Abstract：
INTRODUCTION:Early postgraduate, or junior doctors, are still required to practise in rural and remote communities, and they continue to face numerous issues and difficulties. Within the hospital setting, exposure to rural practice appears to be very limited during internship, and also to some extent, during the second postgraduate year and beyond. This is a major issue for those required to undertake country relieving, rural terms or who will be bonded to rural and remote practice for several years after internship. This research investigated the current issues and difficulties faced by junior doctors, required to undertake rural and remote practice in Queensland, Australia. METHODS:An exploratory study was undertaken. Primary data were collected through semi-structured interviews held with key stakeholders. Stakeholders included: directors of clinical training; medical educators; junior doctors; rural practitioners; academic rural practitioners; and medical administrators. Of the 23 people approached, a total of 19 agreed to be interviewed. The response rate was 82.6%. RESULTS:Similar to the issues identified in the literature, there are currently a number of barriers influencing the ability of junior doctors to practise competently and confidently when undertaking practice in rural and remote communities. Minimal clinical experience, lack of supervision and on-site support, inadequate orientation and uninformed expectations, limited access to relevant education, and the influence of isolation, results in an overall lack of preparation both professionally and personally. When asked, respondents supported the identification of core skills and knowledge, and integration of these and other issues affecting rural practice, into their hospital-based programs. Current hospital-based education and training programs were not adequately preparing junior doctors for rural and remote practice. It was commented that orientation and education, with a rural emphasis, could assist junior doctors in their preparation for country relieving, rural terms and longer placements. CONCLUSIONS:Data collected in this study have confirmed that junior doctors are still being sent to undertake country relieving in their second postgraduate year. Hence, the issues remain for junior doctors when undertaking practice in rural or remote communities, including country relievers and scholarship holders. Results from this study suggest that prior recommendations have not been fully implemented. A recommendation is that initiatives at the undergraduate level, including increasing rural exposure and integration of rural context into training, be further developed at the early postgraduate level. Core rural competencies should be identified and realistic preparation and support strategies put in place in the hospital setting. This will further the effort to prepare junior doctors for rural practice and minimise some of the barriers currently experienced.
journal_name
Rural Remote Healthjournal_title
Rural and remote healthauthors
Smith DMkeywords:
subject
Has Abstractpub_date
2005-10-01 00:00:00pages
348issue
4issn
1445-6354pii
348journal_volume
5pub_type
杂志文章abstract：INTRODUCTION:Many rural communities continue to experience an undersupply of primary care doctor services. While key professional factors relating to difficulties of recruitment and retention of rural primary care doctors are widely identified, less attention has been given to the role of community and place aspects on...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：10.22605/RRH3925
更新日期：2017-04-01 00:00:00
abstract：CONTEXT:Diabetes is a chronic long-term disease with an increasing incidence. There is a need to increase access to effective care and to ensure such care is delivered as locally as possible. The geographical spread of NHS Highland Scotland presents additional challenges to ensuring a skilled workforce given education ...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2013-01-01 00:00:00
abstract：INTRODUCTION:The Nurse Practitioner - Aged Care Models of Practice Initiative supported the roll-out of a range of nurse practitioner (NP) models of practice, across Australia. One of these models was a community-based clinic-located practice, situated in a remote tourist destination where there is no resident general ...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2016-04-01 00:00:00
abstract：INTRODUCTION:The environmental degradation following crude oil exploration in the Niger Delta has resulted in poverty for local rural dwellers. For those who are ill, if herbal treatments and/or self-medication with orthodox drugs are unsuccessful, the only alternative is expensive medical treatment in clinics. Surgica...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2011-01-01 00:00:00
abstract：INTRODUCTION:Farmers and farm workers have higher than expected rates of suicide and undetermined deaths in UK studies, and some rural areas of Scotland have higher than average male suicide rates. Firearm access seems to be an influencing factor in England and Wales. Type of farming, and farming social networks may al...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2006-01-01 00:00:00
