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Adachi K, Hukamdad M, Raymundo A, Pearce C, Mehta AI. In-State Retention Rates of Female Neurosurgery Graduates. World Neurosurg 2024; 188:e155-e162. [PMID: 38762024 DOI: 10.1016/j.wneu.2024.05.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 05/13/2024] [Indexed: 05/20/2024]
Abstract
OBJECTIVE We sought to determine the rate of retaining female neurosurgery graduates in the same states as their medical education and identify medical school and state characteristics associated with high retention rates. METHODS Database from the Centers for Medicare & Medicaid Services was used to extract female physicians indicating "neurosurgery" as their specialty. The top 25 medical schools with the highest number of female neurosurgery graduates were selected. Descriptive analysis was used to determine the retention rate of female neurosurgery graduates. Univariable and multivariable analyses were used to identify medical school and state characteristics associated with high retention rates. RESULTS Medical schools with the highest retention rate included the University of California, San Francisco (60%), the University of Alabama (60%), and the University of Pennsylvania (60%). Univariable and multivariable analysis showed the number of female neurosurgery attendings (β = 0.036, 95% confidence interval [CI] = 0.003 to 0.070, P = 0.04 and β = 0.036, CI = 0.001 to 0.071, P = 0.04.) and the healthcare employment rate (β = 0.098, CI = 0.011 to 0.186, P = 0.03 and β = 0.117, CI = 0.021 to 0.212, P = 0.02) to be positively associated with the retention rate of female neurosurgery graduates. CONCLUSIONS Retaining female neurosurgery graduates within a state is essential for addressing the physician shortage and gender inequality. To encourage female medical students to practice in the same state, medical schools and states should work collectively to improve the visibility of female neurosurgeons and increase employment opportunities.
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Affiliation(s)
- Kaho Adachi
- University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
| | - Mishaal Hukamdad
- University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
| | - Allison Raymundo
- University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
| | - Clairice Pearce
- University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
| | - Ankit I Mehta
- University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA; Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA.
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Connell CJW, Bagg W, Jo E, Poole P. Effects of a regional-rural immersion program in Northland, New Zealand, on returning to work in that region. Aust J Rural Health 2022; 30:666-675. [PMID: 35567770 PMCID: PMC9790617 DOI: 10.1111/ajr.12876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 03/22/2022] [Accepted: 04/06/2022] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION It is well established that rural workforce outcomes are more likely among medical graduates who spend time training in non-urban areas; however, fewer studies have assessed whether graduates are more likely to return to the specific area where they undertook rural training. OBJECTIVE This study aimed to determine whether graduates who had undertaken a regional-rural immersion program in Northland, NZ, were more likely to have returned to work in Northland as of mid-2021, relative to peers who did not participate. DESIGN This prospective cohort study used longitudinal tracking survey responses, medical school administrative data and workforce outcome information. A multinomial model, accounting for other covariates, was built to determine the association between graduates practising in Northland (population ⟨ 100 000), which encompasses both rural (population ⟨ 25 000) and regional (25 000 ⟩ population ⟨ 100 000) areas, and having participated in a Northland-based immersion program during medical school. The study population was University of Auckland domestic medical students graduating between 2009 and 2018, inclusive. Immersion program participants who responded to longitudinal career tracking surveys were included in the study sample. FINDINGS The final sample size was 1320 students (80% of population of interest). Graduates who undertook the Northland immersion program (n = 169) were more likely than non-participants (n = 1151) to be working in Northland as of 2020-2021 (relative risk: 3.2). DISCUSSION AND CONCLUSION Regional-rural immersion programs might preferentially build workforces in that specific region; however, further research is required to understand whether these findings are generalizable, and the main reasons for this effect.
