A case for more year-long internships outside metropolitan areas?

Area of Science:

• Medical Education
• Rural Health Workforce
• General Practice Training

Background:

• The distribution of medical practitioners, particularly general practitioners (GPs), remains a significant challenge in many countries, with a persistent shortage in non-metropolitan areas.
• Understanding factors influencing practice location decisions after medical training is crucial for effective workforce planning.

Purpose of the Study:

• To investigate if medical graduates undertaking their internship year at a non-metropolitan hospital are more inclined to practice outside metropolitan regions post-training compared to their metropolitan-trained counterparts.
• To assess the impact of internship location on subsequent practice location, specifically for general practice and specialist fields.

Main Methods:

• A retrospective follow-up study design was employed.
• Participants included Victorian medical graduates who completed internships at Ballarat Base Hospital (a non-metropolitan setting) and randomly selected, sex-matched interns from metropolitan hospitals in Melbourne and Geelong.
• Practice location was determined in 2002, with a focus on general practice and specialist practice outside metropolitan areas.

Main Results:

• Interns from the non-metropolitan hospital were substantially more likely to be practicing as GPs outside metropolitan areas (44%) compared to metropolitan interns (13%).
• The proportion of interns entering specialist practice outside metropolitan areas was low for both groups (0% and 3%).
• A significant portion of non-metropolitan interns entering general practice (41%) chose to practice within their local health region.

Conclusions:

• Internships in regional settings serve as a valuable pathway for producing non-metropolitan general practitioners, with a notable tendency for local practice.
• Further prospective research is recommended to elucidate the specific impact of regional internships on practice location and to evaluate the potential of increasing such training posts to boost the non-metropolitan medical workforce.