scholarly journals What influences trainee decisions to practise in rural and regional Australia?

2020 ◽  
Vol 26 (6) ◽  
pp. 520
Author(s):  
Alexa Seal ◽  
Catherine Harding ◽  
Joe McGirr
Keyword(s):  
Rural Areas ◽  
Rural Practice ◽  
Substantial Part ◽  
Medical Graduates ◽  
Practice Models ◽  
Binary Regression Analysis ◽  
Royal Australian College ◽  
Key Variables ◽  
Regional Australia ◽  
Remote Medicine

Although international medical graduates (IMGs) make up a substantial part of the Australian rural general practice workforce, most research on factors associated with rural practice has focused on Australian medical graduates (AMGs). This study aimed to determine whether there were differences between IMGs and AMGs in terms of these factors. Registrars in training and recent fellows (Fellowship of the Royal Australian College of General Practitioners/Fellowship of the Australian College of Rural and Remote Medicine) who participated in training in rural and regional Australia were surveyed about practice models and rural practice. Almost two-thirds of participants were practicing or intending to practice in rural areas, with no difference between AMGs and IMGs. None of the variables associated with rural practice for AMGs was found to be associated with rural practice in IMGs in univariate binary regression analysis. Two key variables that are strongly associated with rural medical practice in the current literature, namely rural background and rural exposure, were not significant predictors of rural practice among IMGs. Due to the significant number of IMGs in regional training programs, any future incentives designed to improve rural recruitment and retention need to address factors relevant to IMGs.

scholarly journals General practice registrars’ intentions for future practice: implications for rural medical workforce planning

2016 ◽  
Vol 22 (5) ◽  
pp. 440 ◽  
Author(s):  
Catherine Harding ◽  
Alexa Seal ◽  
Joe McGirr ◽  
Tim Caton
Keyword(s):  
General Practice ◽  
Workforce Planning ◽  
Rural Practice ◽  
Fee For Service ◽  
Ability To Work ◽  
Medical Graduates ◽  
Practice Models ◽  
Part Time ◽  
Future Practice ◽  
General Practice Training

The models of practice that general practice registrars (GPRs) envisage undertaking will affect workforce supply. The aim of this research was to determine practice intentions of current GPRs in a regional general practice training program (Coast City Country General Practice Training). Questionnaires were circulated to 220 GPRs undertaking general practice placements to determine characteristics of ideal practice models and intentions for future practice. Responses were received for 99 participants (45%). Current GPRs intend to work an average of less than eight half-day sessions/week, with male participants intending to work more hours (t(91)=3.528, P=0.001). More than one-third of this regional cohort intends to practice in metropolitan centres. Proximity to family and friends was the most important factor influencing the choice of practice location. Men ranked remuneration for work as more important (t (88)=–4.280, P<0.001) and women ranked the ability to work part-time higher (t(94)=3.697, P<0.001). Fee-for-service payment alone, or in combination with capitation, was the preferred payment system. Only 22% of Australian medical graduates intend to own their own practice compared with 52% of international medical graduates (χ2(1)=8.498, P=0.004). Future general practitioners (GPs) intend to work fewer hours than current GPs. Assumptions about lifestyle factors, practice models and possible professional roles should be carefully evaluated when developing strategies to recruit GPs and GPRs into rural practice.

scholarly journals Student perception about working in rural United States/Canada after graduation: a study in an offshore Caribbean medical school

F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 301
Author(s):  
P Ravi Shankar ◽  
Arun K Dubey ◽  
Atanu Nandy ◽  
Burton L Herz ◽  
Brian W Little
Keyword(s):  
United States ◽  
Rural Areas ◽  
Professional Growth ◽  
Student Perception ◽  
Medical Schools ◽  
The United States ◽  
Rural Practice ◽  
Growth Potential ◽  
Cultural Issues ◽  
The Government

