Decoding Doctor Departure Decisions in Regional Queensland

Background: Medical workforce shortages are a pervasive issue across Australia, with rural and regional hospitals facing particular challenges in maintaining a stable workforce. Frequent turnover of prevocational doctors in these areas can adversely impact service delivery and healthcare outcomes. The primary aim of this study is to investigate the reasons why prevocational doctors leave regional hospitals, and whether these reasons vary across different regional settings. Method: Semi-structured, mixed methods exit interviews were conducted with 83 interns and resident medical officers (RMOs) who resigned from three regional Queensland hospitals (Townsville, Cairns, and Bundaberg) at the end of the 2023 clinical year. Thematic analysis was used to identify common themes, and chi-squared tests assessed quantitative regional differences. Results: The main reasons for starting at a regional hospital included reputation, familiarity with the hospital or region, and proximity to family or friends. Career progression emerged as the primary reason for leaving. There was no significant difference across regions in the reasons for leaving, retention factors, most valuable attributes, and factors influencing resignation. A significant difference between regions was established in the reasons for starting (p=0.01) and areas for improvement (p=0.02). Conclusions: Strengthening regional hospitals by promoting their unique attributes and enhancing career development opportunities is essential for fostering a sustainable medical workforce. The findings highlight key areas where regional hospitals can focus to enhance prevocational doctor retention. Furthermore, a systemic approach to attracting and retaining prevocational doctors is essential for building a future proof workforce capable of meeting the healthcare demands of regional communities.