Self-sufficiency in Intern Supply: The Impact of Expanded Medical Schools, Medical Places and Rural Clinical Schools in Queensland

Objective: The doctor shortage in Australia generally, and the rural shortage in particular, has led to an increase in medical schools, medical places and rural training. If effective, these strategies will first impact on the intern workforce. We studied the source of interns in Queensland. Methods: Analysis of number, source and location of interns by Rural, Remote and Metropolitan Area (RRMA) classification (an index of remoteness) from university and health department records (2003-2008). Odds ratios compared the likelihood of intern supply from Queensland universities and rural clinical schools. Results: Most interns in Queensland graduated from Queensland universities in 2007 (287 [72%]) and 2008 (344 [84%]). Proportions increased across all three RRMA groups from: 82% to 93% in RRMA1; 56% to 68% in RRMA2 and 67% to 79% in RRMA3. The University of Queensland (UQ) provides most interns in all RRMA locations including RRMA3, and this increased from 2007 (n = 33 [35%]) to 2008 (n = 57 [58%]). Interns from interstate decreased from 61 (15%) in 2007 to 40 (10%) in 2008. Interns from overseas fell from 53 (13%) in 2007 to 27 (7%) in 2008. Rural clinical schools compared with traditional urban-based schools were more likely to supply interns to RRMA3 than RRMA1 hospitals in 2007 (OR, 8.8; 95% CI, 4.6-16.7; P< 0.0001) and 2008 (OR, 6.5; 95% CI, 3.5-12.2; P< 0.0001). Conclusions: Queensland is close to self-sufficiency in intern supply and will achieve this in the next few years. Rural clinical schools are playing an important role in producing interns for RRMA3 hospitals. Due to its large cohort, UQ remains the major provider across all RRMA groups.