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There is a significant shortage of doctors in regional and rural areas around the world and this is particularly evident in New Zealand (NZ). Currently in NZ there is a particular shortage of rural general practitioners (GPs) and in this sector an ongoing loss of doctors exists. This exodus is evidenced by a recent workforce survey, which showed that 34% of rural GPs were intending to leave their rural practice within 5 years.1
Currently, 38 rural GPs in NZ are working with doctor/patient ratios of over 1:2000, which is above the 'alert' level set by the Ministry of Health.2 It is also expected that with the aging rural population and the feminisation of the medical workforce, a significantly larger number of doctors will be needed to replace the full-time (mainly male) doctors that are leaving rural practice. In NZ, female doctors work, on average, 8 hours fewer per week than their male counterparts.3
At present only 43% of rural GPs are NZ trained1 emphasising the strong reliance on overseas-trained doctors and the lack of NZ graduates choosing rural medicine. As global medical workforce shortages increase, it is difficult to see this situation improving in the absence of targeted action.
There are limited data on the number of specialists working in rural hospitals but Nixon et al4 stated that of the 120 doctors working in rural hospitals around NZ, almost all were either general practitioners or Medical Officers of Special Scale (MOSSs--experienced doctors who are not members of a specialist college),with only a very small number being surgeons, physicians, or emergency medicine physicians. Regional base hospitals are also particularly vulnerable to staffing changes and workforce shortages.
To address the shortage of rural doctors, the NZ Ministry of Health recommended changes in their Primary Health Care Strategy,2 including:
* Providing training places for students of rural origin, on the grounds they are more likely to return to rural areas;
* Encouraging the Schools of Medicine to move core curricula into rural practices.
Medical schools around the world have tried to tackle the rural workforce shortage by introducing rural-orientated curricula including rural attachments, and/or admitting students from a rural background. In 2000, the University of Otago's Dunedin School of Medicine introduced a 7-week rural placement for their 5th...