Why do medical graduates choose rural careers?

<b>Introduction:</b> This study is based on the metaphor of the ‘rural pipeline’ into medical practice. The four stages of the rural<br />pipeline are: (1) contact between rural secondary schools and the medical profession; (2) selection of rural students into medical<br />programs; (3) rural exposure during medical training; and (4) measures to address retention of the rural medical workforce.<br /><b>Methods:</b> Using the rural pipeline template we conducted a literature review, analysed the selection methods of Australian<br />graduate entry medical schools and interviewed 17 interns about their medical career aspirations.<br /><b>Results:</b> Literature review: The literature was reviewed to assess the effectiveness of selection practices to predict successful<br />gradation and the impact of rural pipeline components on eventual rural practice. Undergraduate academic performance is the<br />strongest predictor of medical course academic performance. The predictive power of interviews is modest. There are limited data<br />on the predictive power of other measures of non-cognitive performance or the content of the undergraduate degree. Prior rural<br />residence is the strongest predictor of choice of a rural career but extended rural exposure during medical training also has a<br />significant impact. The most significant influencing factors are: professional support at national, state and local levels; career<br />pathway opportunities; contentedness of the practitioner’s spouse in rural communities; preparedness to adopt a rural lifestyle;<br />educational opportunities for children; and proximity to extended family and social circle. Analysis of selection methods: Staff<br />involved in student selection into 9 Australian graduate entry medical schools were interviewed. Four themes were identified:<br />(1) rurality as a factor in student selection; (2) rurality as a factor in student selection interviews; (3) rural representation on student<br />selection interview panels; (4) rural experience during the medical course. Interns’ career intentions: Three themes were identified:<br />(1) the efficacy of the rural pipeline; (2) community connectedness through the rural pipeline; (3) impediments to the effect of the<br />rural pipeline, the most significant being a partner who was not committed to rural life<br /><b>Conclusion:</b> Based on the literature review and interviews, 11 strategies are suggested to increase the number of graduates<br />choosing a career in rural medicine, and one strategy for maintaining practitioners in rural health settings after graduation.<div id="refHTML"></div><input id="gwProxy" type="hidden" /><!--Session data--><input id="jsProxy" type="hidden" onclick="jsCall();" /><div id="refHTML"></div>