IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0234620.html
   My bibliography  Save this article

To stay or go? Unpacking the decision-making process and coping strategies of International Medical Graduates practising in rural, remote, and regional Queensland, Australia

Author

Listed:
  • Bunmi S Malau-Aduli
  • Amy M Smith
  • Louise Young
  • Tarun Sen Gupta
  • Richard Hays

Abstract

Australia is one of many countries to rely on International Medical Graduates (IMGs) to fill general practitioner (GP) positions throughout its regional, rural, and remote (RRR) communities. Current government initiatives requiring IMGs to work for specified periods in RRR areas offer only short-term solutions. The need to improve the long-term retention of IMGs practising in RRR areas has motivated this research to improve our understanding of how IMGs make decisions about where to practise. Specifically, this study sought to: (a) identify the factors that influence an IMG’s decision to remain working in RRR areas, and (b) develop a theory, grounded in the data, to explain how these factors are prioritised, evaluated and used to inform a decision to remain working in RRR areas. This study adopted a qualitative approach and employed grounded theory methods. Data collection and analysis occurred concurrently, using constant, comparative analysis, guided by theoretical sampling and data saturation. Data sources were transcripts from semi-structured interviews with IMG registrars (n = 20) and supervisors (n = 5), interviewers’ notes and analytic memos. Interviewees were all currently working in RRR areas of Queensland, Australia. The analysis involved a three-phase coding process, progressing from specific, inductive coding to abstract, abductive coding. The analysis revealed that the IMG decision-making process involves a complex, dynamic, and iterative process of balancing life goals based on life stage. Many factors are considered when assessing the balance of three main life goals: satisfaction with work, family, and lifestyle. The prioritisation and balance of these life goals can vary as the IMG moves through varying work-, family-, and age-related life stages. It is hoped that having this understanding of the complexity of the IMG decision-making process, will better equip medical educators, policy makers and support service providers to tailor services to encourage IMGs to continue practising in these regions.

Suggested Citation

  • Bunmi S Malau-Aduli & Amy M Smith & Louise Young & Tarun Sen Gupta & Richard Hays, 2020. "To stay or go? Unpacking the decision-making process and coping strategies of International Medical Graduates practising in rural, remote, and regional Queensland, Australia," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-20, June.
  • Handle: RePEc:plo:pone00:0234620
    DOI: 10.1371/journal.pone.0234620
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0234620
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0234620&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0234620?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Li, Jinhu & Scott, Anthony & McGrail, Matthew & Humphreys, John & Witt, Julia, 2014. "Retaining rural doctors: Doctors' preferences for rural medical workforce incentives," Social Science & Medicine, Elsevier, vol. 121(C), pages 56-64.
    2. Mu, Chunzhou, 2015. "The age profile of the location decision of Australian general practitioners," Social Science & Medicine, Elsevier, vol. 142(C), pages 183-193.
    3. McGrail, Matthew R. & Humphreys, John S. & Joyce, Catherine M. & Scott, Anthony, 2012. "International medical graduates mandated to practise in rural Australia are highly unsatisfied: Results from a national survey of doctors," Health Policy, Elsevier, vol. 108(2), pages 133-139.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Feder-Bubis, Paula & Bin-Nun, Gabi & Zarhin, Dana & Sherf, Michael & Heiman-Neuman, Nitza, 2023. "Residents' choice of a placement in periphery hospitals in Israel: The significance of personal/family and professional considerations," Health Policy, Elsevier, vol. 132(C).
    2. Thai, Thao & Lancsar, Emily & Spinks, Jean & Freeman, Christopher & Chen, Gang, 2024. "Understanding Australian pharmacy degree holders’ job preferences through the lens of motivation-hygiene theory," Social Science & Medicine, Elsevier, vol. 348(C).
    3. Swami, Megha & Scott, Anthony, 2021. "Impact of rural workforce incentives on access to GP services in underserved areas: Evidence from a natural experiment," Social Science & Medicine, Elsevier, vol. 281(C).
    4. Pedro Ramos & Hélio Alves & Paulo Guimarães & Maria A. Ferreira, 2017. "Junior doctors’ medical specialty and practice location choice: simulating policies to overcome regional inequalities," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(8), pages 1013-1030, November.
    5. Flier, Jeffrey & Rhoads, Jared, 2018. "The US Health Provider Workforce: Determinants and Potential Paths to Enhancement," Working Papers 07662, George Mason University, Mercatus Center.
    6. Yong, Jongsay & Scott, Anthony & Gravelle, Hugh & Sivey, Peter & McGrail, Matthew, 2018. "Do rural incentives payments affect entries and exits of general practitioners?," Social Science & Medicine, Elsevier, vol. 214(C), pages 197-205.
    7. Hadley, Ashley, 2024. "Migration and professional mobility: Rural attraction and retention of South African educated physicians," Social Science & Medicine, Elsevier, vol. 350(C).
    8. Gregory Merlo & Mieke Driel & Lisa Hall, 2020. "Systematic review and validity assessment of methods used in discrete choice experiments of primary healthcare professionals," Health Economics Review, Springer, vol. 10(1), pages 1-9, December.
    9. Chevillard, Guillaume & Mousquès, Julien & Lucas-Gabrielli, Véronique & Rican, Stéphane, 2019. "Has the diffusion of primary care teams in France improved attraction and retention of general practitioners in rural areas?," Health Policy, Elsevier, vol. 123(5), pages 508-515.
    10. Domino Determann & Dorte Gyrd-Hansen & G. Ardine de Wit & Esther W. de Bekker-Grob & Ewout W. Steyerberg & Mattijs S. Lambooij & Line Bjørnskov Pedersen, 2019. "Designing Unforced Choice Experiments to Inform Health Care Decision Making: Implications of Using Opt-Out, Neither, or Status Quo Alternatives in Discrete Choice Experiments," Medical Decision Making, , vol. 39(6), pages 681-692, August.
    11. Pedersen, Line Bjørnskov & Mørkbak, Morten Raun & Scarpa, Riccardo, 2020. "Handling resolvable uncertainty from incomplete scenarios in future doctors' job choice – Probabilities vs discrete choices," Journal of choice modelling, Elsevier, vol. 34(C).
    12. Laetitia Charmaine Rispel & Prudence Ditlopo & Janine Anthea White & Duane Blaauw, 2019. "Socio-economic characteristics and career intentions of the WiSDOM health professional cohort in South Africa," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-19, October.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0234620. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.