Exploring Doctors’ Emerging Commitment to Rural and General Practice Roles over Their Early Career

Producing enough doctors working in general practice or rural locations, or both, remains a key global policy focus. However, there is a lack of evidence about doctors’ emerging commitment to these decisions. This study aimed to explore changes in the level of certainty about career interest in working in general practice and working rurally, as doctors pass through various early career stages. The participants were 775 eligible respondents to a 2019 survey of medical graduates of The University of Queensland from 2002–2018. Certainty levels of specialty choice were similar between GPs and specialists up until the beginning of registrar training. At that point, 65% of GPs compared with 80% of other specialists had strong certainty of their specialty field. Consistently (and significantly) less of those working rurally had strong certainty of the location where they wanted to practice medicine at each career time point. At the start of registrar training, a similar gap remained (strong certainty: 51% rural versus 63% metropolitan). This study provides new evidence that career intent certainty is more delayed for the cohort choosing general practice and rural practice than the other options. The low level of certainty in early career highlights the importance of regular positive experiences that help to promote the uptake of general practice and rural practice.

Exploring preference for, and uptake of, rural medical internships, a key issue for supporting rural training pathways

Background Improved medical care access for rural populations continues to be a major concern. There remains little published evidence about postgraduate rural pathways of junior doctors, which may have strong implications for a long-term skilled rural workforce. This exploratory study describes and compares preferences for, and uptake of, rural internships by new domestic and international graduates of Victorian medical schools during a period of rural internship position expansion. Methods We used administrative data of all new Victorian medical graduates’ location preference and accepted location of internship positions for 2013–16. Associations between preferred internship location and accepted internship position were explored including by rurality and year. Moreover, data were stratified between ‘domestic graduates’ (Australian and New Zealand citizens or permanent residents) and ‘international graduates’ (temporary residents who graduated from an Australian university). Results Across 2013–16, there were 4562 applicants who filled 3130 internship positions (46% oversubscribed). Domestic graduates filled most (69.7%, 457/656) rural internship positions, but significantly less than metropolitan positions (92.2%, p < 0.001). Only 20.1% (551/2737) included a rural location in their top five preferences, less than for international graduates (34.4%, p < 0.001). A greater proportion of rural compared with metropolitan interns accepted a position not in their top five preferences (36.1% versus 7.4%, p < 0.001). The proportion nominating a rural location in their preference list increased across 2013–2016. Conclusions The preferences for, and uptake of, rural internship positions by domestic graduates is sub-optimal for growing a rural workforce from local graduates. Current actions that have increased the number of rural positions are unlikely to be sufficient as a stand-alone intervention, thus regional areas must rely on international graduates. Strategies are needed to increase the attractiveness of rural internships for domestic students so that more graduates from rural undergraduate medical training are retained rurally. Further research could explore whether the uptake of rural internships is facilitated by aligning these positions with protected opportunities to continue vocational training in regionally-based or metropolitan fellowships. Increased understanding is needed of the factors impacting work location decisions of junior doctors, particularly those with some rural career intent.

Teacher Stress and Social Support Usage

In this paper, we explore how the frequency of utilization of social supports is related to teacherdemographics, stress factors, job satisfaction, career intent, career commitment, and theperception of a stigma attached to teacher stress. Using data from self-report questionnaires(N= 264) from teachers in northern Ontario, we found that teachers seldom spoke to their healthcare providers about stress and instead utilized family, friends, fellow teachers, and sometimestheir principals. The frequency of which teachers accessed different social support networks didvary depending on stressor (workload, student behaviour, professional relationships, societalattitudes, and employment conditions). Teachers who frequently talked to their friends aboutstress had a lower sense of career intent and career commitment. Males were less likely to talkto their various social supports about stress. This study adds to the literature by exploring thefrequency of contact with and usage of social supports and their impact on teacher stress andperspectives on teaching.

Need for Power Predicts Career Intent in University Students

Previous research has indicated robust relationships between implicit motives and various indices of career preference and performance, with the implicit need for power ( nPow) and the implicit need for achievement ( nAch) found to associate with leadership and entrepreneurship, respectively. However, relatively little work has examined the relationships between implicit motivation and career intention. In the present study, 149 university students completed questionnaires assessing their intention to embark on entrepreneurial, professional, or leadership careers, while implicit motivation was measured using the picture story exercise. nPow was found to positively predict entrepreneurial intent and to negatively predict professional intent, while higher nPow was positively associated with both entrepreneurial and leadership career choice. nAch did not associate significantly with any of the intent or choice measures. These results tentatively suggest a previously undocumented relationship between nPow and entrepreneurial ambition, and possible differences in the motivational profiles of aspiring and actual entrepreneurs.