# Longer-term impacts of flooding on Australian health systems: insights from medical students on rural clinical placement

## TL;DR

Medical students in rural Australia observed long-term effects of flooding on health systems, including psychological trauma, disrupted services, and vulnerable populations.

## Contribution

The study introduces an analytical framework based on student perspectives, aligning with clinician experiences to guide future research and disaster preparedness.

## Key findings

- Flooding caused psychological trauma and disrupted health services in rural communities.
- Healthcare workers faced burnout, affecting medical education delivery.
- Displacement and delayed housing support worsened health outcomes for vulnerable groups.

## Abstract

To explore the perspectives of medical students in diverse clinical settings to enhance understanding of the sustained, system-wide effects of flooding on health systems.

A qualitative descriptive study using interviews and focus groups (17 April − 12 May 2023). Data were first analysed using inductive content analysis, and an analytical framework was then developed through an iterative process. The analysis and interpretation were refined with input from co-authors, including clinicians based in the region during and after the flooding events.

Rural area of the Northern Rivers region, New South Wales, Australia, 14 months after major river flooding in 2022.

Medical students undertaking rural clinical placements who were in the region after the flooding event.

Of the 39 students in the cohort, 32 (82%) participated. Four key domains of ongoing impact were identified: community, health services, clinicians, and broader social and physical environments. Ten categories emerged, highlighting the breadth of ongoing impacts. These included community psychological trauma, disruptions to health services, staffing challenges, and delays in patient discharge. Significant psychological impacts on healthcare workers were observed, with burnout affecting the delivery of medical education. Displacement was found to limit both access to healthcare and broader health outcomes. Additionally, the floods disproportionately affected socially vulnerable groups, and delays in government housing support contributed to ongoing stress within affected communities.

Our findings demonstrated that catastrophic flooding disrupted health service delivery and community wellbeing, with impacts including psychological trauma, workforce strain, displacement, and disproportionate effects on socially vulnerable groups, as well as consequences for medical education. They highlight the importance of supporting medical students to reflect on and learn from these experiences. The analytical framework developed, grounded in student perspectives and consistent with clinician experiences, contributes to the foundation for future research, intervention design, and preparedness planning.

The online version contains supplementary material available at 10.1186/s12913-026-14171-4.