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Beyond rural clinical schools to “by rural, in rural, for rural”: immersive community engaged rural education and training pathways

Roger P Strasser
Med J Aust 2022; 216 (11): . || doi: 10.5694/mja2.51525
Published online: 20 June 2022

Cradle‐to‐grave regional programs featuring immersive community engaged education are needed to ensure a sustainable rural medical workforce

In this issue of the MJA, Seal and colleagues1 report a multi‐university investigation that found that extended rural clinical school (RCS) placements have a positive impact on rural workforce recruitment and the retention of both rural and metropolitan origin medical graduates. The authors examined the practice locations of medical graduates, as listed in the Australian Health Practitioner Regulation Agency (AHPRA) register, five and eight years after graduation; many doctors were probably still registrars in training locations five years after graduation. The authors considered a limited range of variables in their study, and did not adjust their analyses for registrars who had received bonded or other scholarships, nor for factors such as incentives to relocate and employment opportunities for partners. Nevertheless, there is merit in their conclusion that their “findings reinforce the importance of longitudinal rural and regional training pathways, and the role of RCSs, regional training hubs, and the rural generalist training program in coordinating these initiatives.”1


  • 1 Northern Ontario School of Medicine University, Sudbury, ON, Canada
  • 2 Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand


Correspondence: roger.strasser@nosm.ca

Competing interests:

No relevant disclosures.

  • 1. Seal AN, Playford D, McGrail MR, et al. Influence of rural clinical school experience and rural origin on practising in rural communities five and eight years after graduation. Med J Aust 2022; 216: 572‐577.
  • 2. Australian Department of Health. National medical workforce strategy 2021–2031. 2021. https://www.health.gov.au/resources/publications/national‐medical‐workforce‐strategy‐2021‐2031 (viewed Apr 2022).
  • 3. Strasser R. Will Australia have a fit‐for‐purpose medical workforce in 2025? Med J Aust 2018; 208: 198‐199. https://www.mja.com.au/journal/2018/208/5/will‐australia‐have‐fit‐purpose‐medical‐workforce‐2025
  • 4. Strasser R, Strasser S. Reimagining primary health care workforce in rural and underserved settings [discussion paper: Health, Nutrition, and Population Global Practice of the World Bank]. Aug 2020. https://openknowledge.worldbank.org/handle/10986/34906 (viewed Apr 2022).
  • 5. Strasser R. Immersive community engaged education: more community engaged learning than work‐integrated learning. In: Pretti J, Stirling A (ed). The practice of co‐op and work‐integrated learning in the Canadian context. Canada: World Association for Co‐op and Work‐Integrated Education (WACE), Co‐operative Education and Work‐Integrated Learning (CEWIL), 2021; pp. 72‐81.
  • 6. Worley P, Couper I, Strasser R, et al; CLIC Research Collaborative. A typology of longitudinal integrated clerkships. Med Educ 2016; 50: 922‐932.
  • 7. Strasser R. Students learning medicine in general practice in Canada and Australia. Aust Fam Physician 2016; 45: 22‐25.
  • 8. Strasser R, Worley P, Cristobal F, et al. Putting communities in the driver’s seat: the realities of community engaged medical education. Acad Med 2015; 90: 1466‐1470.
  • 9. Strasser R. Recruiting and retaining a rural medical workforce: the value of active community participation. Med J Aust 2017; 207: 154‐158. https://www.mja.com.au/journal/2017/207/4/recruiting‐and‐retaining‐rural‐medical‐workforce‐value‐active‐community
  • 10. Abelsen B, Strasser R, Heaney D, et al. Plan, recruit, retain: a framework for local healthcare organizations to achieve a stable remote rural workforce. Hum Res Health 2020; 18: 63.

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