Introduction: Rural residents of the United States (US) and Canada face problems in accessing healthcare. International medical graduates (IMGs) play an important role in delivering rural healthcare. IMGs from Caribbean medical schools have the highest proportion of physicians in primary care.  Xavier University School of Medicines admits students from the US, Canada and other countries to the undergraduate medical (MD) course and also offers a premedical program. The present study was conducted to obtain student perception about working in rural US/Canada after graduation.  Methods: The study was conducted among premedical and preclinical undergraduate medical (MD) students during October 2014. The questionnaire used was modified from a previous study. Semester of study, gender, nationality, place of residence and occupation of parents were noted. Information about whether students plan to work in rural US/Canada after graduation, possible reasons why doctors are reluctant to work in rural areas, how the government can encourage rural practice, possible problems respondents anticipate while working in rural areas were among the topics studied.Results: Ninety nine of the 108 students (91.7%) participated. Forty respondents were in favor of working in rural US/Canada after graduation. Respondents mentioned good housing, regular electricity, water supply, telecommunication facilities, and schools for education of children as important conditions to be fulfilled. The government should provide higher salaries to rural doctors, help with loan repayment, and provide opportunities for professional growth.  Potential problems mentioned were difficulty in being accepted by the rural community, problems in convincing patients to follow medical advice, lack of exposure to rural life among the respondents, and cultural issues.Conclusions: About 40% of respondents would consider working in rural US/Canada. Conditions required to be fulfilled have been mentioned above. Graduates from Caribbean medical schools have a role in addressing rural physician shortage. Similar studies in other offshore Caribbean medical schools are required as Caribbean IMGs make an important contribution to the rural US and Canadian health workforce.

Rural midwifery practice in Aotearoa/New Zealand: Strengths, vulnerabilities, opportunities and challenges

2020 ◽  
Vol 56 ◽  
pp. 17-25
Author(s):  
Rea Daellenbach ◽  
Lorna Davies ◽  
Mary Kensington ◽  
Susan Crowther ◽  
Andrea Gilkison ◽  
...  
Keyword(s):  
New Zealand ◽  
Rural Communities ◽  
Social Services ◽  
Health Professionals ◽  
Rural Women ◽  
Rural Areas ◽  
Service Providers ◽  
Rural Practice ◽  
Midwifery Practice ◽  
Adverse Weather

Background: The sustainability of rural maternity services is threatened by underfunding, insufficient resourcing and challenges with recruitment and retention of midwives. Aims: The broader aim of this study was to gain knowledge to inform the optimisation of equitable and sustainable maternity care for rural communities within New Zealand and Scotland, through eliciting the views of rural midwives about their working conditions and practice. This article focuses on the New Zealand midwives’ responses. Method: Invitations to participate in an online questionnaire were sent out to midwives working in rural areas. Subsequently, themes from the survey results were followed up for more in-depth discussion in confidential, online group forums. 145 New Zealand midwives responded to the survey and 12 took part in the forums. Findings: The New Zealand rural midwives who participated in this study outlined that they are attracted to, and sustained in, rural practice by their sense of connectedness to the countryside and rural communities, and that they need to be uniquely skilled for rural practice. Rural midwives, and the women they provide care to, frequently experience long travel times and distances which are economically costly. Adverse weather conditions, occasional lack of cell phone coverage and variable access to emergency transport are other factors that need to be taken into account in rural midwifery practice. Additionally, many participants noted challenges at the rural/urban interface in relation to referral or transfer of care of a woman and/or a baby. Strategies identified that support rural midwives in New Zealand include: locum and mentoring services, networking with other health professionals, support from social services and community service providers, developing supportive relationships with other rural midwives and providing rural placements for student midwives. Conclusion: Midwives face economic, topographic, meteorological and workforce challenges in providing a service for rural women. However, midwives draw strength through their respect of the women, and the support of their midwifery colleagues and other health professionals in their community.

scholarly journals Barriers and facilitators to implementing changes in opioid prescribing in rural primary care clinics

2020 ◽  
Vol 4 (5) ◽  
pp. 425-430
Author(s):  
Michael L. Parchman ◽  
Brooke Ike ◽  
Katherine P Osterhage ◽  
Laura-Mae Baldwin ◽  
Kari A Stephens ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Rural Areas ◽  
Building Blocks ◽  
Rural Practice ◽  
Barriers And Facilitators ◽  
External Support ◽  
Rural Setting ◽  
Opioid Prescribing ◽  
Patient Resources

AbstractBackground:Opioids are more commonly prescribed for chronic pain in rural settings in the USA, yet little is known about how the rural context influences efforts to improve opioid medication management.Methods:The Six Building Blocks is an evidence-based program that guides primary care practices in making system-based improvements in managing patients using long-term opioid therapy. It was implemented at 6 rural and rural-serving organizations with 20 clinic locations over a 15-month period. To gain further insight about their experience with implementing the program, interviews and focus groups were conducted with staff and clinicians at the six organizations at the end of the 15 months and transcribed. Team members used a template analysis approach, a form of qualitative thematic analysis, to code these data for barriers, facilitators, and corresponding subcodes.Results:Facilitators to making systems-based changes in opioid management within a rural practice context included a desire to help patients and their community, external pressures to make changes in opioid management, a desire to reduce workplace stress, external support for the clinic, supportive clinic leadership, and receptivity of patients. Barriers to making changes included competing demands on clinicians and staff, a culture of clinician autonomy, inadequate data systems, and a lack of patient resources in rural areas.Discussion:The barriers and facilitators identified here point to potentially unique determinants of practice that should be considered when addressing opioid prescribing for chronic pain in the rural setting.

scholarly journals Are Ecological Modernization Narratives Useful for Understanding and Steering Social-Ecological Change in the Argentine Chaco?