abstract：INTRODUCTION:This paper reports on research to ascertain the views of general practitioners (GPs) practising in rural and remote areas of South Australia, on evidence-based medicine (EBM). It follows our previous paper that identified, through a literature search, the key issues in moving towards EBM in general practic...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2002-01-01 00:00:00
abstract：INTRODUCTION:In Nepal, a number of private sector medical schools have opened recently; although sufficient numbers of doctors are graduating there continues to be a doctor shortage in rural areas. This article analysed the rural doctor shortage in Nepal and reviewed the international literature for strategies that may...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2010-07-01 00:00:00
abstract：CONTEXT:Finding providers to work in the hospitals and clinics in the small towns of the USA is a significant struggle. In the traditional model, the primary care doctor sees patients in the inpatient setting in addition to a clinic practice. In the usual hospitalist model, providers specialize to work only in the inpa...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：10.22605/RRH4419
更新日期：2018-08-01 00:00:00
abstract：INTRODUCTION:Iran has a major land mine injury problem in its border areas. Mine injuries have a high mortality and morbidity, and the injuries generally occur in remote areas. Iran has a well developed system of rural health workers and clinics, covering most border areas. These have mainly had prevention, immunizatio...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2008-10-01 00:00:00
abstract：INTRODUCTION:Hokianga Hospital is a small rural hospital in the far north of New Zealand serving a predominantly Maori population of 6500. The hospital, an integral part of a comprehensive primary healthcare service, provides continuous acute in-hospital and emergency care. Point-of-care (POC) biochemistry has been ava...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：10.22605/RRH4934
更新日期：2019-04-01 00:00:00
abstract：INTRODUCTION:Prescription opioid (PO) misuse and related harms are high in Canada, and a major public health challenge. In Canada, 1.4 million individuals (4.3% of the total population) self-identify as Aboriginal, among whom substance use and related harms are elevated. While there are reports of PO use and associated...
journal_title：Rural and remote health
pub_type： 杂志文章,评审
doi：
更新日期：2016-10-01 00:00:00
abstract：INTRODUCTION:Behavioral determinants can enable or hinder motivation towards registration and donorship and, subsequently, action or inertia towards organ donation. Nevertheless, there is limited information about the role of self-efficacy in relation to organ donation awareness and presumed consent among individuals a...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：10.22605/RRH5241
更新日期：2019-10-01 00:00:00
abstract：INTRODUCTION:The burden of chronic diseases is rapidly increasing worldwide. In Australia rural populations have a greater burden of disease. Chronic diseases are largely preventable with diet as a key risk factor. With respect to diet-related chronic disease, dietary risk may be due to poor food access, namely, poor a...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2004-10-01 00:00:00
abstract：INTRODUCTION:The Australian Rural Clinical Schools, established nationally in 2000-2001, have provided an opportunity for medical students to undertake their clinical training across a network of hospitals, general practice surgeries and community medical centres in locations throughout Australia. The Rural Clinical Sc...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2006-01-01 00:00:00
abstract：INTRODUCTION:This article describes the use and effectiveness of the participatory action research (PAR) framework to better understand community members' perceptions and risks of pandemic influenza. In 2009, the H1N1 influenza pandemic affected Indigenous populations more than non-Indigenous populations in Oceania and...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2015-07-01 00:00:00
abstract：:FPA Health (Family Planning NSW) has conducted two integrated clinical and health promotion projects with Aboriginal communities in western NSW, Australia. The first was in Coonamble, a small rural community which had been selected as a pilot site for the Royal Australian College of General Practitioners Women's Abori...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2006-04-01 00:00:00
abstract：:Since the first case of the current pandemic (H1N1) 2009 virus reported to WHO on 24 April 2009 on the American continent, the virus has spread in 160 countries and territories. By mid-2009, there were 135,000 cases and 816 deaths recorded. Pandemic preparedness is not advanced in most developing countries. Effective ...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2009-07-01 00:00:00
