Starting rural, staying rural: how can we strengthen the pathway from rural upbringing to rural practice?
OBJECTIVE
To determine if selecting rural background students into the Monash Bachelor of Medicine and Bachelor of Surgery (MBBS) program affects vocational training location and intended practice location after training.


METHODS
Retrospective cohort mail survey.


METHODS
Australia.


METHODS
Rural-background students at Monash 1992-1994 (n=24/40) and 1995-1999 (n=59/120) and urban background students (n=36/93 and 104/300, respectively). Overall study population: 62% female, average age of 28 years; 79% Australian-born; and 60% married/partnered.


METHODS
Rural or urban background, rural undergraduate exposure.


METHODS
Intent towards rural medical practice, vocational training location and subsequent practice location.


RESULTS
There was a positive and significant (P ≤0.05) association between rural background and rural practice intent when respondents began (10-times higher than urban graduates) and completed (three times higher) their MBBS course. Rural practice intent increased fourfold in urban background graduates. There was a positive and significant association between rural background and preferred place of practice in 5-10 years in a Rural, Remote and Metropolitan Area (RRMA) 3-7 community (three times higher). There was a positive, but non-significant association between rural background and RRMA 3-7 community as their current location and first place of practice once vocationally qualified.


CONCLUSIONS
Interest in rural practice is not fully reflected in location during or after vocational training. The beneficial effects of rural undergraduate exposure might be lost if internship and vocational training programs provide insufficient rural clinical experiences and curriculum content. Continuation of the rural pathway might be needed to maintain rural practice intent.
Northern Ontario School of Medicine Centre for Rural and Northern Health Research, Laurentian University, 935 Ramsey Lake Road, Sudbury,Ontario, Canada. roger.strasser@normed.ca
Roger
R
Strasser
John C
JC
Hogenbirk
Michael
M
Lewenberg
Margot
M
Story
Ajay
A
Kevat
D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D002321:Career Choice; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D011365:Professional Practice Location; D012189:Retrospective Studies; D019035:Rural Health Services; D012424:Rural Population; D013337:Students, Medical / Q000523:psychology*; D014505:Urban Population; D014739:Victoria; D000078329:Workforce