2019 ◽  
Vol 11 (13) ◽  
pp. 3593 ◽  
Author(s):  
Matías E. Mastrangelo ◽  
Sebastián Aguiar
Keyword(s):  
Rural Areas ◽  
Developed Countries ◽  
Ecological Modernization ◽  
Ecological Change ◽  
Land Sparing ◽  
Social Ecological ◽  
Deforestation Rates ◽  
Forest Transition Theory ◽  
Key Variables

During the past decades, the Ecological Modernization Theory, and associated ideas such as the Forest Transition Theory and Land Sparing Hypothesis, have dominated the academic and policy arenas regarding the solutions to current environmental crises. However, critiques were raised as these theories, originally conceived for developed countries, started to be applied in developing countries for explaining and prescribing social-ecological transitions. Here, we assess the validity of five key assumptions of Ecological Modernization narratives as applied to the Argentine Chaco, a global deforestation hotspot. We reviewed existing literature and conducted straightforward analysis to disentangle relationships among key variables. Although agriculture intensified, there is no evidence that this intensification inhibited agricultural expansion. Rural depopulation took place between 2001 and 2010; however, deforestation rates did not decrease, and the quality of life of migrants did not increase compared to those that stayed in rural areas. Our review suggests that the consequences of agriculture intensification on biodiversity and the provision of multiple ecosystem services exceeds the area used. Therefore, available evidence does not support the assumed causal relationships of Ecological Modernization, and even contradicts most assumptions. We propose a series of analytical shifts to better capture the complexity of social-ecological transitions in modern commodity frontiers.

Rural Practice

2013 ◽  
Author(s):  
H. Stephen Cooper ◽  
Freddie L. Avant
Keyword(s):  
Social Work ◽  
Rural Communities ◽  
Social Workers ◽  
Rural Areas ◽  
Social Issues ◽  
Work Practice ◽  
Social Work Practice ◽  
Rural Practice ◽  
Direct Result ◽  
Rural Social Work

Rural social work, the history of which stretches back more than a century, has been revitalized since the mid-1970s. The renewed interest in rural social work has led to an increase in scholarship on rural social work practice, much of which is a direct result of the efforts of the Rural Social Work Caucus and its annual National Institute on Social Work and Human Services in Rural Areas. Recent research endeavors have moved our understanding of the differences between rural and urban communities beyond the common definitions, which are limited to population and population density. We have also come to realize that there are many different types of rural communities, all of which have different characteristics, needs, etc. Specifically, the concept of rural is not monolithic. Rural practitioners and researchers have also reached a better understanding of the following: rural culture and lifestyles, the importance of approaching rural communities from a strengths perspective rather than a deficit or problem focus, and the challenges to rural practice presented by the characteristics that are common across rural communities (e.g., lack of anonymity, dual relationships). Not surprisingly, the increase in research on rural social work practice has been accompanied by an interest in preparing social workers for rural practice and growth in the number of graduate programs focused on such. The importance of these programs lies in the unique nature of the challenges faced by rural communities. For example, many rural communities are experiencing sharp population declines while at the same time seeing substantial increases in adults who are 65 years of age and older. Other common trends include: economic decline and subsequent increase in social issues; substantial issues with substance abuse, especially methamphetamine and opioids; lack of technology infrastructure; concerns related to the environment and/or conversation of natural resources; and lack of services for veterans. The key to successfully addressing these issues in rural communities is involvement from social workers who are prepared to practice in the rural context.

scholarly journals Breast cancer management in Australian rural indigenous women: trends and challenges

2017 ◽  
Vol 4 (2) ◽  
pp. 620
Author(s):  
Zackariah V. K. Clement
Keyword(s):  
Breast Cancer ◽  
Rural Areas ◽  
Interpersonal Relationship ◽  
Incidence Rates ◽  
Indigenous Women ◽  
Indigenous Australians ◽  
Cancer Management ◽  
Breast Cancer Management ◽  
Barriers And Challenges ◽  
Regional Australia