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Affiliation(s)
| | - Warwick Bagg
- Department of Medicine, School of MedicineThe University of AucklandAucklandNew Zealand
| | - Emmanuel Jo
- Department of Medicine, School of MedicineThe University of AucklandAucklandNew Zealand,Analytics and Intelligence SectionHealth Workforce, Ministry of HealthWellingtonNew Zealand
| | - Phillippa Poole
- Department of Medicine, School of MedicineThe University of AucklandAucklandNew Zealand
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Malau-Aduli BS, Jones K, Alele F, Adu MD, Drovandi A, Knott G, Young L, Jo C. Readiness to enter the workforce: perceptions of health professions students at a regional Australian university. BMC MEDICAL EDUCATION 2022; 22:89. [PMID: 35139831 PMCID: PMC8827198 DOI: 10.1186/s12909-022-03120-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Perceived readiness for practice can help mitigate the stress and uncertainty associated with transitioning from university into the workforce. This study aimed to identify factors influencing the readiness for clinical practice among final-year medical, dental, and pharmacy students at an Australian regional university. METHODS The study utilised a sequential explanatory mixed-methods approach with surveys administered for the quantitative phase and interviews/focus groups for the qualitative phase. Descriptive statistics and inductive thematic analysis were utilised for the quantitative and qualitative data, respectively. Triangulation of findings from both phases facilitated in-depth understanding of the factors that influenced participants' self-perceived readiness for clinical practice. RESULTS From the three disciplines, 132 students completed the survey and 14 participated in the focus groups and interviews. Students felt most prepared in their patient-centred capabilities, core skills, and advanced consultation skills, and least prepared in their system-related capabilities and clinical care skills. Themes identified as essential enablers and confidence builders in relation to workforce readiness in all three disciplines were: gained knowledge and skills, value of clinical placement experiences, support from peers, family and staff. However, students felt their work-readiness was impaired by heavy academic workloads and poor knowledge of health care systems, which affected skills development. Participants suggested additional support in health care system and clinical governance, mental healthcare, and induction to placement sites to further improve their work readiness. CONCLUSIONS The findings of this study suggest that improving work-readiness of healthcare students requires alignment of learning needs to real-world practice opportunities, ensuring support systems are appropriate, and early familiarisation with the healthcare system.
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Affiliation(s)
- Bunmi S Malau-Aduli
- College of Medicine and Dentistry, James Cook University, QLD 4811, Townsville, Queensland, Australia.
| | - Karina Jones
- College of Medicine and Dentistry, James Cook University, QLD 4811, Townsville, Queensland, Australia
| | - Faith Alele
- College of Medicine and Dentistry, James Cook University, QLD 4811, Townsville, Queensland, Australia
| | - Mary D Adu
- College of Medicine and Dentistry, James Cook University, QLD 4811, Townsville, Queensland, Australia
| | - Aaron Drovandi
- College of Medicine and Dentistry, James Cook University, QLD 4811, Townsville, Queensland, Australia
| | - Gillian Knott
- College of Medicine and Dentistry, James Cook University, QLD 4811, Townsville, Queensland, Australia
| | - Louise Young
- College of Medicine and Dentistry, James Cook University, QLD 4811, Townsville, Queensland, Australia
| | - Clara Jo
- College of Medicine and Dentistry, James Cook University, QLD 4811, Townsville, Queensland, Australia
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Poole P, Van Lier D, Verstappen A, Bagg W, Connell CJW, Nixon G, Wilkinson TJ. How rural is rural? The relationship between rural background of medical students and their career location intentions. Aust J Rural Health 2021; 29:363-372. [PMID: 34080758 DOI: 10.1111/ajr.12743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 02/18/2021] [Accepted: 03/02/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Rural background is associated with greater interest in rural practice. However, there is no universally agreed definition of 'rural' background used in medical school selection. This study explored the association between definitions of 'rural' background and students' intended career locations. DESIGN Prospective cohort study using survey data on career intention, hometown size, rurality of background, home address, high school and intended career location. SETTING University of Auckland, New Zealand (NZ). PARTICIPANTS Commencing medical students 2009-2017, inclusive. MAIN OUTCOME MEASURES Univariate associations between student background according to 7 definitions of 'rural', and 3 definitions of intended practice location based on population size: urban intention (>100 000); regional intention (25 000-100 000); rural intention (<25 000). RESULTS The sample size was 1592 students. 27.4% had a rural background by at least one definition. All definitions of rural background were associated with a greater rural intention. Applying a restrictive definition of rural (population<25 000) was associated with a higher likelihood of rural intention, but captured a smaller number of students. There was strong agreement between the population size of a student's background and intended practice location (chi-square P < .0001). CONCLUSION Rural intention varies by definition, but the number of students captured by each definition is important. Applying a binary or overly restrictive definition may limit interested students. Medical schools should adopt a definition of 'rural' that optimises the number of eligible students and their propensity to work rurally. Further, alternative ways of identifying students with rural intentions without a rural background should be explored.
