{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T06:01:25Z","timestamp":1792216885401,"version":"4.4.0"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"1","content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Educ"],"published-print":{"date-parts":[[2017,12]]},"DOI":"10.1186\/s12909-017-1095-9","type":"journal-article","created":{"date-parts":[[2017,12,28]],"date-time":"2017-12-28T01:14:48Z","timestamp":1514423688000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Risk factors associated with academic difficulty in an Australian regionally located medical school"],"prefix":"10.1186","volume":"17","author":[{"given":"Bunmi S.","family":"Malau-Aduli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"O\u2019Connor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin A.","family":"Ray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yolanda","family":"van der Kruk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Bellingan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peta-Ann","family":"Teague","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2017,12,28]]},"reference":[{"issue":"8 Suppl","key":"1095_CR1","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.1097\/00001888-199908000-00024","volume":"74","author":"C Boelen","year":"1999","unstructured":"Boelen C. Adapting health care institutions and medical schools to societies\u2019 needs. Acad Med. 1999;74(8 Suppl):S11\u201320.","journal-title":"Acad Med"},{"issue":"1","key":"1095_CR2","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1057\/hep.2008.35","volume":"22","author":"K Boursicot","year":"2009","unstructured":"Boursicot K, Roberts T. Widening participation in medical education: challenging elitism and exclusion. High Educ Policy. 2009;22(1):19\u201326.","journal-title":"High Educ Policy"},{"key":"1095_CR3","doi-asserted-by":"crossref","unstructured":"Dunbabin JS, Levitt L. Rural origin and rural medical exposure: their impact on the rural and remote medical workforce. Rural Remote Health [internet] 2003;3:212. Epub 2003 Jun 25.","DOI":"10.22605\/RRH212"},{"key":"1095_CR4","unstructured":"Gale T, Parker S. Widening Participation in Australian Higher Education. Report to the Higher Education Funding Council of England (HEFCE) and the Office for Fair Access (OFFA), England. Leicester, UK: CFE (Research and Consulting) Ltd, 2013."},{"key":"1095_CR5","doi-asserted-by":"crossref","unstructured":"Hays RB. New medical school for regional Australia. Med J Aust. 2000;172(8):362\u20133.","DOI":"10.5694\/j.1326-5377.2000.tb124006.x"},{"key":"1095_CR6","first-page":"371","volume":"169","author":"RB Hays","year":"2001","unstructured":"Hays RB, Bower AJ. Modifying academic ranking of rural and remote medical school applicants. MJA. 2001;169:371\u20132.","journal-title":"MJA"},{"key":"1095_CR7","doi-asserted-by":"crossref","unstructured":"Ray RA, Woolley T, Sen Gupta T. James Cook University\u2019s rurally orientated medical school selection process: quality graduates and positive workforce outcomes. Rural and Remote Health 15: 3424. (Online) 2015. Available: https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/26442581 .","DOI":"10.22605\/RRH3424"},{"key":"1095_CR8","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1111\/medu.12540","volume":"49","author":"E Southgate","year":"2015","unstructured":"Southgate E, Kelly BJ, Symonds IM. Disadvantage and the \u2018capacity to aspire\u2019 to medical school. Med Educ. 2015;49:73\u201383. doi: 10.1111\/medu.12540 .","journal-title":"Med Educ"},{"issue":"2","key":"1095_CR9","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1097\/00001888-199702000-00008","volume":"72","author":"A Tekian","year":"1997","unstructured":"Tekian A, Foley RP. Why do medical students from under-represented minorities choose \u2013 or not choose \u2013 primary care careers? Acad Med. 1997;72(2):94\u20135.","journal-title":"Acad Med"},{"issue":"11","key":"1095_CR10","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1097\/ACM.0b013e31826daf74","volume":"87","author":"ME Young","year":"2012","unstructured":"Young ME, Razack S, Hanson MD, Slade S, Varpio L, Dore KL, McKnight D. Calling for a broader conceptualisation of diversity: surface and deep diversity in four Canadian medical schools. Acad Med. 2012;87(11):1501\u201310.","journal-title":"Acad Med"},{"key":"1095_CR11","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1111\/j.1365-2923.2008.03274.x","volume":"43","author":"J Mathers","year":"2009","unstructured":"Mathers J, Parry J. Why are there so few working-class applicants to medical schools? Learning from the success stories. Med Educ. 2009;43:219\u201328.","journal-title":"Med Educ"},{"key":"1095_CR12","unstructured":"McKenzie K, Schweitzer R. Who succeed s at university? Factors predicting academic performance in first year Australian university students. Higher Educ Res. Dev. 2001;20:21\u201333."