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Why do medical graduates choose rural careers?
Open accessAbstract
INTRODUCTION: This study is based on the metaphor of the 'rural pipeline' into medical practice. The four stages of the rural pipeline are: (1) contact between rural secondary schools and the medical profession; (2) selection of rural students into medical programs; (3) rural exposure during medical training; and (4) measures to address retention of the rural medical workforce. METHODS: Using the rural pipeline template we conducted a literature review, analysed the selection methods of Australian graduate entry medical schools and interviewed 17 interns about their medical career aspirations. LITERATURE REVIEW: The literature was reviewed to assess the effectiveness of selection practices to predict successful gradation and the impact of rural pipeline components on eventual rural practice. Undergraduate academic performance is the strongest predictor of medical course academic performance. The predictive power of interviews is modest. There are limited data on the predictive power of other measures of non-cognitive performance or the content of the undergraduate degree. Prior rural residence is the strongest predictor of choice of a rural career but extended rural exposure during medical training also has a significant impact. The most significant influencing factors are: professional support at national, state and local levels; career pathway opportunities; contentedness of the practitioner's spouse in rural communities; preparedness to adopt a rural lifestyle; educational opportunities for children; and proximity to extended family and social circle. Analysis of selection methods: Staff involved in student selection into 9 Australian graduate entry medical schools were interviewed. Four themes were identified: (1) rurality as a factor in student selection; (2) rurality as a factor in student selection interviews; (3) rural representation on student selection interview panels; (4) rural experience during the medical course. Interns' career intentions: Three themes were identified: (1) the efficacy of the rural pipeline; (2) community connectedness through the rural pipeline; (3) impediments to the effect of the rural pipeline, the most significant being a partner who was not committed to rural life CONCLUSION: Based on the literature review and interviews, 11 strategies are suggested to increase the number of graduates choosing a career in rural medicine, and one strategy for maintaining practitioners in rural health settings after graduation.
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“In our study, rural vocational placements and a rural background increased the likelihood of working in a rural area, confirming what has been shown in other studies [44, 45].”
From Doctor retention and distribution in post-apartheid South Africa: tracking medical graduates (2007–2011) from one university (2019) · cites this paper as [44]
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Metadata
- Authors
- Henry, J., Edwards, B., & Crotty, B.
- Affiliations
- Deakin University (AU)
- Venue
- Rural and Remote Health
- Publisher
- Rural and Remote Health
- Published
- 2009-02-28
- Volume
- 9
- Issue
- 1
- Pages
- 1083-1083
- ISSN
- 1445-6354 (ISSN-L)
- OpenAlex
- W2113454309
- Cited by
- 169
- References
- 48
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 3 · 2023: 14 · 2022: 4 · 2021: 12 · 2020: 13 · 2019: 8 · 2018: 8 · 2017: 11 · 2016: 14 · 2015: 20 · 2014: 9 · 2013: 10 · 2012: 19
- FWCI
- 16.26
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Rural and Remote Health (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Deakin Research Online (Deakin University) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health Workforce Issues
- Social Sciences › Gender Studies › Diversity and Career in Medicine
- Social Sciences › Education › Medical Education and Admissions
- Keywords
- rural medical workforce, career choice, medical graduates, graduate entry medicine, student selection, rural exposure, rural retention, career aspirations, rural lifestyle, partner commitment
- MeSH terms
- Adult, Attitude of Health Personnel, Australia, Career Choice, Faculty, Medical, Health Services Needs and Demand, Humans, Internship and Residency, Life Style, Personnel Selection, Professional Practice Location, Surveys and Questionnaires, Residence Characteristics, School Admission Criteria, Students, Medical, Training Support, Victoria, Rural Health Services, Intention
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