Factors associated with Australian female doctors' long term, as opposed to short term, rural Family Medicine work

Abstract

Objective: In light of current debate around securing and distributing the General Practitioner (GP) workforce in Australia, we analysed rural health workforce data to identify characteristics associated with long-term tenure for rural female GPs, an importantly lacking part of the rural workforce in Australia.

Methods: In this cohort study, 555 currently practicing rural female GPs with long, versus short, rural work histories were surveyed annually. Their data were compared.

Results: In logistic regression, as expected the factors associated with 7+ years (long-term) versus <7 years (short-term) rural work were: being older (odds ratio [OR] 6.18, 95% confidence interval [CI] 1.16, 13.0, P < 0.001); being an Australian resident (OR 4.64, 95% CI 2.17, 9.91, P < 0.001); having a practice teaching commitment (OR 3.55, 95% CI 1.67, 7.55, P = 0.001); having multiple children (OR 2.19, 95% CI 1.23, 3.88, P = 0.008); rural health club experience as a medical student (OR 5.23, 95% CI 1.11, 23.86, P = 0.033); and, marginally, being rurally experienced as an undergraduate through the Rural Clinical School programme (OR 8.89, 95% CI 0.921, 85.75, P = 0.059) and having a rural background spouse (OR 1.20, 95% CI 0.94, 4.21, P = 0.070).

Conclusion: The factors involved in long-term rural work for female GPs include a longitudinal set from medical school into postgraduate practice life, some based on Australian government policy initiatives and others on lifestyle choices. These factors should be considered in providing a clinically mature female GP workforce to rural populations.

Keywords: gender; graduate medical education/fellowship training; primary care; rural health; underserved populations (e.g. underinsured, minorities); women in Family Medicine.