PDF(Pubmed)
Abstract：
OBJECTIVE: This study aims to determine the associations between specialty type and practice location at postgraduate year 10 (PGY10), matched with PGY5 and PGY8 work locations, and earlier rural exposure/experience.
METHODS: A cohort study of medicine graduates from nine Australian universities.
METHODS: 1220 domestic medicine graduates from the class of 2011.
METHODS: Practice location recorded by the Australian Health Practitioner Regulation Agency in PGY10; matched graduate movement between PGYs 5, 8 and 10 as classified by the Modified Monash Model, stratified by specialty type (predominantly grouped as general practitioner (GP) or non-GP).
RESULTS: At PGY10, two-thirds (820/1220) had achieved fellowship. GPs were 2.8 times more likely to be in non-metropolitan practice (28% vs 12%; 95% CI 2.0 to 4.0, p<0.001) than graduates with non-GP (all other) specialist qualifications. More than 70% (71.4%) of GPs who were in non-metropolitan practice in PGY5 remained there in both PGY8 and PGY10 versus 29.0% of non-GP specialists and 36.4% of non-fellowed graduates (p<0.001). The proportion of fellowed graduates observed in non-metropolitan practice was 14.9% at PGY5, 16.1% at PGY8 and 19.0% at PGY10, with this growth predominantly from non-GP specialists moving into non-metropolitan locations, following completion of metropolitan-based vocational training.
CONCLUSIONS: There are strong differences in practice location patterns between specialty types, with few non-GP specialists remaining in non-metropolitan practice between PGY5 and PGY10. Our study reinforces the importance of rural training pathways to longer-term work location outcomes and the need to expand specialist vocational training which supports more rural training opportunities for trainees outside general practice.
METHODS: A cohort study of medicine graduates from nine Australian universities.
METHODS: 1220 domestic medicine graduates from the class of 2011.
METHODS: Practice location recorded by the Australian Health Practitioner Regulation Agency in PGY10; matched graduate movement between PGYs 5, 8 and 10 as classified by the Modified Monash Model, stratified by specialty type (predominantly grouped as general practitioner (GP) or non-GP).
RESULTS: At PGY10, two-thirds (820/1220) had achieved fellowship. GPs were 2.8 times more likely to be in non-metropolitan practice (28% vs 12%; 95% CI 2.0 to 4.0, p<0.001) than graduates with non-GP (all other) specialist qualifications. More than 70% (71.4%) of GPs who were in non-metropolitan practice in PGY5 remained there in both PGY8 and PGY10 versus 29.0% of non-GP specialists and 36.4% of non-fellowed graduates (p<0.001). The proportion of fellowed graduates observed in non-metropolitan practice was 14.9% at PGY5, 16.1% at PGY8 and 19.0% at PGY10, with this growth predominantly from non-GP specialists moving into non-metropolitan locations, following completion of metropolitan-based vocational training.
CONCLUSIONS: There are strong differences in practice location patterns between specialty types, with few non-GP specialists remaining in non-metropolitan practice between PGY5 and PGY10. Our study reinforces the importance of rural training pathways to longer-term work location outcomes and the need to expand specialist vocational training which supports more rural training opportunities for trainees outside general practice.
摘要：
目的：本研究旨在确定研究生10年级（PGY10）专业类型与实习地点之间的关联，与PGY5和PGY8工作地点相匹配，和更早的农村暴露/经验。
方法：一项来自澳大利亚9所大学的医学毕业生的队列研究。
方法：1220名2011届国内医学毕业生。
方法：在PGY10中由澳大利亚健康从业者监管机构记录的实践位置；根据改良的莫纳什模型分类，PGYs5、8和10之间的匹配研究生运动，按专业类型分层(主要分为全科医生(GP)或非GP)。
结果：在PGY10，三分之二（820/1220）获得了奖学金。与具有非GP（所有其他）专科资格的毕业生相比，全科医生在非大都市执业的可能性要高2.8倍（28％vs12％；95％CI2.0至4.0，p<0.001）。PGY8和PGY10中，超过70％（71.4％）的非大都市全科医生仍在PGY8和PGY10中，而非GP专家为29.0％，非同胞毕业生为36.4％（p<0.001）。在非大都市实践中观察到的毕业生比例在PGY5为14.9％，在PGY8为16.1％，在PGY10为19.0％，这种增长主要来自非GP专家进入非大都市地区。在完成大都市职业培训之后。
结论：专业类型之间的实践位置模式存在很大差异，在PGY5和PGY10之间，很少有非GP专家留在非大都市实践中。我们的研究加强了农村培训途径对长期工作地点成果的重要性，以及扩大专业职业培训的必要性，这将为普通实践以外的受训者提供更多的农村培训机会。
方法：一项来自澳大利亚9所大学的医学毕业生的队列研究。
方法：1220名2011届国内医学毕业生。
方法：在PGY10中由澳大利亚健康从业者监管机构记录的实践位置；根据改良的莫纳什模型分类，PGYs5、8和10之间的匹配研究生运动，按专业类型分层(主要分为全科医生(GP)或非GP)。
结果：在PGY10，三分之二（820/1220）获得了奖学金。与具有非GP（所有其他）专科资格的毕业生相比，全科医生在非大都市执业的可能性要高2.8倍（28％vs12％；95％CI2.0至4.0，p<0.001）。PGY8和PGY10中，超过70％（71.4％）的非大都市全科医生仍在PGY8和PGY10中，而非GP专家为29.0％，非同胞毕业生为36.4％（p<0.001）。在非大都市实践中观察到的毕业生比例在PGY5为14.9％，在PGY8为16.1％，在PGY10为19.0％，这种增长主要来自非GP专家进入非大都市地区。在完成大都市职业培训之后。
结论：专业类型之间的实践位置模式存在很大差异，在PGY5和PGY10之间，很少有非GP专家留在非大都市实践中。我们的研究加强了农村培训途径对长期工作地点成果的重要性，以及扩大专业职业培训的必要性，这将为普通实践以外的受训者提供更多的农村培训机会。
