The Medical Schools Outcomes Database MSOD: A national resource for medical education and workforce

1
The Medical Schools Outcomes Database (MSOD) A
national resource for medical education and
workforce planningJustin Beilby, Jonathan P.
Gerber, Louis I. Landau, Bal KaurMedical Deans
Australia and New Zealand
,
C P M E C
2
MSOD project aims

• To develop an agreed national process to collect
  reliable demographic and educational data on
  medical students for all Australian medical
  schools
• To establish a national database for monitoring
  and reporting on outcomes of medical education
  programs
• Use the national database for tracking students
  throughout their careers to assist workforce
  planning, policies and strategies.

3
Why a national collaboration?

• Education imperative
• To monitor which factors most influence career
  choice and location of practice
• Workforce imperative
• To evaluate outcomes of Australian
  jurisdictional governments individual
  university workforce initiatives
• Accountability
• To assess value for money from government
  expenditure on medical education initiatives.

4
Concept

PGY1/ Intern Survey
Reference John Humphreys, 2007
5
MSOD data collections

• Commencing Students Questionnaire
• demographics, rurality, previous tertiary
  education, income, scholarships, career
  intentions(geographic location, type)
• 2. Annual Medical Schools Data
• clinical placements (location,duration, type,
  infrastructure resourcing i.e RCS/RUSC/UDRH),
  enrolment status, rural club membership,
  electives
• 3. Exit Questionnaire
• update demographics, internship location,
  contact details, career intentions (geographic
  location, type)
• 4. PGY1(Intern) Questionnaire - Postgraduate
  Training
• update demographics, status of current work
  situation, internship rotations (discipline,
  rural location, hours), additional tertiary
  education, contact details, career intentions
  (geographic location, type)
• 5. Medical Practice
• in practice, career destination (location, type)

6
Response rates

• 2006 85.5 (from 56.7 to 98)
• 2007 91.2 (from 77.2 to 100)
• 2008 94.6 (from 90.1 to 100)

7
Progress summary

• Accomplishments to date
• A uniform national minimum data base
• Collaboration trust among medical schools
• Agreed principles, nationally consistent
  definitions, organisational processes, and
  communication
• Australian government commitment to resourcing
  medical schools
• Successful engagement of all key stakeholders
• Stakeholder confidence in confidentiality and
  security of all data
• Method for longitudinally tracking graduates

8
Increasing workforce flexibility

• Flexibility of workforce
• To what extent can student career preferences be
  influenced while in medical school?
• How many switch from entry to exit
• Overall
• Decided undecided
• Generalism specialism

9
Increasing workforce flexibility

• Overall specialty switching
• Of those decided at entry, only 18 have the same
  intended specialty at exit.
• There is considerable switching.

N 96, based on pilot sample
10
Increasing workforce flexibility

• Switching between decided and undecided. Of 89
  who at some point were undecided
• 21 were undecided at entry only
• 68 were undecided at exit
• 39 were undecided at exit only
• 29 were undecided at both entry and exit
• Students become more undecided during medical
  school.

N 89, based on pilot sample
11
Increasing workforce flexibility
N 89, based on pilot sample
12
Building training capacity

• Key early findings of effects of clinical
  placements.
• Two case studies rural GP

13
Case 1 - Rural intentions

• Split the sample into four categories
• Staying rural
• Staying city
• Going rural
• Going city
• Examined key associations with the four categories

Source Gerber Landau (submitted)
14
Factors affecting intentions
15
Multivariate prediction of exit intentions

• Holding entry intention constant
• When considered simultaneously, key predictors
  are
• GP intentions
• Later rural placements

Source Humphreys Gerber (in prep)
16
Case 2 - GP intentions
Marital status Longer GP placements
Most demographics Entry scheme scholarship
GP placements in early years
No effect
Decreasing GP intention
Increasing GP intention
17
Conclusions

• Placements have both positive and negative
  influences
• Rural placements increase rural intentions
• Early GP placements decrease GP intentions
• Longer GP placements increase GP intentions
• Increase in undecided specialties across medical
  school.

18
Building training capacity

• MSOD data indicate key trends
• Future research will confirm these relationships
  and trends and compare across
• Jurisdictions
• School type (e.g. urban/regional, undergraduate
  vs postgraduate, type of mission statement)

19
The Enhanced Virtuous Cycle
MSOD Investment
RESEARCH
GOVERNMENT
Rural Policy Models
Workforce planning
Knowledge creation
Improved health systems
SOCIETY
Improved Health workforce planning
HEALTH SYSTEM
Health Policy reform
20
National Health Workforce Taskforce (NHWT)
National Clinical Placements Project --- linkage

• Yearly plan data collection of placement
  information across various health professions.
• Minimum Data Set being finalised by a Reference
  Group.
• Interim Data Collection by universities to begin
  in 2010.
• MSOD has a 5-year dataset on placements of
  medical students to inform the NHWT process.

21
Future directions

• Further tracking into pre-vocational years will
  help define total packages that influence career
  choice.
• Address decision making across a range of
  specialties (focusing particularly on workforce
  shortages eg public health, pathology,
  administration)
• Medical education research base