title: Vocational training of general practitioners in rural locations is critical for the Australian rural medical workforce.
abstract: OBJECTIVE
  To investigate associations between general practitioner vocational training location and subsequent practice location, including the effect of rural origin.
  
  
  METHODS
  Annual panel survey of GPs (from the MABEL study) who completed their vocational training and transitioned to independent practice, 2008-2014.
  
  
  METHODS
  Rural practice location in the 5 years after vocational registration for participants in four primary cohorts: (1) rural origin/rural training; (2) metropolitan origin/rural training; (3) rural origin/metropolitan training; and (4) metropolitan origin/metropolitan training.
  
  
  RESULTS
  During the study period, 610 doctors completed GP vocational training and commenced independent practice. 74-91% of rural origin/rural training cohort GPs remained in rural areas during their first 5 years after completing training, with 61-70% remaining in the same community. Conversely, 87-95% of metropolitan origin/metropolitan training cohort GPs remained in metropolitan areas. GPs from the other two cohorts initially remained in their training location type, but gradually moved towards their origin type. Generalised estimating equation logit models identified a highly significant association between rural training pathways and subsequent rural practice that was sustained for 5 years after vocational registration; it was substantially strengthened when combined with rural origin (cohort 2 v cohort 4: odds ratio [OR], 24; 95% CI, 13-43; cohort 1 v cohort 4: OR, 52; 95% CI, 24-111).
  
  
  CONCLUSIONS
  This study provides new quantitative evidence of strong associations between rural GP vocational training location and subsequent rural practice location, which is strengthened when combined with rural origin. This evidence supports current government policy supporting rural GP vocational training and quotas for medical student selection based on rural origin.
authors: Monash University, Churchill, VIC matthew.mcgrail@monash.edu.
authors: Matthew R
authors: MR
authors: McGrail
authors: Monash University, Bendigo, VIC.
authors: Deborah J
authors: DJ
authors: Russell
authors: Monash University, Bairnsdale, VIC.
authors: David G
authors: DG
authors: Campbell
mesh_terms: D000328:Adult; D001315:Australia; D002321:Career Choice; D005260:Female; D058005:General Practitioners / Q000193:education*; D006801:Humans; D008297:Male; D011365:Professional Practice Location / Q000706:statistics & numerical data*; D019035:Rural Health Services; D012424:Rural Population; D013337:Students, Medical / Q000706:statistics & numerical data*; D014829:Vocational Education / Q000592:standards*