Building a sustainable rural physician workforce

Chapter 1: Characterising Australia’s rural specialist physician workforce: the professional profile and satisfaction of junior doctors consultants Objective: To assess differences in demographic characteristics, metropolitan physicians Australia. Design, setting participants: Cross-sectional, population level national survey Medicine Australia: Balancing Employment Life longitudinal cohort study (collected 2008–2016). Participants were from four career stage groups: pre-registrars (physician intent); registrars; new (< 5 years since Fellowship); consultants. Main outcome measures: Level across various job aspects, such as hours worked, working conditions, support networks educational opportunities, comparing based physicians. Results: included 1587 (15% rural), 1745 registrars (9% 421 (20% rural) 1143 (13% rural). Rural all stages demonstrated equivalent most compared with counterparts. Some examples being less likely to agree they had good access supervision qualified (odds ratio [OR], 0.6; 95% CI, 0.3–0.9) more a poorer network (OR, 1.9; 1.2–2.9). In terms demographics, relatively background or trained overseas. Although women, female be location 0.4–0.8). Conclusion: Junior settings have similar experience, which is important attracting future trainees. Increased opportunities for training should prioritised, along addressing concerns about isolation those areas, not only among but also Finally, making practice attractive could greatly improve consultant distribution. 2: General paediatricians social construction identity explore general non-metropolitan areas. In-depth qualitative interviews conducted paediatricians, plus informants colleges, government agencies academia who involved policy programs recruitment specialists locations three states two territories. This research part Training Pathways Professional Support Building Physician Workforce Study, 2018–19. Individual collective descriptors identity. We interviewed 36 key informants. regional, remote Australia grounded breadth their training, by — geographic location, served specific where cultural context specifically shapes practice. deeply engaged local community its economic vulnerability, described size dynamics economies determinants viable They often complemented formal informal areas special interest, balanced against subspecialist availability, dependent on demographics. While valuing roles, showed limited inclination industrial organisation. Despite consensus descriptors, highly value generalism engagement. The structural bias that preferences urban will need addressed further develop coordinated strategies advanced contexts, integral. 3: Sustainable training: leadership fragile environment Objectives: understand Royal Australasian College Physicians (RACP) including supervisor trainee perspectives, identify contributors sustainability sites, quality. A cross-sectional mixed-methods design was used. sample RACP trainees Fellows completed online surveys. Survey respondents indicated willingness participate purposively recruited cover perspectives range geographic, parameters. Fellows’ trainees’ work life satisfaction, experiences respectively, location. reported high levels one exception inner regional lower regarding use abilities. Not having associated satisfaction. Our findings indicate culture undermining prevalent at reduce negative impacts site accreditation viability. Trainees challenges navigating pathways, ensuring development, flexibility meet family needs. small number some sites poses supervisors results blurring roles; an obstacle provision sites; overlap between service roles can difficult supervisors. emphasise distinctive nature make it environment. Leadership critical sustaining 4: Principles guide sustainable workforce draw project, first physicians, define set principles applicable guiding action. Design: used elements Delphi approach systematic data collection codesign, applied hybrid participatory action planning achieve principles. Eight interconnected foundational built around regions people identified: FP1, grow your own “connected to” place; FP2, select invested practice; FP3, ground need; FP4, immersion exposure; FP5, optimise invest medicine; FP6, include academic learning components; FP7, join up steps training; FP8, plan roles. These eight build workforce. Application principles, stakeholders responsible organisations, are needed national, state