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Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners
RESEARCH ARTICLE (Open Access)

The rural medical generalist workforce: The Royal New Zealand College of General Practitioners’ 2014 workforce survey results

Deanne L. Wong 1 , Garry Nixon 2
+ Author Affiliations
- Author Affiliations

1 The Royal New Zealand College of General Practitioners, Wellington, New Zealand

2 Dunstan Hospital, Clyde, and University of Otago, Dunedin, New Zealand

Correspondence to: Deanne L. Wong, PO Box 10-440, Wellington 6143, New Zealand. Email: Deanne.Wong@rnzcgp.org.nz

Journal of Primary Health Care 8(3) 196-203 https://doi.org/10.1071/HC15055
Published: 7 September 2016

Journal Compilation © Royal New Zealand College of General Practitioners 2016.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Abstract

INTRODUCTION: Previous surveys have revealed a New Zealand rural medical generalist workforce that is mainly male, older and dependent on international medical graduates (IMGs).

AIMS: To provide a snapshot of the New Zealand rural medical generalist workforce in 2014 and to make comparisons with the urban medical generalist workforce. To assess future workforce losses and find ways to address them.

METHODS: In March/April 2014, a survey of members of The Royal New Zealand College of General Practitioners used the SurveyMonkey tool. A comparative analysis was undertaken of self-identified rural and urban respondents.

RESULTS: The response rate was 55.9% (2525/4514). Of the 2203 working respondents, 17.1% self-identified as rural, working in rural general practice or rural hospital medicine. Compared with urban respondents, more rural generalists were male (57.5% rural vs 45.5% urban; P < 0.01), aged ≥ 55 years (38.2% rural vs 32.6% urban; P = 0.04) and involved in teaching (53.0% rural vs 30.0% urban; P < 0.01). IMGs were an integral part of the rural generalist workforce (52.8% rural vs 38.7% urban; P < 0.01). More rural generalists worked ≥ 36 h per week (66.8% rural vs 50.4% urban; P < 0.01) and they were more likely to retire within the next 10 years (40.4% rural vs 34.7% urban; P = 0.0417).

DISCUSSION: The rural medical generalist workforce continues to be mainly male, older and consist of a high proportion of IMGs. Findings confirm the fragility of this workforce and highlight the need for renewed efforts to improve recruitment and retention.

KEYWORDS: New Zealand; rural medical workforce; general practice; rural hospital medicine; recruitment and retention


References

[1]  Strasser R, Neusy AJ. Context counts: training health workers in and for rural remote areas. Bull World Health Organ 2010; 88 777–82.
Context counts: training health workers in and for rural remote areas.Crossref | GoogleScholarGoogle Scholar | 20931063PubMed |

[2]  Ministry of Health. Health of the Health Workforce 2013 to 2014. Wellington: Ministry of Health; 2014.

[3]  Ministry of Health. The Role of the Health Workforce New Zealand. Wellington: Ministry of Health; 2014.

[4]  Ministry of Health. A comparison of primary health care provided by rural and non-rural general practices: the National Primary Medical Care Survey (NatMedCa): 2001/02 Report 4. Wellington: Ministry of Health; 2004. [cited 2016 May 19]. Available from: www.health.govt.nz/publication/comparison-primary-health-care-provided-rural-and-non-rural-general-practices

[5]  Goodyear-Smith F, Janes R, New Zealand Institute of Rural Health. The 2005 Rural Health Workforce Survey. Wellington: Ministry of Health; 2006.

[6]  The Royal New Zealand College of General Practitioners. 2007 RNZCGP Membership Survey: General Practice in New Zealand Part III. Wellington: The RNZCGP; 2009.

[7]  The Royal New Zealand College of General Practitioners. 2008 RNZCGP Membership Survey. Wellington: The RNZCGP; 2009.

