Know your context
Recruitment and retention of rural doctors is influenced by personal factors such as rural background, career intent and service orientation. Rural training, rural curricular content, and rural student clinical rotations also influence retention of rural doctors.
ImplementabilityMedium hard to implement: may take some organizational change to implement.
- Diverse range of challenging clinical work; and the feeling of ‘making a difference’.
- Developing regional professional networks
- Engage local communities to help attract and retain rural professionals
- Provide access to universities in regional centers
- Increase access to CPD through travel subsidy, locum backfill and management support
- Invest in infrastructure and IT support for online education, and develop blended learning models to deliver CPD while also addressing professional isolation
- Enhancing opportunities for career progression appropriate to life stage
- Address workplace culture and provide stress management training & personal support to rural professionals
- Adopt public recognition measures (rural health days, awards etc. to lift the profile of working in rural and remote areas)
Success factors
Community engagement and personal relationships are powerful motivators for retention. Many professionals either grew up rurally or were attracted to a rural lifestyle, and those who are parents also felt that it was a good place to raise their children.
Challenges
While personal factors are not modifiable, communities can nevertheless play a role in attracting health workers by promoting their region, developing economic and educational infrastructure and fostering culture that supports these values.
Lack of employment opportunities for spouses; perceived inadequate quality of secondary schools; age related issues (retirement, desire for younger peer social interaction, and intention to travel); limited opportunity for career advancement; unmanageable workloads; and inadequate access to Continuous Professional Development. CPD is not just to refresh skills but for professional stimulation.
‘Push’ factors in the personal domain included insufficient community infrastructure such as transportation, secondary schools, access to shops and jobs for spouses. Access to adequate accommodation was also a concern in more remote regions.
Doctor
Nurse
Engagement of communities in defining their recruitment and retention strategy is essential to the development of partnerships that will make the entire suite of interventions work. Having communities involved in defining the approach that will be used in their community ensures that solutions are feasible in their specific environment, and that community members are more likely to sustain them.
Ensuring that the new employee and their family is made to feel welcome in the community, and supported to become integrated in community recreation and other activities, is a key factor in ensuring a positive start and long stay in the community. This can mean involving community partners in meeting with the new recruits and their families, giving tours of the town, health services, and schools to ensure they are able to register in recreational and other programs.
Another important support that is often thought to be too complex to address is spousal employment. Lack of work opportunities for spouses is known to be a key barrier in the recruitment of professionals to rural locations. Dedicating resources to assisting spouses to learn about work opportunities is a good start to addressing this barrier.
Chisholm, M., Russell, D., & Humphreys, J. (2011). Measuring rural allied health workforce turnover and retention: What are the patterns, determinants and costs?. Australian Journal Of Rural Health, 19(2), 81-88. doi:10.1111/j.1440-1584.2011.01188.x