abstract：:Domestic migrant workers were stranded far from home when India declared nationwide lockdown to combat the pandemic of novel coronavirus (COVID-19). A large number of these workers were left with no economic support, no food and in many cases nowhere to live. The pandemic posed a serious health threat to these people,...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：10.22605/RRH6186
更新日期：2020-11-01 00:00:00
abstract：INTRODUCTION:There has been much recent investment to improve the recruitment and retention of medical graduates in rural Australia. This paper describes the different outcomes of the strategies used at the James Cook University (JCU) medical school to improve the recruitment and retention of medical graduates in north...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2016-01-01 00:00:00
abstract：INTRODUCTION:Mental health literacy assists patients to recognize, manage and prevent emotional disorders such as depression. Depression literacy is a specific type that varies among populations; however, there is a paucity of research on the depression literacy of rural Americans. The purposes of this study were to ev...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2011-01-01 00:00:00
abstract：INTRODUCTION:Violence and injuries are under-reported in developing countries, especially during natural disasters such as floods. Compounding this, affected areas are isolated from the rest of the country. During 2007 Bangladesh experienced two consecutive floods which affected almost one-third of the country. The obj...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2010-01-01 00:00:00
abstract：:There are trends towards centralising hospital care within the NHS, for many excellent reasons. Yet this has a disproportionate impact upon those patients who live at a distance from their hospital, and this impact has not been well reported or researched, but studies have demonstrated that the utilisation of services...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2005-04-01 00:00:00
abstract：CONTEXT:Hypothyroidism is a significant cause of pericardial effusion. However, large pericardial effusions due to hypothyroidism are extremely rare. Hormone replacement therapy is the cornerstone of treatment for hypothyroidism and regular follow-up of patients after initiation of the therapy is indicated. Herein, the...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：10.22605/RRH4384
更新日期：2018-05-01 00:00:00
abstract：INTRODUCTION:The chronic diseases associated with overweight and obesity are major contributors to the excess disease burden of Aboriginal Australians. Surveillance of overweight and obesity is required to monitor these conditions, and to develop and evaluate interventions to improve health and wellbeing. Remote Aborig...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2012-01-01 00:00:00
abstract：INTRODUCTION:Although parents in developed market economies regard head lice infections (pediculosis) as a significant problem, health departments generally rate pediculosis as a low priority health issue, encouraging parents to manage and control it. But how well equipped and willing are parents to manage the infectio...
journal_title：Rural and remote health
pub_type： 杂志文章,多中心研究
doi：
更新日期：2007-07-01 00:00:00
abstract：CONTEXT:Diabetes mellitus is a healthcare burden in India. Seventy-four percent of India's population lives in rural areas with limited access to healthcare resources. Telemedicine can play a big role in screening people with diabetes at grassroots level. In the telescreening model, single field 45-degree photographs a...
journal_title：Rural and remote health
pub_type： 杂志文章,随机对照试验
doi：
更新日期：2014-01-01 00:00:00
abstract：:In 2001, it was estimated that 4.7 million South Africans were living with HIV/AIDS. Prevalence figures have risen steadily over the past 10 years in most African countries, and in only a few, like Uganda, does the epidemic show signs of waning. In Africa, the status of the obese has risen enormously. If you're fat, y...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2004-04-01 00:00:00
abstract：INTRODUCTION:The Papua New Guinea Department of Health monitors the performance of the health system using a computerised national health information system. This article draws on the recent evaluation of a national-wide donor-project community development initiative to highlight the problems of the lack of and disaggr...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2010-10-01 00:00:00
abstract：INTRODUCTION:Chronic conditions are a growing healthcare concern. People living in rural regions are particularly affected because many barriers exist to accessing services and supports. Peer support for chronic condition self-management, where people living with chronic conditions learn about how to care for themselve...
journal_title：Rural and remote health
pub_type： 杂志文章,评审
doi：
更新日期：2016-01-01 00:00:00
abstract：INTRODUCTION:Portions of Montgomery County, Virginia, are designated a Medically Underserved Area with a large portion of this population experiencing limited access to healthcare services. In September 2008, the Federal Bureau of Primary Care awarded the authors a planning grant to assess community need in Montgomery ...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2012-01-01 00:00:00
