Evaluating the impact of the Adelaide Rural Clinical School longitudinal clinical placement on the rural medical workforce: A retrospective cohort study of graduates, 2004–2019

Abstract Objective To evaluate the contribution of the Adelaide Rural Clinical School (ARCS) longitudinal integrated clerkship to the rural medical workforce. Methods Design : Retrospective cohort study. Setting : Practice location data were sourced from the Australian Health Practitioner Regulation Agency (AHPRA, January 2021) and matched using university records. Participants : University of Adelaide medical school alumni graduating between 2004 and 2019 (ARCS alumni who completed a full year of rural training [ n = 423], metropolitan‐trained peers [ n = 1655]). Main outcome measures : The proportions of medical graduates working in a rural location (Modified Monash Model [MMM3‐7] or Australian Statistical Geography Standard [ASGS‐RA2‐5] classifications). Logistic regression was used to examine the association between ARCS training and working rurally, and the influence of rural background and sociodemographic factors. Results Working in a rural location was almost three times more frequent among ARCS alumni than their metropolitan‐trained peers, using the MMM3‐7 (14.7% vs. 5.3%) classification; for ASGS‐RA2‐5 classification (21.3% vs. 8.9%). In adjusted analysis, working rurally (MMM3‐7) was associated with having a rural/remote residence on enrolment (OR 8.29, 95% CI 4.22–16.26) and was 3.1 times more likely for ARCS alumni (OR 3.06, 95% CI 2.06–4.53) than their peers. The magnitude of the effects of ARCS training on whether they are working rurally was similar among those with metropolitan or rural background ( p ‐value for interaction 0.873). Similar associations were observed using ASGS‐RA2‐5 classifications. Conclusions Extended rural placements through the Adelaide Rural Clinical School increased the rural medical workforce, with a similar impact among those with a rural or metropolitan background.