},{"key":"1095_CR13","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1046\/j.1365-2923.2001.01042.x","volume":"35","author":"D James","year":"2001","unstructured":"James D, Chilvers C. Academic and non-academic predictors of success on the Nottingham undergraduate medical course 1970-1995. Med Educ. 2001;35:1056\u201364.","journal-title":"Med Educ"},{"issue":"2","key":"1095_CR14","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1002\/j.0022-0337.2008.72.2.tb04462.x","volume":"72","author":"DC Holmes","year":"2008","unstructured":"Holmes DC, Doering JV, Spector M. Associations among predental credentials and measures of dental school achievement. J Dental Educ. 2008;72(2):142\u201352.","journal-title":"J Dental Educ"},{"issue":"6","key":"1095_CR15","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1080\/01421590500156269","volume":"27","author":"J Cleland","year":"2005","unstructured":"Cleland J, Arnold R, Chesser A. Failing finals is often a surprise for the student but not the teacher: identifying difficulties and supporting students with academic difficulties. Med Teach. 2005;27(6):504\u20138.","journal-title":"Med Teach"},{"key":"1095_CR16","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1111\/j.1365-2923.2008.03037.x","volume":"42","author":"J Cleland","year":"2008","unstructured":"Cleland J, Milne A, Sinclair H, Lee AJ. Cohort study on predicting grades: is performance on early MBChB assessments predictive of later undergraduate grades? Med Educ. 2008;42:676\u201383.","journal-title":"Med Educ"},{"issue":"5","key":"1095_CR17","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1007\/s10459-011-9324-1","volume":"17","author":"B Shulruf","year":"2012","unstructured":"Shulruf B, Poole P, Wang GY, Rudland J, Wilkinson T. How well do selection tools predict performance later in a medical programme? Adv Health Sci Educ. 2012;17(5):615\u201326.","journal-title":"Adv Health Sci Educ"},{"issue":"5","key":"1095_CR18","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1097\/ACM.0b013e3182864299","volume":"88","author":"DM Dunleavy","year":"2013","unstructured":"Dunleavy DM, Kroopnick MH, Dowd KW, Searcy CA, Zhao X. The predictive validity of the MCAT exam in relation to academic performance through medical school: a national cohort study of 2001-2004 matriculants. Acad Med. 2013;88(5):666\u201371.","journal-title":"Acad Med"},{"issue":"3","key":"1095_CR19","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1111\/j.1365-2923.1996.tb00739.x","volume":"30","author":"KH Simpson","year":"1996","unstructured":"Simpson KH, Budd K. Medical student attrition: a 10-year survey in one medical school. Med Educ. 1996;30(3):172\u20138.","journal-title":"Med Educ"},{"key":"1095_CR20","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1046\/j.1365-2929.2004.01815.x","volume":"38","author":"W Arulampalam","year":"2004","unstructured":"Arulampalam W, Naylor R, Smith J. Factors affecting the probability of first year medical students\u2019 dropout in the UK: a logistic analysis for the intake cohorts of 1980\u201392. Med Educ. 2004;38:492\u2013503.","journal-title":"Med Educ"},{"key":"1095_CR21","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1111\/j.1365-2929.2007.02710.x","volume":"41","author":"W Arulampalam","year":"2007","unstructured":"Arulampalam W, Naylor R, Smith JP. Dropping out of medical school in the UK: explaining the changes over 10 years. Med Educ. 2007;41:385\u201394.","journal-title":"Med Educ"},{"issue":"5","key":"1095_CR22","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1097\/00007611-198105000-00025","volume":"74","author":"BY Fogleman","year":"1981","unstructured":"Fogleman BY, Zwagg RV. Demographic, situational, and scholastic factors in medical school attrition. South Med J. 1981;74(5):602\u20136.","journal-title":"South Med J"},{"issue":"4","key":"1095_CR23","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1097\/00001888-199904000-00047","volume":"74","author":"KL Huff","year":"1999","unstructured":"Huff KL, Fang