Rural Work and Specialty Choices of International Students Graduating from Australian Medical Schools: Implications for Policy

Almost 500 international students graduate from Australian medical schools annually, with around 70% commencing medical work in Australia. If these Foreign Graduates of Accredited Medical Schools (FGAMS) wish to access Medicare benefits, they must initially work in Distribution Priority Areas (mainly rural). This study describes and compares the geographic and specialty distribution of FGAMS. Participants were 18,093 doctors responding to Medicine in Australia: Balancing Employment and Life national annual surveys, 2012–2017. Multiple logistic regression models explored location and specialty outcomes for three training groups (FGAMS; other Australian-trained (domestic) medical graduates (DMGs); and overseas-trained doctors (OTDs)). Only 19% of FGAMS worked rurally, whereas 29% of Australia’s population lives rurally. FGAMS had similar odds of working rurally as DMGs (OR 0.93, 0.77–1.13) and about half the odds of OTDs (OR 0.48, 0.39–0.59). FGAMS were more likely than DMGs to work as general practitioners (GPs) (OR 1.27, 1.03–1.57), but less likely than OTDs (OR 0.74, 0.59–0.92). The distribution of FGAMS, particularly geographically, is sub-optimal for improving Australia’s national medical workforce goals of adequate rural and generalist distribution. Opportunities remain for policy makers to expand current policies and develop a more comprehensive set of levers to promote rural and GP distribution from this group.

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Retirement patterns of Australian doctors aged 65 years and older

Australian Health Review ◽

10.1071/ah14176 ◽

2015 ◽

Vol 39 (5) ◽

pp. 582 ◽

Cited By ~ 5

Author(s):

Catherine M. Joyce ◽

Wei C. Wang ◽

Hayley M. McDonald

Keyword(s):

Job Satisfaction ◽

Public Hospital ◽

Private Hospital ◽

Working Hours ◽

Intention To Leave ◽

Career Stage ◽

Medical Workforce ◽

Medical Work ◽

Policy Makers ◽

Retirement Intentions

Objective To investigate retirements over a 4-year period among Australian general practitioners (GPs) and specialists aged 65 years and over, and factors influencing retirement. Methods Data from Medicine in Australia: Balancing Employment and Life (MABEL) for the years 2009–12 were analysed for 435 GPs and 643 specialists aged 65 years and over at the time of entry to the MABEL survey. Discrete time survival analysis was used. Results The retirement rates were 4.1% (2009), 5.1% (2010), 4.2% (2011) and 10.4% (2012). Retirement was associated with: (1) the intention to leave medical work in 2009 and 2010; (2) working fewer hours in private consulting rooms in 2010 and 2012; (3) having lower job satisfaction in 2009 and 2011; (4) being older in 2009; (5) working fewer hours in a public hospital in 2012; and (6) working fewer hours in a private hospital in 2010. Doctors who intended to reduce their working hours were less likely to retire in 2009. Conclusions Strategies to support doctors at the late career stage to provide their valued contributions to the medical workforce for as long as possible may include increasing job satisfaction and addressing barriers to reducing work hours. What is known about the topic? Much of the available literature provides measures of retirement intentions. What does this paper add? The present study examined actual retirements and the factors associated with them. What are the implications for practitioners? Consideration should be given by policy makers to ensure that doctors are retained for as long as possible as active contributors to the medical workforce in a safe, appropriate manner.

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Does performance at the intercollegiate Membership of the Royal Colleges of Surgeons (MRCS) examination vary according to UK medical school and course type? A retrospective cohort study

BMJ Open ◽

10.1136/bmjopen-2021-054616 ◽

2022 ◽

Vol 12 (1) ◽

pp. e054616

Author(s):

Ricky Ellis ◽

Peter A Brennan ◽

Duncan S G Scrimgeour ◽

Amanda J Lee ◽

Jennifer Cleland

Keyword(s):

Cohort Study ◽

Medical School ◽

Regression Models ◽

Medical Training ◽

Medical Schools ◽

School Factors ◽

Logistic Regression Models ◽

Individual Level ◽

Medical Graduates ◽

The Uk

ObjectivesThe knowledge, skills and behaviours required of new UK medical graduates are the same but how these are achieved differs given medical schools vary in their mission, curricula and pedagogy. Medical school differences seem to influence performance on postgraduate assessments. To date, the relationship between medical schools, course types and performance at the Membership of the Royal Colleges of Surgeons examination (MRCS) has not been investigated. Understanding this relationship is vital to achieving alignment across undergraduate and postgraduate training, learning and assessment values.Design and participantsA retrospective longitudinal cohort study of UK medical graduates who attempted MRCS Part A (n=9730) and MRCS Part B (n=4645) between 2007 and 2017, using individual-level linked sociodemographic and prior academic attainment data from the UK Medical Education Database.MethodsWe studied MRCS performance across all UK medical schools and examined relationships between potential predictors and MRCS performance using χ2 analysis. Multivariate logistic regression models identified independent predictors of MRCS success at first attempt.ResultsMRCS pass rates differed significantly between individual medical schools (p<0.001) but not after adjusting for prior A-Level performance. Candidates from courses other than those described as problem-based learning (PBL) were 53% more likely to pass MRCS Part A (OR 1.53 (95% CI 1.25 to 1.87) and 54% more likely to pass Part B (OR 1.54 (1.05 to 2.25)) at first attempt after adjusting for prior academic performance. Attending a Standard-Entry 5-year medicine programme, having no prior degree and attending a Russell Group university were independent predictors of MRCS success in regression models (p<0.05).ConclusionsThere are significant differences in MRCS performance between medical schools. However, this variation is largely due to individual factors such as academic ability, rather than medical school factors. This study also highlights group level attainment differences that warrant further investigation to ensure equity within medical training.

