title: Clinical training in the top end: impact of the Northern Territory Clinical School, Australia, on the Territory's health workforce.
abstract: BACKGROUND
  The Northern Territory Clinical School (NTCS), a teaching site of the Flinders University School of Medicine, was established in Darwin, Northern Territory (NT; 1997) in response to a need for regional clinical training. An enrolment quota of NT resident, Aboriginal and Torres Strait Islander students was implemented to encourage the recruitment of local applicants to the medical program. The objective of this study was to assess the impact of the NTCS and the quota program on the NT health workforce at the intern and junior doctor levels.
  
  
  METHODS
  A database was constructed to compile the training location, quota participation, place of internship, and NT medical registration of 452 Flinders School of Medicine graduates (1999-2005). Statistical analysis of de-identified data yielded outcomes regarding length of placement in the NT, internship state, and registration by the NT medical board.
  
  
  RESULTS
  Students enrolled with the NTCS elected to spend significantly more time in the NT during their final year of medical school than non-NTCS Flinders University students (16.7 +/- 7.9 weeks vs 1.9 +/- 3.9 weeks; p<0.01). Quota students undertook longer NT placements than their non-quota NTCS peers (20.4 +/- 8.9 weeks vs 15.3 +/- 6.9 weeks; p<0.05). A significant proportion (54%) of NTCS alumni completed their internship training in the NT, and NTCS students were more than 10 times more likely to spend their intern year in the NT than non-NTCS Flinders graduates. Of the quota cohort, 70% chose an internship position at NT hospitals. Likewise, NTCS students were more than 10 times as likely to have current or expired registration on the NT medical register as other Flinders School of Medicine graduates.
  
  
  CONCLUSIONS
  The NTCS has trained over 140 medical students, many of which have joined the NT health workforce as interns and junior doctors. The quota program has been an effective method of enlisting local students who express an interest in living and studying in the NT. Current studies are underway to assess the impact of NTCS recruitment and training strategies on the regional workforce shortage. This preliminary data supports the concept that 'training locals locally' has had positive outcomes for the NT health workforce.
authors.affiliation: Northern Territory Clinical School, Flinders University, Royal Darwin Hospital, Darwin, Northern Territory, Australia. anna.smedts@flinders.edu.au
authors.forename: Anna
authors.initials: A
authors.lastname: McDonnel Smedts
authors.forename: Michael P
authors.initials: MP
authors.lastname: Lowe
mesh_terms: D004504:Education, Medical, Undergraduate; D007396:Internship and Residency / Q000706:statistics & numerical data; D008507:Medically Underserved Area; D015876:Northern Territory; D010820:Physicians / Q000600:supply & distribution*; D019035:Rural Health Services; D012577:Schools, Medical; D000078329:Workforce; D000095283:Australian Aboriginal and Torres Strait Islander Peoples