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Urban washout: How strong is the rural‐background effect?
Author(s) -
Hogenbirk John C.,
McGrail Matthew R.,
Strasser Roger,
Lacarte Sara A.,
Kevat Ajay,
Lewenberg Michael
Publication year - 2015
Publication title -
australian journal of rural health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.48
H-Index - 49
eISSN - 1440-1584
pISSN - 1038-5282
DOI - 10.1111/ajr.12183
Subject(s) - mcnemar's test , medicine , logistic regression , odds ratio , rural area , confidence interval , bachelor , family medicine , demography , odds , geography , sociology , statistics , mathematics , archaeology , pathology
Objective To test predictors of practice location of fully qualified M onash U niversity B achelor of M edicine, B achelor of S urgery ( MBBS ) graduates. Design Cohort survey, 2011. Setting A ustralia. Participants Rural (n = 67/129) and urban (n = 86/191) background doctors starting at M onash U niversity 1992–1999. Approximately 60% female, 77% married/partnered, 79% A ustralian‐born, mean age 34 years, 31% general practitioners, 72% fully qualified and 80% training/practising in major cities. Main outcome measures First and current practice location once fully qualified. Intended practice location in 5–10 years. Results Logistic regression found that rural versus urban background was a significant predictor of rural (outside major city) first practice location (odds ratio (OR) 5.0, 95% confidence interval ( CI ) 1.3–19.2) and rural current practice location ( OR 5.6, 95% CI 1.5–21.2) for fully qualified doctors. General practitioner versus other medical specialists significantly predicted first ( OR 7.2, 95% CI 2.1–25.2) or current ( OR 3.6, 95% CI 1.1–11.9) rural practice location. Preference for a rural practice location in 5–10 years was predicted by rural background ( OR 4.4, 95% CI 1.6–11.8) and positive intention towards rural practice upon completing MBBS ( OR 4.6, 95% CI 1.7–12.6). Surveyed in 2011, 28% of those who also responded to the 2006 survey shifted their preferred future practice location from rural to urban communities versus 13% shifting from urban to rural ( M c N emar– B owker test, P = 0.02). Conclusion The majority of fully qualified M onash MBBS graduates practicing in rural communities have rural backgrounds. The rural‐background effect diminished over time and may need continued support during training and full practice.