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General practice training in regional and rural Australia: A cross-sectional analysis of the Registrar Clinical
Amanda Tapley1,2, Andrew R Davey1,2, Mieke L van Driel3
1School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia.
Objective:
We aimed to investigate registrar, practice and consultation characteristics associated with varying degrees of GP registrars' practice rurality.
Design:
A cross-sectional analysis of 12 rounds of data collection (2010-2015) from the longitudinal Registrar Clinical Encounters in Training study, an ongoing, cohort study of Australian GP registrars. The principal analysis used was a generalised ordered logistic regression.
Setting/Participants:
GP registrars in training practices within five of 17 GP regional training providers in five Australian states.
Main Outcome Measure:
Degree of rurality of the practice in which the registrar undertook training terms was calculated from the practice postcode using the Australian Standard Classification-Remoteness Area classification.
Results:
A total of 1161 registrars contributed data for 166 998 patient consultations (response rate 95.5%). Of these, 56.9% were in major city practices (ASGC-RA1), 25.7% were in inner-regional practices (ASGC-RA2) and 17.4% were in outer-regional/rural practices (ASGC-RA3-5). Several statistically significant associations (P = < .001) were found within regional/rural practices (ASGC-RA2-5), when compared with major city practices (ASGC-RA1). These included registrar characteristics such as being in Term 1, being medically trained overseas, and having worked at the practice previously; patient characteristics such as the patient being an existing patient, being older and being Aboriginal or Torres Strait Islander; and consultation characteristics such as performance of procedures.
Conclusion:
Our findings suggest that registrars are undertaking rural practice early in their GP training and are being exposed to a rich and challenging mix of clinical and educational practice.
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