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Day 1 – FRAME and Commonwealth Department of Health

Welcome to Country by Ms Samia Goudie, Senior Lecturer, Indigenous Health, ANU.
Professor Nick Glasgow (Dean, ANU Medical School) welcomed participants to the ANU and Canberra, and congratulated the Department on the extremely successful policy that has supported RCSs and UDRHs in addressing rural workforce shortages. RCS staff were commended for their work, leadership, the example they set and encouragement they provide to graduates. Medical Schools are much richer for having rural clinical schools with RCSs broadening horizons and assisting Medical Schools to think differently about curriculum.
1.  Rural Clinical School/Regional Medical School Round Up
Three-minute presentations from each clinical school on one of the following topics
  • Progress collecting destination data, or
  • Research activity in supporting rural medical/health workforce outcomes, or
  • Activities around staff retention impacts and reducing professional isolation
See Appendix 1. Powerpoint Presentations
In Summary
University of Adelaide
  • Conducted a study of 2013 students.
  • Students indicated areas for improvement. Sites are very diverse but students want consistency across disciplines and sites.
  • Students acknowledge the importance of professional etiquette.
  • The RCS has been oversubscribed with rural requests. 73 applicants for 46 places.
Australian National University
  • Is a small medical school and data collection has reflected the size and intimacy of school (letters to students / survey / local sites keeping in contact / Facebook).
  • Data collection has been labour intensive and time consuming. ANU will now use a survey monkey tool.
  • There are issues in terms of the rural pipeline and availability of rural internship places. ANU students do not have priority unless they completed Year 12 in NSW.
Deakin University
  • Covers an area approximately 300 km east west and 150 km north south.
  • There are 2 hospital based RCSs - Warrnambool & Ballarat and 10 longitudinal placements.
  • It is difficult to compare the different towns.
  • Deakin has introduced initiatives to reduce professional isolation including the creation of Regional coordinators, building working relationships with hospitals and general practices, improving collaboration & cooperation.
Flinders University
  • The School of Medicine is 40 years old and next year the University celebrates 50 years.
  • The new Vice Chancellor, Professor Colin Stirling commences at end of 2015 and has a good understanding of Medicine.
  • Flinders is proud of the proportion of graduates working in RA4 and RA3.
  • There are limited internships available in SA. Flinders encourages policy makers to push for more GP and specialist pathways.
James Cook University
  • Conducts an Exit Survey in which they collect data and ask graduates to consent to being contacted.
  • Uses a Facebook page and sends friend requests.
  • In the future, JCU will select every 5th cohort to maintain close contact.
  • 67% of graduates are working outside major cities and 47% in outer regional / remote areas.
University of Melbourne
  • Peer review for medical educators.
  • Formal accreditation – CPD points.
Monash University
  • Graduate Tracking Study with data from 2004-05 cohorts to present day.
  • Early results indicating that the relationship between the total number of weeks in Years 4 and 5 rural placement and rural outcome is statistically significant.
University of Newcastle
  • New building in Tamworth and a joint medical program with the University of New England
  • Colocation has created opportunities for interprofessional learning activities with nursing, allied health and medicine.
  • Newcastle is supporting health professionals to reduce isolation through interprofessional activities including clinical skills bootcamps, simulation activities in small town sites, critical care masterclass.
University of New South Wales
  • 3 different types of surveys – Undergraduate Destination Survey, Graduate Destination Survey & FRAME survey.
  • Results indicate graduates with 3 years of RCS experience indicate rural areas as their preferred work location.
University of Notre Dame Australia
  • Campuses at Sydney and Fremantle. RCSs at Lithgow, Wagga Wagga and Ballarat.
  • Lifestyle factors decision impact on GP trainees.
  • There are pathways to general practice around the Wagga campus but specialist pathways are limited.
  • Practice models influence decision to practice rurally.
  • RCS impact on intension to practice rurally.
University of Queensland
  • Surveyed graduates from 2002 – 2011 to gain a cross sectional snap shot.
  • The questionnaire was long and collected a lot of data.
  • Results have been submitted for publication.
University of Sydney
  • Plenty of rural exposure means graduates are more likely to work rurally.
  • Sydney has RCSs at Dubbo, Orange, Lismore & Broken Hill.
  • There are insufficient PGY1 places and very little vocational training opportunities.
  • RCSs are graduating doctors with no pathway for them.
University of Tasmania
  • Study compared graduates from the RCS with graduates from clinical schools in Hobart and Launceston.
  • Snapshot study using APRHA database & Postcodes for 2002 – 2013; 974 graduates; 202 RCS; Located 89% of students.
  • Mapped grads against postcodes to see where currently practising.
  • RCS grads 4 times more likely to work in RA3-5 areas compared with other UTAS grads.
  • More work needed on the pipeline / specialist training places.
University of Western Australia
  • UWA & UNDA (Fremantle) have a joint RCS program at 14 sites across WA.       It is the biggest school in Australia and most staff are local doctors teaching into the program.
  • The RCS hosts lots of meetings both f2f and via VC, but more is needed to keep staff engaged.
  • The RCS is cultivating research and it is making a difference, keeping tutors interested and enthusiastic.
University of Western Sydney
  • 2 rural clinical schools – Bathurst / Lismore.
  • 301 Graduates to date.
  • 50% of student intake has to be from Western Sydney. It is difficult to encourage graduates to leave Western Sydney to practice rurally.
  • UWS is looking to learn from other universities.
University of Wollongong
  • Graduated 4 cohorts to date.
  • Looking at student intentions.
  • Longitudinal integrated clerkship. Not all end up in GP.
  • Now time to track students. Next phase in research is to see if intentions translate into reality.
Key messages
  • There is an urgent need for more post graduate training posts / removal of barriers to rural practice.
  • It would be useful for the Department to see data and results, reports, published studies etc.  Data are helpful when briefing Ministers on outcomes.
  • The longer students spend in RCS, the stronger the intention to go rural.
  • Research indicates short term rural placements do not influence rural career but do change knowledge and attitudes towards rural health.
  • Shorter rural placements in earlier years are used as a recruiting tool into long term rural clinical placements. Early clinical immersion influences decision to go rural in years 3 – 5.
  • The current FRAME position is that individual universities should determine whether to allocate funding towards short term rural placements or longer term rural placements.