Building a rural medical workforce: the foundations of a place-based approach to program evaluation

IntroductionTo address the maldistribution of medical practitioners within Deakin University’s rural training footprint, a place-based Rural Training Stream (RTS) was established (2022). Formal definition of the footprint has enabled priority admission of 30 local students annually. This paper descr...

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Main Authors: Lara Fuller, Jessica Beattie, Vincent L. Versace, Gary D. Rogers, Matthew Richard McGrail
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1582793/full
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author Lara Fuller
Jessica Beattie
Vincent L. Versace
Gary D. Rogers
Matthew Richard McGrail
author_facet Lara Fuller
Jessica Beattie
Vincent L. Versace
Gary D. Rogers
Matthew Richard McGrail
author_sort Lara Fuller
collection DOAJ
description IntroductionTo address the maldistribution of medical practitioners within Deakin University’s rural training footprint, a place-based Rural Training Stream (RTS) was established (2022). Formal definition of the footprint has enabled priority admission of 30 local students annually. This paper describes graduate workforce outcomes for the footprint, providing a baseline for future evaluation of the RTS.MethodsGraduates’ (2011–2022) Principal Places of Practice (2023) were extracted from the Australian Health Practitioner Regulation Agency register and linked with demographic, admission and training data. Descriptive statistics, univariate analysis and multinomial logistic regression were employed to describe associations with practice in three defined rural Tiers (Tier 1: Deakin’s rural footprint, Tier 2: other rural Victoria, Tier 3: other rural Australia), with metropolitan practice as the reference group.Results120 (39.2%) graduates were working in Tier 1 and 93 (30.4%) in each of Tiers 2 and 3. Significant associations (p < 0.001) with working in the footprint were: post-graduate years 1–3 (OR 7.2), rural longitudinal integrated clerkship and rural clinical school (RCS) pathway (OR 6.8); RCS pathway only (OR 4.1), general practice specialty (OR 4.7) and rural background (OR 3.0).DiscussionThe differential effect of rural training on graduates working in the rural footprint, compared with other parts of rural Victoria and Australia is noteworthy. Attrition of graduates from the footprint beyond post-graduate year three highlights the urgency of expanding rural specialty training pathways. These baseline data reinforce the place-based design of the RTS and provide a foundation for future evaluation of local workforce outcomes.
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spelling doaj-art-de96dca5ee6f48b493df56f53153b48a2025-08-20T03:30:33ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-06-011210.3389/fmed.2025.15827931582793Building a rural medical workforce: the foundations of a place-based approach to program evaluationLara Fuller0Jessica Beattie1Vincent L. Versace2Gary D. Rogers3Matthew Richard McGrail4School of Medicine, Deakin University, Geelong, VIC, AustraliaRural Community Clinical School, School of Medicine, Deakin University, Colac, VIC, AustraliaDeakin Rural Health, School of Medicine, Deakin University, Warrnambool, VIC, AustraliaSchool of Medicine, Deakin University, Geelong, VIC, AustraliaRural Clinical School, The University of Queensland, Rockhampton, QLD, AustraliaIntroductionTo address the maldistribution of medical practitioners within Deakin University’s rural training footprint, a place-based Rural Training Stream (RTS) was established (2022). Formal definition of the footprint has enabled priority admission of 30 local students annually. This paper describes graduate workforce outcomes for the footprint, providing a baseline for future evaluation of the RTS.MethodsGraduates’ (2011–2022) Principal Places of Practice (2023) were extracted from the Australian Health Practitioner Regulation Agency register and linked with demographic, admission and training data. Descriptive statistics, univariate analysis and multinomial logistic regression were employed to describe associations with practice in three defined rural Tiers (Tier 1: Deakin’s rural footprint, Tier 2: other rural Victoria, Tier 3: other rural Australia), with metropolitan practice as the reference group.Results120 (39.2%) graduates were working in Tier 1 and 93 (30.4%) in each of Tiers 2 and 3. Significant associations (p < 0.001) with working in the footprint were: post-graduate years 1–3 (OR 7.2), rural longitudinal integrated clerkship and rural clinical school (RCS) pathway (OR 6.8); RCS pathway only (OR 4.1), general practice specialty (OR 4.7) and rural background (OR 3.0).DiscussionThe differential effect of rural training on graduates working in the rural footprint, compared with other parts of rural Victoria and Australia is noteworthy. Attrition of graduates from the footprint beyond post-graduate year three highlights the urgency of expanding rural specialty training pathways. These baseline data reinforce the place-based design of the RTS and provide a foundation for future evaluation of local workforce outcomes.https://www.frontiersin.org/articles/10.3389/fmed.2025.1582793/fullrural medical educationrural footprintplace-basedprogram evaluationlongitudinal integrated clerkshiprural clinical school
spellingShingle Lara Fuller
Jessica Beattie
Vincent L. Versace
Gary D. Rogers
Matthew Richard McGrail
Building a rural medical workforce: the foundations of a place-based approach to program evaluation
Frontiers in Medicine
rural medical education
rural footprint
place-based
program evaluation
longitudinal integrated clerkship
rural clinical school
title Building a rural medical workforce: the foundations of a place-based approach to program evaluation
title_full Building a rural medical workforce: the foundations of a place-based approach to program evaluation
title_fullStr Building a rural medical workforce: the foundations of a place-based approach to program evaluation
title_full_unstemmed Building a rural medical workforce: the foundations of a place-based approach to program evaluation
title_short Building a rural medical workforce: the foundations of a place-based approach to program evaluation
title_sort building a rural medical workforce the foundations of a place based approach to program evaluation
topic rural medical education
rural footprint
place-based
program evaluation
longitudinal integrated clerkship
rural clinical school
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1582793/full
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