Longlook: initial outcomes of a longitudinal integrated rural clinical placement program

Abstract

Objective: To assess outcomes in terms of academic performance and subsequent career choice in medical students undertaking a longitudinal integrated rural clinical placement. Design: This was a retrospective, observational, cohort study. Setting: The ‘Longlook’ program is a longitudinal integrated rural clinical placement run collaboratively by Griffith University, Queensland Rural Medical Education and Queensland Health as part of the Griffith medical program. Participants: Participants in this study were students completing years 3 and 4 in the Griffith medical program between 2010 and 2013. Assessment data were available for 683 participants, and internship location was available for all 472 students allocated within Queensland (87% of graduated students). Interventions: Introduction of Longlook program. Main outcome measures: The primary outcome measures were performance in overall and clinical assessments, and intern location (rural versus urban). Results: When performance in prior year was taken into account, there were no statistically significant differences in academic performance in year 3 or 4 for rural and urban students. Of Longlook students who have graduated, 31/46 (67%) have undertaken internship at a rural location compared with 63/426 (15%) for urban hospital-based students (odds ratio 11.91; 95% confidence interval 6.08–23.32). Conclusions: We have demonstrated that it is feasible to implement a parallel longitudinal integrated rural clinical placement in an established conventional postgraduate medical program and provide similar learning outcomes. Initial findings suggest that this experience is translating into positive outcomes in terms of future careers in rural settings. There is a need to reappraise the structure of initiatives aimed at promoting rural careers in medicine.