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Effectiveness of an Educational Intervention in Reducing New International Postgraduates’ Acculturative Stress in Malaysian Public Universities: Protocol for a Cluster Randomized Controlled Trial (Preprint)

10.2196/preprints.12950 ◽

2018 ◽

Author(s):

Musheer Abdulwahid Al-Jaberi ◽

Muhamad Hanafiah Juni ◽

Hayati Kadir Shahar ◽

Siti Irma Fadhilah Ismail ◽

Murad Abdu Saeed ◽

...

Keyword(s):

International Students ◽

Acculturative Stress ◽

Educational Program ◽

Public Universities ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Policy Makers ◽

Randomized Controlled ◽

Cluster Randomized

BACKGROUND Universities around the world, including Malaysia, have attracted many international students from different countries. Research has reported that acculturative stress resulting from international students’ attempts to adjust to the cultures of host countries is one of the most challenging issues that affects their lives in general and academic lives in particular. OBJECTIVE This study aims to examine the effectiveness of an educational intervention on acculturative stress among new postgraduate international students joining Malaysian public universities. METHODS A cluster randomized controlled trial design with Malaysian public universities as the unit of randomization will be used in this study. Public universities will be randomized in a 1:1 ratio to be either in the intervention (educational program) or control group (waiting list). Participants in the intervention group will receive 7 sessions in 9 hours delivered by an expert in psychology and the researcher. The control group will receive the intervention once the 3-month follow-up evaluation is completed. RESULTS The data will be analyzed using the generalized estimation equation with a confidence interval value of 95%; significant differences between and within groups are determined as <i>P</i><.05. The results of the study underlie the effectiveness of educational program in decreasing acculturative stress of new international students and enabling them to cope with a new environment. The results of this study will contribute to previous knowledge of acculturative stress, acculturation, and adjustment of international students. Furthermore, such results are expected to play a role in raising university policy makers’ awareness of their postgraduate international students’ acculturative stress issues and how they can help them avoid such stress and perform well in their academic life. CONCLUSIONS We expect that the intervention group will score significantly lower than the wait-list group on the immediate and 3-month postintervention evaluation of acculturative stress and achieve a higher level of adjustment. Results will have implications for international students, policy makers at universities, the Malaysian Ministry of Higher Education, and future research. CLINICALTRIAL Clinical Trials Registry India CTRI/2018/01/011223; http://ctri.nic.in/Clinicaltrials/showallp.php?mid1= 21978&amp;EncHid=&amp;userName=Muhamad%20Hanafiah%20Juni INTERNATIONAL REGISTERED REPORT PRR1-10.2196/12950

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The Long-Term Consequences of Civil War for Migration: The Case of Tajikistan

10.31235/osf.io/qn5xv ◽

2019 ◽

Cited By ~ 1

Author(s):

Michelle O'Brien

Keyword(s):

Civil War ◽

Armed Conflict ◽

District Level ◽

Policy Makers ◽

Peace Accord ◽

Logistic Regression Models ◽

Individual Household ◽

Level I ◽

And Migration

Armed conflict is socially transformative. Although migration research has established the proximate relationship between armed conflict and increases in migration, much less attention has been paid to the long-term, or distal relationship. This research leverages the case of the 1992-1997 Tajikistani Civil War to examine the distal relationship between armed conflict and migration decisions nearly a decade after the war had ended. Using a series of logistic regression models and a selection-based endogeneity correction, I estimate the likelihood of migrating in 2006, given the intensity of conflict experience at the district level. I find that, controlling for individual, household, and district-level indicators, the legacy of conflict continues to influence migration – for men and for ‘stayers’ – nearly a decade after the peace accord was signed. Some evidence suggests that certain kinds of development projects can moderate this relationship. In conflict-affected countries, incorporating the legacy of conflict into empirical research can help scholars and policy-makers better understand migration in the aftermath of war.

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Building a local medical workforce in Tasmania: where are international fee-paying medical graduates likely to work?

