title: Regional universities and rural clinical schools contribute to rural medical workforce, a cohort study of 2002 to 2013 graduates.
abstract: BACKGROUND
  Rural clinical schools and regionally based medical schools have a major role in expanding the rural medical workforce. The aim of this cohort study was to compare location of practice of graduates from the University of Tasmania School of Medicine's clinical schools based in the larger cities of Hobart and Launceston (UTAS SoM), with those graduates who spent at least 1 year at the University of Tasmania School of Medicine's Rural Clinical School based in the smaller regional city of Burnie (UTAS RCS) in Australia. Specifically, the aim was to quantify the proportion who worked in an Australian regional or remote location, or in the regional cities and smaller towns within Tasmania.
  
  
  METHODS
  The 2014 locations of practice of all graduates from the UTAS SoM and UTAS RCS between 2002 and 2013 were determined using the postcode listed in the Australian Health Practitioners Authority database. These postcodes were mapped against the Australian Bureau of Statistics Australian Standard Geographic Classification - Remoteness Areas (ASGC-RA) and the 2011 Census population data for Tasmania to define Modified Monash Model classifications.
  
  
  RESULTS
  The study tracked 974 UTAS SoM graduates; 202 (21%) spent at least 1 year at the Rural Clinical School (UTAS RCS graduates). Students who had spent a year at the UTAS RCS were five times more likely to be working in RA3 to RA5 than those who hadn't spent a clinical year there (28% vs 7%, χ2(1)=59.5, p<0.0001) (odds ratio (OR) 4.9, 95% confidence interval (CI) 3.2-7.6). Using the Modified Monash Model, it was found that UTAS RCS graduates were nine times more likely (OR 9.0, 95%CI 4.7-17.2) to be working in the regional cities and smaller towns of Tasmania.
  
  
  CONCLUSIONS
  This study adds to the growing evidence that training medical students in rural areas delivers graduates that work rurally. The additional year spent in a rural area, even when their medical school is in a regional city, significantly affects their workplace choices over the first 3 years post-graduation.
authors.affiliation: UTAS Rural Clinical School, Burnie, Tasmania, Australia. lizzi.shires@utas.edu.au.
authors.forename: Lizzi
authors.initials: L
authors.lastname: Shires
authors.affiliation: UTAS Rural Clinical School, Burnie, Tasmania, Australia. penny.allen@utas.edu.au.
authors.forename: Penny
authors.initials: P
authors.lastname: Allen
authors.affiliation: UTAS Rural Clinical School, Burnie, Tasmania, Australia. colleen.cheek@utas.edu.au.
authors.forename: Colleen
authors.initials: C
authors.lastname: Cheek
authors.affiliation: UTAS Rural Clinical School, Burnie, Tasmania, Australia. debbie.wilson@utas.edu.au.
authors.forename: Wilson
authors.initials: W
authors.lastname: Deb
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016208:Databases, Factual; D004503:Education, Medical, Graduate / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D011177:Postal Service; D011365:Professional Practice Location / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000706:statistics & numerical data; D013337:Students, Medical / Q000706:statistics & numerical data*; D013648:Tasmania; D000078329:Workforce; D055815:Young Adult
keywords: Administrator; Australia/Pacific; Determinants of Health; Medical; Other; Postgraduate; Public Health; Undergraduate; Workforce