• Andrew Bonney, Judy Mullan, Athena Hammond, Pippa Burns, Georgia Yeo, Brett Thomson, Sharon Flynn, and Tom Carrigan.
• School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia.
• Aust J Rural Health. 2019 Dec 1; 27 (6): 476-481.

ObjectiveIncreased exposure to post-graduate rural medical training is associated with increased likelihood of future rural practice. Training rotations in rural emergency departments provide a possible avenue for such exposure, but have been under-investigated. This study aimed to compare junior medical officers' emergency department experiences in a metropolitan and a rural hospital to inform rural health workforce initiatives.DesignMixed-method case-study design.SettingTwo 10-week periods in the respective emergency departments.ParticipantsFour junior medical officers at the rural site and 22 junior medical officers at the metropolitan hospital.Main Outcome MeasuresCaseloads extracted from electronic medical records and training experience.ResultsData were collected over 142 days. The average number of patients seen per day, per junior medical officer, was significantly higher at the rural hospital emergency department (7.2 patients per day) in comparison with the metropolitan hospital (4.3 patients per day). Junior medical officers at the rural hospital saw relatively more lower acuity patients. The seven junior medical officers who were interviewed provided consistently positive responses regarding their training experiences in both locations. This was particularly evident in the rural hospital and was attributed to one-on-one supervision.ConclusionsMost junior medical officers agreed that their expectations for support and learning opportunities were met and/or exceeded. However, junior medical officers reported feeling more supported at the rural hospital due to direct contact and communication with senior medical officers. Placement in a smaller hospital emergency department did not disadvantage the junior medical officers' training in this case-study and provided a positive rural training experience. These findings support workforce policies which encourage rural hospital emergency department training.© 2019 National Rural Health Alliance Ltd.

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