Educated for the region? A register-based sequence analysis modelling medical doctors' career trajectories

Area of Science:

• Medical Education
• Healthcare Workforce Studies
• Rural Health

Background:

• Recruiting and retaining doctors in rural and primary healthcare is a global challenge.
• Norway's Northern region faces similar issues with medical personnel.
• The Arctic University of Norway (UiT) implemented initiatives to train doctors for Northern Norway, including preferential admission and rural practice.

Purpose of the Study:

• To analyze the long-term career trajectories of medical graduates from UiT The Arctic University of Norway.
• To understand how graduates' background characteristics influence their career paths in different healthcare settings.
• To evaluate the effectiveness of educational interventions in addressing rural healthcare staffing needs.

Main Methods:

• Utilized longitudinal registry data to track doctors' careers over a decade.
• Employed sequence analysis to model career paths based on location, area type, and healthcare sector.
• Applied cluster analysis to identify distinct career trajectories and logistic regression to explore background associations.

Main Results:

• Identified seven distinct career trajectories among medical graduates.
• Northern-origin doctors were more likely to stay in Northern Norway.
• The majority (53.7%) pursued urban specialist careers, while only 12.8% worked in Northern rural primary healthcare, predominantly those with Northern and rural backgrounds.

Conclusions:

• Despite targeted educational initiatives, most medical graduates do not end up in Northern rural primary healthcare roles.
• Graduates' geographical origins and rural backgrounds influence their career choices.
• Educational interventions need refinement to better align with the goal of strengthening rural and primary healthcare in Northern Norway.