D. When are students most at risk of encountering academic difficulty? A study of the 1992 matriculants to US medical schools. Acad Med. 1999;74(4):454\u201360.","journal-title":"Acad Med"},{"issue":"2","key":"1095_CR24","doi-asserted-by":"crossref","first-page":"102","DOI":"10.7205\/MILMED.169.2.102","volume":"169","author":"JE Stetto","year":"2004","unstructured":"Stetto JE, Gackstetter GD, Cruess DF, Hooper TI. Variables associated with attrition from Uniformed Services University of the Health Sciences medical school. Mil Med. 2004;169(2):102\u20137.","journal-title":"Mil Med"},{"key":"1095_CR25","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/1472-6920-12-43","volume":"12","author":"J Yates","year":"2012","unstructured":"Yates J. When did they leave and why? A retrospective case study of attrition on the Nottingham undergraduate medical course. BMC Med Educ. 2012;12:43.","journal-title":"BMC Med Educ"},{"issue":"1","key":"1095_CR26","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1111\/j.1365-2929.2006.02648.x","volume":"41","author":"J Yates","year":"2007","unstructured":"Yates J, James D. Risk factors for poor performance on the undergraduate medical course: cohort study at Nottingham University. Med Educ. 2007;41(1):65\u201373.","journal-title":"Med Educ"},{"issue":"9","key":"1095_CR27","first-page":"717","volume":"56","author":"TL Willoughby","year":"1981","unstructured":"Willoughby TL, Arnold L, Calkins V. Personal characteristics and achievements of medical students from urban and non-urban areas. J Med Educ. 1981;56(9):717\u201326.","journal-title":"J Med Educ"},{"issue":"4","key":"1095_CR28","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1097\/00001888-199904000-00043","volume":"74","author":"G Strayhorn","year":"1999","unstructured":"Strayhorn G. Participation in a premedical summer programme for under-represented minority students as a predictor of academic performance in the first three years of medical school: two studies. Acad Med. 1999;74(4):435\u201347.","journal-title":"Acad Med"},{"issue":"3","key":"1095_CR29","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1046\/j.1365-2923.2004.01762.x","volume":"38","author":"AM Ward","year":"2004","unstructured":"Ward AM, Kamien M, Lopez DG. Medical career choice and practice location: early factors predicting course completion, career choice and practice location. Med Educ. 2004;38(3):239\u201348.","journal-title":"Med Educ"},{"issue":"3","key":"1095_CR30","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1023\/A:1018383708357","volume":"1","author":"M Hojat","year":"1996","unstructured":"Hojat M, Gonnella JS, Erdmann JB, Veloski JJ. The fate of medical students with different levels of knowledge: are the basic medical sciences relevant to physician competence? Adv Health Sci Educ Theory Pract. 1996;1(3):179\u201396.","journal-title":"Adv Health Sci Educ Theory Pract"},{"issue":"10","key":"1095_CR31","doi-asserted-by":"crossref","first-page":"777","DOI":"10.2471\/BLT.09.072462","volume":"88","author":"R Strasser","year":"2010","unstructured":"Strasser R, Neusy A. Context counts: training health workers in and for rural and remote areas. Bulletin of the World Health Organisation Oct. 2010;88(10):777\u201382.","journal-title":"Bulletin of the World Health Organisation Oct"},{"issue":"6","key":"1095_CR32","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1111\/j.1365-2923.1992.tb00202.x","volume":"26","author":"RL Neame","year":"1992","unstructured":"Neame RL, Powis DA, Bristow T. Should medical students be selected only from recent school-leavers who have studied science? Med Educ. 1992;26(6):433\u201340.","journal-title":"Med Educ"},{"issue":"6","key":"1095_CR33","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1111\/j.1445-5994.1992.tb04872.x","volume":"22","author":"DA Powis","year":"1992","unstructured":"Powis DA, Waring TC, Bristow T, O\u2019Connell DL. The structured interview as a tool for predicting premature withdrawal from medical school. Aust NZ J Med. 1992;22(6):692\u20138.","journal-title":"Aust NZ J Med"},{"key":"1095_CR34","doi-asserted-by":"crossref","unstructured":"Henry JA, Edwards BJ, Crotty B: Why do medical graduates choose rural careers? Rural and Remote Health 2009, 9:1083 (online).","DOI":"10.22605\/RRH1083"},{"key":"1095_CR35","first-page":"155","volume":"18","author":"JD Singer","year":"1993","unstructured":"Singer JD, Willet JB. It\u2019s about time: using discrete-time survival analysis to study duration and timing of events. J Educ Stats. 