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Affiliation(s)
- Phillippa Poole
- School of Medicine, University of Auckland, Auckland, New Zealand
| | - Dylan Van Lier
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Antonia Verstappen
- Centre for Medical and Health Sciences Education, University of Auckland, Auckland, New Zealand
| | - Warwick Bagg
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | | | - Garry Nixon
- Division of Health Sciences, University of Otago, Dunedin, New Zealand
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Woolley T, Ross S, Larkins S, Sen Gupta T, Whaleboat D. "We learnt it, then we lived it": Influencing medical students' intentions toward rural practice and generalist careers via a socially-accountable curriculum. MEDICAL TEACHER 2021; 43:93-100. [PMID: 33016806 DOI: 10.1080/0142159x.2020.1817879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The James Cook University (JCU) medical school has a mission to produce graduates committed to practising with underserved populations. This study explores the views of final-year students regarding the influence of the JCU medical curriculum on their self-reported commitment to socially-accountable practice, intentions for rural practice, and desired postgraduate training pathway. METHODS Cross-sectional survey of final year JCU medical students (n = 113; response rate = 65%) to determine whether their future career directions (intentions for future practice rurality and postgraduate specialty training pathway) are driven more by altruism (commitment to socially accountable practice/community service) or by financial reward and/or prestige. RESULTS Overall, 96% of responding students reported their JCU medical course experiences had cultivated a greater commitment towards 'socially-accountable' practice. A commitment to socially-accountable practice over financial reward and/or prestige was also significantly associated with preferring to practise Medicine in non-metropolitan areas (p = 0.036) and intending to choose a 'generalist' medical discipline (p = 0.003). CONCLUSIONS The findings suggest the JCU medical curriculum has positively influenced the commitment of its graduating students towards more socially accountable practice. This influence is a likely result of pre-clinical teachings around health inequalities and socially-accountable medical practice in combination with real-world, immersive experiences on rural and international placements.
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Affiliation(s)
- Torres Woolley
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
| | - Simone Ross
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
| | - Sarah Larkins
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
| | - Tarun Sen Gupta
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
| | - Donald Whaleboat
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
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Phelps D, Kelly D. A call for collaboration: linking local and non-local rangeland communities to build resilience. RANGELAND JOURNAL 2020. [DOI: 10.1071/rj20048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The people who live in Australia’s rangelands are vital for maintaining natural systems, agricultural production, infrastructure for tourism and many services and products which benefit the nation. However, the number of people living within many rangeland regions is declining, services are being withdrawn and resilience undermined. Social capital is an important concept within the resilience literature. Bonding social capital is based strong ties within relatively homogenous local groups, bridging social capital is based on ties between more diverse local groups and linking social capital is based on ties between local and external groups. Within the rangelands, there are often strong bonding and bridging social capitals based on internal social and formal connections, but gaps in linking social capital due to weak or imbalanced connections with external groups and organisations. There is evidence that all three social capitals are needed for regional resilience, and the gap in linking is thus a key issue. People who live outside the rangelands can help rebuild this resilience by linking their skills, knowledge and expertise with local groups and communities. Many city-based scientists, policy makers, influencers and other professionals work in and have empathy for the rangelands. By connecting meaningfully with local groups such as Landcare, service clubs, philanthropic groups or Indigenous Rangers, they would find many benefits to their own endeavours through improved policies, knowledge and service delivery. Central-western Queensland is provided as an example where many such mutual benefits and networks already exist, offering pathways for linking local residents with external experts. Current platforms offer opportunities for a greater range of external academic institutions and organisations to engage with locals, with everyone standing to gain.
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