Local regional workforce returns on investment of a locally governed and delivered general practice vocational training program
Scott KitchenerGriffith Health, Griffith University, Parklands Drive, Southport, Qld 4125, Australia. Email: s.kitchener@griffith.edu.au
Australian Health Review 44(2) 254-257 https://doi.org/10.1071/AH18027
Submitted: 3 February 2018 Accepted: 15 January 2019 Published: 29 March 2019
Abstract
This study evaluated a program arising from the Commonwealth policy of regionalised training for general practice with regard to the outcomes for the region investing in the training program. A complete operational audit was performed of the outcomes of a training provider of the Commonwealth program, evaluating workforce contribution and retention in the region during and after training, stratified for the effects of locally contextualising, advanced skill training and origin of trainee. The local regional workforce contribution during training peaked at 130 full-time equivalents in 2015. Cumulatively, 53% of alumni remained in the region, but over 40% moved to practice in metropolitan south-east Queensland and other Australian capital cities. Local contextualising of training, completing additional advanced skills training and being an Australian graduate were associated with increased retention in the region. A regional training program is a significant local asset introducing potential general practitioners (GPs) to the region. However, this regional area has become a ‘rural’ training ground for GPs into metropolitan practice rather than local investment translating as comprehensively as possible into long-term local workforce. The Commonwealth program should focus on local workforce outcomes as an evaluation metric rather than the proportion of trainees in rural training.
What is known about the topic? Retention in regional areas following the Australian General Practice Training (AGPT) program measured on a national basis is greater following regional-based training.
What does this paper add? Local workforce return on investment for training providers in GP is substantial. Contextualised local rural training, Australian graduates and trainees completing advanced rural training improve local return on training investment. A significant proportion of this rural local training program investment provides GPs for metropolitan southeast Queensland.
What are the implications for practitioners? National and regional investment in the AGPT should recognise that despite the lesser supervisory medical workforce and resources, regional training still supports metropolitan GP workforce development. Australian graduates are more likely to remain in a region following local training, as are those who have additionally completed advanced rural skill training.
References
[1] Strasser R, Couper I, Wynn-Jones J, Rourke J, Chater A, Reid S. Education for rural practice in rural practice. Educ Prim Care 2016; 27 10–14.| Education for rural practice in rural practice.Crossref | GoogleScholarGoogle Scholar | 26862793PubMed |
[2] Campbell DG, Greacen JH, Giddings PH, Skinner LP. Regionalisation of general practice training – are we meeting the needs of rural Australia? Med J Aust 2011; 194 S71–4.
| 21644857PubMed |
[3] Sen Gupta T, Hays R. Training for general practice: how Australia’s program compare to other countries. Aust Fam Physician 2016; 45 18–21.
[4] Wearne S, Giddings P, McLaren J, Gargan C. Where are they now? The career paths of the Remote Vocational Training Scheme registrars. Aust Fam Physician 2010; 39 53–6.
| 20369136PubMed |
[5] Trumble SC. The evolution of general practice training Australia. Med J Aust 2011; 194 S59–62.
| 21644854PubMed |
[6] General Practice Education and Training (GPET). GPET annual report to 30 June 2014. 2014. Available at: http://www.agpt.com.au/About-Us/Annual-Report [verified 3 March 2019].
[7] McGrail MR, Russell DJ, Campbell DG. Vocational training of general practitioners in rural locations is critical for the Australian rural medical workforce. Med J Aust 2016; 205 216–21.
| Vocational training of general practitioners in rural locations is critical for the Australian rural medical workforce.Crossref | GoogleScholarGoogle Scholar | 27581268PubMed |
[8] Robinson M, Slaney G. Choice or chance! The influence of decentralized training on GP retention in the Bogong region of Victoria and New South Wales. Rural Remote Health 2013; 13 2231
| 23489136PubMed |
[9] Nelson M, Bunyard J, Quinn S, Williams D. Porrige. A cohort study of general practice registrars. Aust Fam Physician 2011; 40 138–41.
| 21597518PubMed |