Gender equity at last: a national study of medical students considering a career in rural medicine.

BACKGROUND: The rural medical workforce internationally suffers from a significant imbalance between male- and female- identifying practitioners. Not only do male doctors outnumber female doctors, but additionally female doctors work fewer hours than their male counterparts. This has health implications for rural communities. In response, In Australia, Rural Clinical Schools (RCSs) are a national training strategy to increase the number of graduates entering the rural medical workforce. It has been observed that RCSs attract a greater number of female students than male students. However, the future work intentions of male versus female RCS students is not known. This paper therefore asked whether male and female RCS students have equivalent intent for future rural practice. METHODS: Participants were all students who attended RCSs from 2015 to 2017, who completed an exit survey that gathered data on demographic, experiential and intentional variables. Univariate analyses examined differences between the sexes. A multivariate model was constructed to determine the independent predictors for rural intention. RESULTS: There were 2017 respondents across the 3 years, of whom 937 identified as male, and 1138 identified as female. In univariate analysis, female-identifying students had significantly higher rural intention than male-identifying students. There were no other sex-based differences in age, rural background, overall perception of support, and overall excellence of clinical education whilst in RCS. However, in multivariate analysis, sex was not a significant predictor for rural work intention, whereas older age, rural background, and first preference for RCS were all predictive of increased rural intent, as expected from the literature. There were no differences between male and female students in their perceptions of the overall support and the clinical education provided by RCS. CONCLUSION: We conclude from this national study that sex is not an independent predictor for future rural work intention among RCS students. Considering the disproportionate number of female students entering RCS, this is reassuring for ultimately achieving rural workforce gender equity.

Examining Psychological Self-Sufficiency among African American Low-Income Jobseekers in a Health Profession Career Pathways Program.

The aim of this study was to explore the experiences and perceptions of low-income African American jobseekers participating in the Health Profession Opportunity Grants (HPOG) program by employing a mixed method (Qual-Quant) approach. For qualitative data, two in-depth focus groups were conducted with a total of 12 participants who either completed one program or graduated from the HPOG program. With quantitative data, amediation path analysis was conducted using Model 4 of the PROCESS macro (3.1) with a total of 386 participants. The qualitative content analysis of the focus groups generated an overarching theme of the relationship influence on generating hope that included four phenomenological categories: (a) staff and instructors' approach to engagement and support with on-going accessibility and close follow-up; (b) experience-based career motivation; (c) hope as the core driver to overcoming perceived barriers; and (d) supportive relationships as key to instilling hope. In addition, the quantitative analysis confirmed a full mediation model with the path from perceived employment barriers to economic self-sufficiency being mediated by employment hope. The model suggested that the psychological self-sufficiency (PSS) process is key to increasing the economic self-sufficiency (ESS) outcome. Findings supported the importance ofa relationship-based, culturally competent practice to strengthen the PSS process in health profession workforce development among low-income African American jobseekers.