James Cook University MBBS graduate intentions and intern destinations: a comparative study with other Queensland and Australian medical schools.

INTRODUCTION Since 1999 the number of medical school places in Australia has increased substantially in response to workforce shortages, with some of the increased capacity in regional and rural communities. The James Cook University (JCU) School of Medicine, the first of a number of new medical schools, was established with a mission to address the health needs of rural, remote and tropical Australia through aligning student selection, curriculum and assessment practices to encourage generalist postgraduate careers needed in rural and regional areas. This article reports early evidence on the career outcomes of graduates in the first six cohorts from 2005 to 2010, and compares this with available data from other Queensland and Australian medical schools. METHODS Data were gathered from two sources to allow comparisons of career intentions and intern allocations of graduates from JCU with those from other Australian medical schools. An exit survey of JCU graduates provided JCU student data while the Medical Students Outcomes Database provided comparable data for eight other, largely metropolitan, schools. RESULTS At graduation, 88% of JCU medical students intended to practise outside Australian capital cities compared with 31% of graduates from other medical schools (odds ratio [OR]: 16.5). More JCU medical graduates than others planned to work in rural towns or regional centres with a population of less than 100 000 (46% compared with 16% for the rest of Australia; OR: 4.6). Sixty-seven percent of JCU graduates undertook their internship outside a metropolitan centre compared with 17% of others (OR: 10.0), and 47% in outer regional centres compared with 5% (OR: 16.6), respectively. Medical graduates from JCU were more likely to prefer general practice as a career (OR: 1.5), particularly rural medicine (OR 2.5), but otherwise had similar preferences to others. Interest in 'working in a rural area' increased over the course duration from 68% at entry to 76% at graduation. CONCLUSION While further follow up is needed to track career progression over a longer time, the data so far suggest that the career outcomes of JCU medical graduates are aligned with the workforce needs of the region, and different from those graduating from Australia's predominantly metropolitan medical schools, as predicted by the program's design.