Why paediatricians rural out going to the country but support opportunities for change

To determine the knowledge of vacant country specialist positions, the main barriers to filling country specialist positions, the acceptance of hypothetical creative employment models and to gain understanding of what would it take for respondents to accept a country position.

Mailed self-report questionnaires to all 103 Queensland paediatricians and finishing paediatric trainees (response rate 93.1%) to explore reasons for the long-term vacancy of the Staff Paediatrician position at the Mount Isa Base Hospital, North-west Queensland, Australia.

Of the respondents, 87.4% were aware of the vacant position. The lack of adequate locum cover for leave (97.8%), on-call load (92.2%), professional isolation (91.4%), and family commitments (91.4%) were identified as the four most frequently recognized recruitment barriers. Of the respondents, 30.2% said they could be attracted to such a position if they were guaranteed the ability to return to their present post in 2 years, 30.7% said they could be attracted to a rural exchange, and 73.1% suggested the position would be more attractive to new Fellows if at the end of a 2-year period they were guaranteed some Visiting Medical Officer sessions or a temporary Staff Paediatrician position at a tertiary centre. Significantly, fewer of the 30-39-years age group said available job opportunities for their spouse made it impossible for them to consider the advertised position, compared to older age groups (P = 0.003). In response to the question 'What would it take for you to consider such a position?', 22.6% answered a change in employment package, 22.6% a change in family commitments, 16.6% too subspecialized, and 7.1% could possibly consider a locum or exchange in the future.

Specialist positions, such as the advertised position, are well known, but remain unfilled because they are considered unsustainable. However, the response to hypothetical creative employment models suggests this could be changed, provided specialist training (e.g. paediatric training) is kept general and the younger consultant is given consideration.