1993;18:155\u201395.","journal-title":"J Educ Stats"},{"key":"1095_CR36","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/j.2517-6161.1972.tb00899.x","volume":"34","author":"DR Cox","year":"1972","unstructured":"Cox DR. Regression models and life tables. J R Stat Soc. 1972;34:187\u2013220.","journal-title":"J R Stat Soc"},{"key":"1095_CR37","unstructured":"Allison PD. Survival analysis using the SAS System: A Practical Guide. Cary, NC; SAS Institute, Inc. 1995."},{"key":"1095_CR38","volume-title":"Modelling statistical data in medical research","author":"D Collett","year":"2003","unstructured":"Collett D. Modelling statistical data in medical research. 2nd ed. London: Chapman & Hall\/CRC; 2003.","edition":"2"},{"key":"1095_CR39","unstructured":"O\u2019Connor T, Malau-Aduli B.S, Ray R, Kerlen Y. Engaging students experiencing academic difficulty in the health profession courses. 2016 ANZAPHE conference, 19\u201323 March, Perth, Australia."},{"issue":"5","key":"1095_CR40","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1111\/j.1365-2923.2010.03898.x","volume":"45","author":"L O\u2019Neill","year":"2011","unstructured":"O\u2019Neill L, Wallstedt B, Eika B, Hartvigsen J. Factors associated with dropout in medical education: a literature review. Med Educ. 2011;45(5):440\u201354.","journal-title":"Med Educ"},{"key":"1095_CR41","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1111\/j.1365-2923.2009.03519.x","volume":"43","author":"G Garvey","year":"2009","unstructured":"Garvey G, Rolfe IE, Pearson SA, Treloar C. Indigenous Australian medical students\u2019 perceptions of their medical school training. Med Educ. 2009;43:1047\u201355. https:\/\/doi.org\/10.1111\/j.1365-2923.2009.03519.x .","journal-title":"Med Educ"},{"issue":"10","key":"1095_CR42","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1097\/01.ACM.0000238047.48977.05","volume":"81","author":"D Acosta","year":"2006","unstructured":"Acosta D, Olsen P. Meeting the needs of regional minority groups: the University of Washington\u2019s programmes to increase the American Indian and Alaskan native physician workforce. Acad Med. 2006;81(10):863\u201370.","journal-title":"Acad Med"},{"key":"1095_CR43","doi-asserted-by":"crossref","unstructured":"Spencer A, Young T, Williams S, Yan D, Horsfall S. Survey on Aboriginal issues within Canadian medical programmes. Med Educ. 2005;39(11):1101\u20139.","DOI":"10.1111\/j.1365-2929.2005.02316.x"},{"issue":"2","key":"1095_CR44","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1111\/j.1365-2923.2008.03267.x","volume":"43","author":"LC Urlings-Strop","year":"2009","unstructured":"Urlings-Strop LC, Stijnen T, Themmen APN, Splinter TAW. Selection of medical students: a controlled experiment. Med Educ. 2009;43(2):175\u201383.","journal-title":"Med Educ"},{"key":"1095_CR45","doi-asserted-by":"crossref","unstructured":"Chowdry H, Crawford C, Dearden L, Goodman A, Vignoles A. Widening participation in higher education: analysis using linked administrative data. Discussion paper no 4991. Volume discussion paper no 4991. Bonn: Institute for the Study of. Labour. 2010;","DOI":"10.1920\/wp.ifs.2010.1004"},{"key":"1095_CR46","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s12909-015-0339-9","volume":"15","author":"RA Ray","year":"2015","unstructured":"Ray RA, Young L, Lindsay DB. The influences of background on beginning medical students\u2019 perceptions of rural medical practice. BMC Medical Education. 2015;15:58.","journal-title":"BMC Medical Education"}],"updated-by":[{"DOI":"10.1186\/s12909-018-1170-x","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2018,4,9]],"date-time":"2018-04-09T00:00:00Z","timestamp":1523232000000}}],"container-title":["BMC Medical Education"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-017-1095-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,30]],"date-time":"2024-06-30T04:10:50Z","timestamp":1719720650000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmededuc.biomedcentral.com\/articles\/10.1186\/s12909-017-1095-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12]]},"references-count":46,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,12]]}},"alternative-id":["1095"],"URL":"https:\/\/doi.org\/10.1186\/s12909-017-1095-9","relation":{},"ISSN":["1472-6920"],"issn-type":[{"value":"1472-6920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12]]},"article-number":"266"}}