An analysis of ACRRM trainee data found that registrars who did a procedural-heavy advanced skill like anaesthetics or obstetrics were more likely to stay working rural.
Rural doctors who mastered a more procedural advanced skill as part of their ACRRM fellowship are far more likely to continue practicing in a rural area post-fellowship than their peers who chose population health or internal medicine.
Speaking at Rural Medicine Australia in Adelaide on Thursday, ACRRM lead statistician James Dawber presented findings from an analysis of the current practice locations, according to AHPRA, of 949 doctors who fellowed with ACRRM over the past decade.
Just less than one in four of these doctors were listed on their AHPRA registration as currently practising or living in an MMM1 location.
“Who are these people? Who are those who are these 23% in [MM1 locations], and how [do they] they differ to our fellows in those regional rural areas?” Mr Dauber said.
The ACRRM analysis found that factors which were more strongly associated with metro practice post-fellowship included being an overseas-trained doctor, doing any metropolitan placement and being older at the start of training.
On the flip side, there were positive associations between doctors practicing rurally and doctors who passed their fellowship exams at the first attempt, joined ACRRM earlier in their career or completed any procedural advanced skills training (AST).
As part of ACRRM fellowship, all doctors must complete advanced skills training in one of 12 approved disciplines; this normally takes 12 months.
Related
Fellows who had completed either an obstetrics or anaesthetics AST were the most likely to remain practising rurally post-fellowship, followed by those who did paediatrics or emergency medicine.
Doctors who did population health, adult internal medicine, surgery, Aboriginal and Torres Strait Islander health, remote medicine, academic practice, mental health or palliative care AST were more likely to be registered in an MM1 location.
Although the correlation between completing surgery AST and practicing in the city may seem like an outlier, one audience member did note that the training for surgery AST often required training in a city.
Following a multivariate analysis using a logistic regression model, doing a procedural AST was the strongest predictor of a doctor remaining rural and doing any metro placement was the strongest predictor of a doctor working in MM1.
The second-strongest predictor of a doctor working in MM1 post-fellowship was if they were an overseas trained doctor.
But despite the data offering a promising insight, the secret to predicting rural retention remains one of life’s unsolved mysteries.
Mr Dawber cautioned against using the data to form opinions about which rural generalists in training would end up working rurally.
“[Being an overseas trained doctor] is actually more predictive than I thought it would be, but not predictive enough to really use … I think I’d be more concerned about discriminating against people based on these broad groups,” he said,
“But I think we should be considering [this data] in terms of the challenges that overseas trained doctors might face, in in terms of is there something that we can do to help them stay rural?”
Rural Medicine Australia 2026, jointly hosted by ACRRM and the RDAA, is being held at the Adelaide Convention Centre from 22 to 24 October.