Cancer patients residing in Australian rural areas have a 7% higher mortality when compared to their counterparts in urban centres. Close to half of the indigenous Australians reside in regional and remote areas. Despite of the lower incidence rates among the indigenous women, and increase in overall breast screen participation indigenous women have lower participation rates when compared to non-indigenous women and the mortality from breast cancer is similar in both groups. Due to their relative the indigenous women with breast cancer living in the rural and regional Australia face several barriers and challenges. Although there is no perfect algorithm to address this problem, government should provide adequate specialist, allied health and support services to the patient’s rural and regional areas and this should not be any different to the services offered to their urban counterparts. A multidisciplinary approach should be taken to the management of breast cancer for all indigenous women in the rural areas. Outreach clinics and Tele-oncology can overcome some of the challenges of access. Health professionals should also be trained in culturally sensitive and effective communication strategies to improve interpersonal relationship, trust, compliance and overall patient outcomes.

scholarly journals Recruiting and Retaining Allied Health Professionals in Rural Australia: Why is it so Difficult?

2004 ◽  
Author(s):  
Janet Struber
Keyword(s):  
Rural Communities ◽  
Health Professionals ◽  
Rural Areas ◽  
Allied Health ◽  
Health Service Delivery ◽  
Rural Practice ◽  
Allied Health Professionals ◽  
Attrition Rates ◽  
Recruitment And Retention ◽  
Health Related

Rural communities in Australia have particular health needs, and the recruitment and retention of Allied Health Professionals (AHPs) is a significant concern. Despite the increasing number of AHPs being trained, vacancy and attrition rates in rural areas continue to rise. Professional and social isolation combined with rapidly changing health service delivery structures are identified as major deterrents to long-term rural practice. While strategies are now being implemented, endeavours to resolve the issues lag well behind initiates offered to Medical and Nursing staff. Given the wealth of political, professional and health related issues underlying the recruitment and retention of AHPs to rural areas, total resolution of this issue may not be possible. A unified approach by AHPs combined with concerted effort and collaboration on the part of all the stakeholders may, however, allow management at a level required to sustain a viable rural AHP workforce.

scholarly journals Encouragers and discouragers affecting medical graduates' choice of regional and rural practice locations

2017 ◽  
Vol 17 (4) ◽  
Author(s):  
Ann McKillop ◽  
Craig Webster ◽  
Win Bennett ◽  
Barbara O'Connor ◽  
Warwick Bagg
Keyword(s):  
Rural Practice ◽  
Medical Graduates

scholarly journals Rural revitalization under the background of balancing urban and rural development: A case study of Batang village, Guangdong province, China

2019 ◽  
Author(s):  
Weihong Guo ◽  
◽  
Bin Li ◽  
Yuquing Zhang ◽  
◽  
...  
Keyword(s):  
Sustainable Development ◽  
Rural Development ◽  
Rural Areas ◽  
Field Survey ◽  
Guangdong Province ◽  
Living Environment ◽  
Rural Practice ◽  
Development Mode ◽  
Rural Revitalization ◽  
Urban And Rural Areas

Since reform and opening up, the development of Chinese urban and rural areas has shown an evolution of integration from isolation. The government promulgated national policies and related planning strategies, aiming at realizing the goal of rural revitalization through the system reform and planning adjustment of balancing urban and rural development. In the complex process of social development, there are many problems with rural areas, such as lack of infrastructure, unbalanced economic development, dilapidated living environment and insufficient sharing between urban and rural areas. On the premise of meeting the requirements of national laws and policies, this paper takes the planning of Batang village in Yunfu city of Guangdong province as an example. Combine with ReBAM theory to make sure Batang village is suit for developing tourism. And based on field survey made a Batang plan by planning knowledge. Through literature review and field survey to explore how to realize the revitalization of the rural areas under the development mode of balancing urban and rural development. The conclusion of the research took rural tourism as the breakthrough point, and formed complementary and dislocation development mode with the city. In living aspect, the research optimized infrastructure and improved people's living environment as well as summarized cultural elements to inherit rural civilization. In production aspect, it exploited rural commercial potential and income-generating path, and completed the transformation from passive development to active revitalization to achieve prosperity industry and life. In ecology aspect, it combined with sustainable development model to create an ecological and livable rural landscape. At last, the research established urban and rural co-management system and shared rural information platform to achieve effective governance, to ensure that tourism mode as a starting point for rural revitalization planning can be sustainable development. The research of this paper practiced the national experience of rural revitalization as a pilot project, facilitated the implementation of relevant policies and supported planning for rural revitalization, and explored the methods of rural revitalization under the background of balancing urban and rural development. Based on the acceptance of the plan by local villagers, the approval of Guangdong Postgraduate Education Innovation Project in 2018 and got the third prize of National Competition for Ecological Wisdom Inspired Urban and Rural Practice in 2019, it is hoped that the research will contribute to the rural revitalization under the background of balancing urban and rural development.

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