Factors influencing rural versus metropolitan work choices for emergency physicians

To survey Fellows of the Australasian College for Emergency Medicine (FACEM) on how a range of factors influenced their decision to accept their most recent position. To compare this information between rural and metropolitan FACEM.

Analytical cross-sectional survey of FACEM. Sections included baseline demographics and a range of questions regarding the presence, absence and influence of 14 professional and 12 personal/external factors on the decision to accept their current position.

Questionnaires were returned by 498 (61.9%) of 805 FACEM. Eighty-seven (18.4%) were currently employed in rural areas. Rural FACEM were more likely to be male (odds ratio 2.0 [95% CI 1.1-3.9]) and to have worked for >12 months as a registrar in a rural hospital (odds ratio 4.5 [95% CI 2.2-9.1]). Negative influences for FACEM accepting rural positions included lack of access to continuing education, less acceptable on-call arrangements, fewer employment opportunities for their partner and less educational opportunities for their children. Positive influences included acceptable remuneration, desirable lifestyle, a higher indigenous caseload and more affordable housing.

The influence of different types of factors appears to differ between rural and metropolitan FACEM and this information might assist in the formulation of strategies aimed at increasing the rural workforce.