$13.4 million for rural health scholarships – will it make a difference?

In the 2014-2015 federal budget, the government announced an extra $13.4 million for rural nursing and allied health scholarships for 500 students, in a bid to address workforce shortages in rural and remote areas. But is there evidence that says such scholarships will actually be effective in achieving this?

To be honest, an online search has not revealed much data on this…. but from what was revealed…. It didn’t look too promising……

The Health Department talks of the government establishing a network of Rural Clinical Schools (RCS) and University Departments of Rural Health (UDRH) in the 1990s, with the programs increasing the number and length of time health professional students spend in rural clinical placements.

Willis et al talk about the cost of a rural placement being a burden to students due to transport and accommodation. Programs such as the John Flynn Placement Program, which commenced for medical students in 1997, sees the cost of rural placements covered for 300 students each year.

Research by Courtney et al does support the theory that exposure to rural clinical experience can have a positive influence of these students being recruited to rural areas on graduation in the case of nursing students. Analysis of pre and post test data found a 12% increase in the number of students intending to seek employment in a rural setting, compared to a 5% increase in students who undertook a metropolitan placement.

Following the Grattan Institute (aka the Mason review) report reviewing Australian government health workforce programs, the Medical Rural Bonded Scholarship (MRBS) was continued in 2014 at the last minute, but would appear to be on shaky ground for 2015. The Mason review recommended that the MRBS be phased out as there was no solid evidence to suggest that students with a MRBS were going on to be rural doctors. It favoured the RAMUS Scheme, which assists students from a rural background to study medicine.

The Australian College of Rural and Remote Medicine responded to the Grattan Institute report by saying it had missed the mark with respect to GP services for the bush:

“The solutions for the rural medical workforce are not complicated: get the right mix of people into medical school and rural clinical schools, pick the promising rural GPs early, line up graduate jobs and any return of service, deliver quality seamless training that is based in the regions and provide inspiration, advice and support along the path to rural practice.”

A study by Devine et al published in October 2013, Rural Allied Health Scholarships: do they make a difference? recognised that a number of strategies had put in place to address the rural and remote health workforce shortage in Australia. It looked at the outcomes from the Queensland Health Rural Scholarship Scheme (QHRSS) between 2000 and 2010, and showed that 13.7% of the scholarship holders broke their service bond, and 45.2% had an outstanding commitment to the scholarship at the time of the data being collected as they were still studying or had deferred their service obligations. The study found that 56.8% of QRHSS holders’ initial graduate positions were in a rural or remote location. Queensland Health has withdrawn its scholarship program until further notice.

The Devine et al study suggested that support structures for scholarship holders to ensure that they are work-ready for the
clinical challenges in rural and remote areas, as well as support beyond the workplace in areas such as accommodation and social networking may improve the system for graduates entering the rural workforce.

While an extra $13.4 million in scholarships to assist in building the rural and remote workforce sounds like a great idea, obviously there is more to it than just throwing money at students. I’d love to get some comments from some rural workforce experts on how the government should spend the $13.4 million to get some real results for rural and remote Australians.

Click here for the Urbis report detailing the background to the Department of Health’s previous policies. Click here for a list of the government’s health workforce programs from 2012-2013.

Click here to go to My Health Career’s page on scholarship opportunities for health courses.

Amanda – Founder My Health Career :)

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