Rural and Remote Health ◽

10.22605/rrh4292 ◽

2017 ◽

Vol 17 (3) ◽

Cited By ~ 1

Author(s):

Colleen Cheek ◽

Richard Hays ◽

Penny Allen ◽

Gary Walker ◽

Lizzi Shires

Keyword(s):

Medical Workforce ◽

Medical Graduates

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YOUR DOCTOR IS NOT IN, BY JANE M. ORIENT

PEDIATRICS ◽

10.1542/peds.94.3.317 ◽

1994 ◽

Vol 94 (3) ◽

pp. 317-317

Author(s):

J. F. L.

Keyword(s):

Abdominal Pain ◽

Medical Practice ◽

Practice Guidelines ◽

Clinton Administration ◽

Medical Schools ◽

Improve Quality ◽

Ear Infection ◽

Medical Graduates ◽

The Government

The government has signed a contract to pay $850,000 for development of "practice guidelines" and "protocols" to tell doctors how to treat an ear infection, a $20 problem. If the Clinton administration has its way, there will be protocols for the treatment of virtually every ailment. Yet there is no evidence that protocols save money or improve quality. Nurses, for instance, outperform protocols in deciding how to treat abdominal pain. So why aren't doctors raising a cry of alarm? Many have been browbeaten into submission, or have discovered that it's easier to play the game than to buck the system. But also, a different type of person is entering medical practice these days. Although the evidence is largely anecdotal, Dr. Orient says that the best students are avoiding medical schools and the schools are lowering their standards. (In 1990, 16% of medical graduates flunked the national boards, compared with 9% in 1984.)

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Older People’s Nonphysical Contacts and Depression During the COVID-19 Lockdown

The Gerontologist ◽

10.1093/geront/gnaa144 ◽

2020 ◽

Author(s):

Bruno Arpino ◽

Marta Pasqualini ◽

Valeria Bordone ◽

Aïda Solé-Auró

Keyword(s):

Intergenerational Relationships ◽

Panel Survey ◽

Social Contacts ◽

Policy Makers ◽

Logistic Regression Models ◽

Slowing Down ◽

Social Closeness ◽

Depressive Feelings ◽

Quota Sampling ◽

Design And Methods

Abstract Background and Objectives With the goal of slowing down the spread of the SARS-CoV-2 virus, restrictions to physical contacts have been taken in many countries. We examine to what extent intergenerational and other types of nonphysical contacts have reduced the risk of increased perceived depressive feelings during the lockdown for people aged 50+. Research Design and Methods We implemented an online panel survey based on quota sampling in France, Italy, and Spain in April 2020, about 1 month after the start of the lockdown. Our analyses are based on logistic regression models and use post-stratification weights. Results About 50% of individuals aged 50+ felt sad or depressed more often than usual during the lockdown in the 3 considered countries. Older people who increased or maintained unchanged nonphysical contacts with noncoresident individuals during the lockdown were at a lower risk of increased perceived depressive feelings compared to those who experienced a reduction in nonphysical contacts. The beneficial effect of nonphysical contacts was stronger for intergenerational relationships. The effects were similar by gender and stronger among individuals aged 70+, living in Spain and not living alone before the start of the lockdown. Discussion and Implications In the next phases of the COVID-19 pandemic, or during any future similar pandemic, policy makers may implement measures that balance the need to reduce the spread of the virus with the necessity of allowing for limited physical contacts. Social contacts at a distance may be encouraged as a means to keep social closeness, while being physically distant.

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Achieving self-sufficiency: training Australia’s future medical workforce

Australian Health Review ◽

10.1071/ah17019 ◽

2018 ◽

Vol 42 (6) ◽

pp. 640

Author(s):

Brian Fernandes ◽

Edward R. Scheffer Cliff ◽

Amelia Chowdhury

Keyword(s):

Vocational Training ◽

Junior Doctors ◽

International Medical Graduates ◽

Medical Workforce ◽

Rural And Remote ◽

Remote Areas ◽

Medical Graduates ◽

Department Of Health ◽

Self Sufficiency ◽

Rural And Remote Areas

There is an oversupply of Australian junior doctors, but significant training bottlenecks are developing, and geographical maldistribution in rural and remote areas remains. Last year, the Federal Minister for Immigration rejected a Department of Health recommendation for the removal of 41 health roles from the Skilled Occupation List after concerns that rural and regional communities would be left without access to medical services in areas currently serviced by international medical graduates. In an effort to achieve workforce self-sufficiency, Australia must ensure access to high-quality vocational training places in rural and regional settings while managing immigration of overseas-trained health professionals.

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An update on mental health services in Iraq

Psychiatric Bulletin ◽

10.1017/s0955603600003640 ◽

2003 ◽

Vol 27 (12) ◽

pp. 461-462

Author(s):

Riadh T. Abed

Keyword(s):

Mental Health ◽

Medical Education ◽

Health Services ◽

Medical School ◽

Health System ◽

Medical Schools ◽

Medical Graduates ◽

Iraqi Kurdistan ◽

British System ◽

Set Up

In the 1970s, Iraq made strides towards building a comprehensive, well-equipped health system free at the point of delivery. Medical education in Iraq was originally modelled on the British system and started with Baghdad Medical School in 1927. Two more medical schools were founded in Mosul and Basrah, providing Iraq with good numbers of high-calibre medical graduates. After 1968, several other medical schools were set up in various parts of Iraq, including three in Iraqi Kurdistan.

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