[8]  Matthews C, Bagg W, Yielder J, et al. Does Pukawakawa (the regional-rural programme at University of Auckland) influence workforce choice. N Z Med J 2015; 128 35–43.
| 25721960PubMed |

[9]  Farry P, Adams J, Walters L, et al. Development of the Rural Immersion Programme for 5th-year medical students at the University of Otago. N Z Med J 2010; 123 16–23.
| 20930906PubMed |

[10]  Bagg W, Dare AJ, O’Connor BJ, et al. Setting up new learning environments in regional and rural areas. N Z Med J 2010; 123 83–90.
| 20389324PubMed |

[11]  Shelker W, Zaharic T, Sijnja B, et al. Influence of rural background and rural medical training on postgraduate medical training and location in New Zealand. N Z Med J 2014; 127 12–6.
| 25290494PubMed |

[12]  Ministry of Health. Rural primary health care. Wellington: Ministry of Health; 2014. [cited 2015 November 5]. Available from: www.health.govt.nz/our-work/primary-health-care/primary-health-care-subsidies-and-services/rural-primary-health-care

[13]  The Royal New Zealand College of General Practitioners. 2014 RNZCGP Workforce Survey. Wellington: The RNZCGP; 2014.

[14]  Medical Council of New Zealand. The New Zealand Medical Workforce in 2013 and 2014. Wellington: Medical Council of New Zealand; 2016.

[15]  National Ethics Advisory Committee. Ethical guidelines for observational studies: observational research, audits and related activities. Revised edition. Wellington: Ministry of Health; 2012.

[16]  Fraser J. Rural health: a literature review for the National Health Committee. Prepared for the Health Services Research Centre, School of Government, Victoria University of Wellington. Wellington: Victoria University of Wellington; 2006.

[17]  Statistics New Zealand. New Zealand: an urban/rural profile update. Wellington: Statistics New Zealand; 2015. [cited 2015 October 28]. Available from: www.stats.govt.nz/browse_for_stats/Maps_and_geography/Geographic-areas/urban-rural-profile-update.aspx

[18]  Fearnley D, Lawrenson R, Nixon G. ‘Poorly Defined’: unknown unknowns in New Zealand rural health. N Z Med J 2016; 129 77–81.
| 27507724PubMed |

[19]  New Zealand Rural General Practice Network and Ministry of Health. Rural funding changes: alliancing overview. Working within Rural Service Level Alliance Teams workshop. Wellington; 2014.

[20]  Statistics New Zealand. 2013 Census QuickStats about Māori. Wellington: Statistics New Zealand; 2013. [cited 2015 December 10]. Available from: www.stats.govt.nz/Census/2013-census/profile-and-summary-reports/quickstats-about-maori-english.aspx

[21]  Pande MM. General practice in urban and rural New Zealand: results of the 2007 RNZCGP membership survey. J Prim Health Care 2009; 1 108–13.
| 20690360PubMed |

[22]  Environmental Health Indicators New Zealand. Urban-rural profile. Wellington: Massey University; 2014. [cited 2015 December 11]. Available from: www.ehinz.ac.nz/indicators/population-information/urbanrural-profile/

[23]  Lawrenson R, Reid J, Nixon G, et al. The New Zealand Rural Hospital Doctors Workforce Survey 2015. N Z Med J 2016; 129 9–16.
| 27349258PubMed |

[24]  Ministry of Health. New Zealand health strategy future direction. Wellington: Ministry of Health; 2016.

[25]  Ministry of Health. Statement of intent 2015 to 2019. Wellington: Ministry of Health; 2015.

[26]  Poole PJ, Moriarty HJ, Wearn AM, et al. Medical student selection in New Zealand: looking to the future. N Z Med J 2009; 122 88–100.
| 20145692PubMed |

[27]  Perez D, Belton A. Demography of medical students at the University of Otago 2004–2008: a changing spectrum? N Z Med J 2013; 126 63–70.
| 23793122PubMed |

[28]  The Royal New Zealand College of General Practitioners. 2012 Māori Strategy. Wellington: The RNZCGP; 2012. (Currently being refreshed)

[29]  The Royal New Zealand College of General Practitioners. Rural General Practice in 2015: education, recruitment, retention and standards. Wellington: The RNZCGP; 2016.

[30]  Raymont A, Boyd M, Malloy T, et al. Rural health care in New Zealand: the case of Coast to Coast Health Centre, Wellsford, an early Integrated Family Health Centre. J Prim Health Care 2015; 7 309–15.
Rural health care in New Zealand: the case of Coast to Coast Health Centre, Wellsford, an early Integrated Family Health Centre.Crossref | GoogleScholarGoogle Scholar | 26668836PubMed |