10,133 (19.1%) | |
Gender | Male | 5539 (54.8%) | 4374 (51.4%) | 27,993 (52.9%) |
Female | 4562 (45.2%) | 4144 (48.7%) | 24,940 (47.1%) | |
Rural background | Rural Australia/NZ (DMG) | 1482 (15.5%) | 1410 (18.1%) | 8376 (17.0%) |
Rural elsewhere (FGAMS) | 46 (0.5%) | 30 (0.4%) | 216 (0.4%) | |
Rural elsewhere (OTD) | 399 (4.2%) | 227 (2.9%) | 1719 (3.5%) | |
Not rural | 7623 (79.8%) | 6125 (78.6%) | 38,965 (79.1%) | |
Time in Australian workforce | 0–15 years | 4792 (48.4%) | 3870 (45.8%) | 24,377 (46.6%) |
>15 years | 5112 (51.6%) | 4584 (54.2%) | 27,972 (53.4%) | |
Outcomes | ||||
Geographical distribution | Metropolitan | 7608 (75.7%) | 6312 (74.8%) | 39,773 (75.6%) |
Large regional | 1060 (10.6%) | 890 (10.6%) | 5393 (10.3%) | |
Other rural | 1382 (13.8%) | 1238 (14.7%) | 7439 (14.1%) | |
Specialty # | General practice | 3361 (41%) | 3143 (42%) | 18,924 (41%) |
All other specialties | 4772 (59%) | 4414 (58%) | 26,726 (59%) | |
TOTAL | 10,101 | 8520 | 53,006 |
Career Stage | Doctor Group | Work Rurality | Specialty # | |||
---|---|---|---|---|---|---|
Metropolitan | Large Regional | Other Rural | General Practice | All Other Specialties | ||
Wave 5–10: 0–15 years in Australian workforce | DMGs (17,011) | 79.1% | 10.0% | 10.9% | 37.2% | 62.8% |
FGAMS (1313) | 75.7% | 11.6% | 12.6% | 38.8% | 61.2% | |
OTDs (6053) | 59.7% | 14.2% | 26.1% | 51.4% | 48.6% | |
Wave 5–10: >15 years in Australian workforce | DMGs (23,456) | 77.2% | 9.6% | 13.3% | 40.5% | 59.5% |
FGAMS (857) | 88.2% | 2.3% | 9.5% | 46.6% | 53.4% | |
OTDs (3659) | 74.0% | 9.9% | 16.1% | 46.8% | 53.2% | |
Aggregate Wave 5–10 | DMGs (40,467) | 77.9% | 9.8% | 12.3% | 39.4% | 60.6% |
FGAMS (2170) | 80.7% | 8.0% | 11.3% | 42.7% | 57.3% | |
OTDs (9710) | 65.3% | 12.7% | 22.0% | 48.6% | 51.4% |
Reference Category | Doctor Characteristics | Work as a Rural Doctor (OR, 95% CI) | Work as a GP # (OR, 95% CI) |
---|---|---|---|
Model 1: | |||
Ref: DMG | FGAMS | 0.93 (0.77–1.13) | 1.27 (1.03–1.57) * |
Ref: OTDs | FGAMS | 0.48 (0.39–0.59) ** | 0.74 (0.59–0.92) ** |
Ref: Male | Female | 0.81 (0.74–0.88) ** | 1.69 (1.55–1.83) ** |
Ref: Metro origin | Rural origin | 2.54 (2.32–2.79) ** | 1.30 (1.18–1.44) ** |
Ref: >15 years work in Aus | 0–15 years work in Aus | 1.05 (0.97–1.13) | 0.79 (0.73–0.86) ** |
Model 2: Doctor Group and Childhood Origin Ref: DMG and Metro BG | DMG and Rural BG | 2.73 (2.46–3.03) ** | 1.29 (1.16–1.44) ** |
OTD and Metro BG | 2.11 (1.89–2.35) ** | 1.71 (1.53–1.91) ** | |
OTD and Rural BG | 3.96 (3.25–4.81) ** | 2.32 (1.88–2.87) ** | |
FGAMS and Metro BG | 0.94 (0.76–1.16) | 1.27 (1.02–1.59) * | |
FGAMS and Rural BG | 2.64 (1.63–4.28) ** | 1.60 (0.84–3.03) | |
Model 3: Doctor Group and Gender Ref: DMG and Male | DMG and Female | 0.83 (0.75–0.91) ** | 1.77 (1.61–1.95) ** |
OTD and Male | 2.00 (1.76–2.27) ** | 1.84 (1.61–2.09) ** | |
OTD and Female | 1.52 (1.30–1.77) ** | 2.82 (2.41–3.30) ** | |
FGAMS and Male | 1.00 (0.77–1.30) | 1.65 (1.25–2.17) ** | |
FGAMS and Female | 0.70 (0.53–0.93) * | 1.65 (1.22–2.23) ** | |
Model 4: Doctor Group and Work time in Australia Ref: DMG and >15 years | DMG and 0–15 years | 0.84 (0.76–0.92) ** | 0.72 (0.66–0.79) ** |
OTD and >15 years | 1.16 (0.98–1.38) | 1.35 (1.16–1.57) ** | |
OTD and 0–15 years | 2.35 (2.09–2.64) ** | 1.54 (1.37–1.73) ** | |
FGAMS and >15 years | 0.53 (0.35–0.80) ** | 1.46 (1.08–1.97) * | |
FGAMS and 0–15 years | 1.15 (0.94–1.42) | 0.82 (0.62–1.08) |
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McGrail, M.R.; O’Sullivan, B.G.; Russell, D.J. Rural Work and Specialty Choices of International Students Graduating from Australian Medical Schools: Implications for Policy. Int. J. Environ. Res. Public Health 2019, 16, 5056. https://doi.org/10.3390/ijerph16245056
McGrail MR, O’Sullivan BG, Russell DJ. Rural Work and Specialty Choices of International Students Graduating from Australian Medical Schools: Implications for Policy. International Journal of Environmental Research and Public Health. 2019; 16(24):5056. https://doi.org/10.3390/ijerph16245056
Chicago/Turabian StyleMcGrail, Matthew R., Belinda G. O’Sullivan, and Deborah J. Russell. 2019. "Rural Work and Specialty Choices of International Students Graduating from Australian Medical Schools: Implications for Policy" International Journal of Environmental Research and Public Health 16, no. 24: 5056. https://doi.org/10.3390/ijerph16245056