title: Rural training and the state of rural health services: effect of rural background on the perception and attitude of first-year medical students at the university of melbourne.
abstract: The aim of this project is to investigate the relationship between medical students' background and their perception of the state of rural health services; willingness to undertake internship training or work as a doctor in a rural hospital; expected benefits and disadvantages of training or working as a doctor in a rural hospital; and factors interfering with acceptance of a job as a doctor in rural areas. A questionnaire-based survey was distributed to 100 first-year medical students attending the Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne at the end of semester 1. The response rate was 97%, including 44 males and 53 females. A strong relationship was found between rural background and an intention to undertake internship training in a rural hospital (86% of students from a rural background expressed this desire vs 30% of students from an urban background). Furthermore, all students from a rural background expressed a desire to work as a doctor in a rural hospital after completing postgraduate training. Compared to urban students, students from a rural background showed a more positive attitude towards health services in rural areas including public hospitals ( P = 0.02), private general practice ( P = 0.004), ambulance service ( P = 0.0002) and baby health centres ( P = 0.005). Citizenship or gender was not significantly related to the perception of any of these services. The ranking of factors interfering with acceptance of a job as a doctor in rural areas were different for rural and urban students. Students from rural backgrounds reported spouse/partner needs (76% vs 49%, P = 0.038) and school availability for children (59% vs 30%, P = 0.023) as barriers more frequently than urban students, respectively). On the other hand, urban students rated the following factors higher: personal factors (76% vs 53%, respectively), education opportunities (56% vs 24%), social/cultural facilities (50% vs 41%) and the need for frequent travel (29% vs 12%). None of these interfering factors were significantly different. Urban students were more likely than rural students to report that their views were a result of adverse media reports. In conclusion, students from a rural background were more willing to be trained or to work as doctors in rural areas. This was associated with a greater adverse influence by the media upon students.
authors.affiliation: Faculty Education Unit, The University of Melbourne, Melbourne, Victoria, Australia. s.azer@medicine.unimelb.edu.au
authors.forename: S A
authors.initials: SA
authors.lastname: Azer
authors.forename: D
authors.initials: D
authors.lastname: Simmons
authors.forename: S L
authors.initials: SL
authors.lastname: Elliott
mesh_terms: D001210:Asia, Southeastern / Q000208:ethnology; D001291:Attitude of Health Personnel; D001315:Australia; D002321:Career Choice; D004641:Emigration and Immigration; D005260:Female; D005550:Foreign Medical Graduates / Q000523:psychology; D006780:Hospitals, Rural / Q000592:standards; D006801:Humans; D007396:Internship and Residency / Q000592:standards; D008297:Male; D008402:Mass Media; D011365:Professional Practice Location; D012111:Residence Characteristics / Q000706:statistics & numerical data; D019035:Rural Health Services / Q000592:standards; D012424:Rural Population; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D014195:Travel; D000078329:Workforce