Registrars who trained in Australia’s most rural and remote regions were no more likely than their peers to fail assessments or drop out – but much more likely to stay working in the bush.
Fears that rural generalist and GP registrars training in the bush are at a disadvantage can be put to bed, according to ACRRM’s lead statistician Dr James Dawber.
Speaking at Rural Medicine Australia 2024 – the annual combined RDAA and ACRRM conference – last week, Dr Dawber presented results from a small study of ACRRM fellows and registrars.
“One of the research questions that came up … was whether the rurality or remoteness of a registrar’s placements affects their fellowship outcomes,” he told delegates.
“There were some concerns that, perhaps if you’re a registrar working really far out, that you might not be seeing as many patients or as many different types of [presentations].
“So, when you come to our assessments … you’ll be a bit more limited in in how to deal with certain scenarios at our [structured patient scenario] exam, for example.”
There were also concerns that registrars working in remote Australia may feel more isolated, to the extent that they drop out of the program altogether.
Using administrative data routinely collected by the college, Dr Dawber measured “success” across three areas: rural retention, drop-out rates and exam performance.
He defined rural and remote registrars as those who had spent the majority of their training time working in a Modified Monash Model level 4 (medium-sized towns) or higher.
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Registrar training time related to advanced specialised training, which makes up the final 12 months of ACRRM fellowship, was excluded. So were results from registrars who had been training for less than one year.
Ultimately, there was weak evidence of an association between rurality of training placement and likelihood of withdrawing, but this shrunk when data was adjusted for confounding factors.
There was no statistically significant difference in registrar performance based on rurality of training location across ACRRM’s four major assessments.
The only area with statistically significant findings was what Dr Dawber termed “rural stickiness”, or the likelihood of continuing to practice rurally.
“If you were mostly rurally trained, you’re much more likely to be a fellow working in a rural area,” he said.
“It makes sense … to stick around where you were trained.
“But still, it’s nice to have evidence.”
Rural Medicine Australia 2024 was held at Darwin Convention Centre between 23 and 26 October.
