title: International medical graduates mandated to practise in rural Australia are highly unsatisfied: results from a national survey of doctors.
abstract: OBJECTIVE
  Rural communities worldwide are increasingly reliant on international medical graduates (IMGs) to provide health care access, with many countries utilising health policies which mandate IMGs to practise only in rural designated areas of (medical) workforce shortage for many years. The objective of this study is to analyse the satisfaction of IMGs in their current work location, particularly in relation to the effect of mandating IMGs to small rural communities.
  
  
  METHODS
  We used data of 3502 general practitioners (GPs) from Wave 2 of the Medicine in Australia: Balancing Employment and Life (MABEL) longitudinal study of Australian doctors. The main outcome measures were the level of professional and non-professional satisfaction expressed by GPs with respect to various job and social aspects.
  
  
  RESULTS
  We found that non-professional satisfaction of mandated IMGs was significantly lower across all social aspects, whilst professional satisfaction was also significantly lower for most job aspects relating to their professional autonomy. In contrast, non-mandated IMGs were similarly satisfied compared to Australian trained GPs.
  
  
  CONCLUSIONS
  Mandated IMGs are currently filling a critical shortage in rural areas of Australia. However, long-term success of this policy is problematic unless outstanding issues affecting their significantly reduced professional and non-professional satisfaction can be addressed.
authors.affiliation: Gippsland Medical School, Monash University, Northways Road, Churchill, VIC 3842, Australia. matthew.mcgrail@monash.edu
authors.forename: Matthew R
authors.initials: MR
authors.lastname: McGrail
authors.forename: John S
authors.initials: JS
authors.lastname: Humphreys
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Joyce
authors.forename: Anthony
authors.initials: A
authors.lastname: Scott
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D003625:Data Collection; D005260:Female; D005550:Foreign Medical Graduates / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D037141:Mandatory Programs / Q000706:statistics & numerical data; D008507:Medically Underserved Area; D010549:Personal Satisfaction; D019035:Rural Health Services; D000078329:Workforce