Intended rural career modalities of final-year James Cook University medical students.

Abstract

Geographic mal-distribution towards urban over rural medical practice exists worldwide. The James Cook University medical school has focused its selection and curriculum on selecting and training students to address medical workforce needs for local regional, rural and remote areas. This study investigates final-year James Cook University medical students' intended rural practice modality and association with rurality of upbringing. Cross-sectional survey of final-year James Cook University medical students in 2018 (n=147; response rate=76%). Association between students' rurality of hometown at entry to medical school and self-reported intentions for rural practice. Overall, final-year students' preferred rural practice modality was "for a specific number of years" (38, 25%), followed by "periodic short-term locum" (33, 23%), "permanently based" (26, 18%), "orbiting" (21, 14%), "none" (14, 10%), "long-term shared position" (9, 6%) and "specialist outreach clinics" (6, 4%). Urban hometown at entry to medical school was associated with students preferring periodic rural practice, with rural-origin students contrastingly preferring more permanent rural practice. Only 10% of James Cook University medical students did not want a rural career in any form, suggesting the majority, regardless of urban or rural hometown, are open to some type of rural practice. Urban-origin medical students around Australia might be a significant, untapped resource for periodic and more permanent rural practice if they can be provided with extended, immersive rural placements experiences. Government funding models should provide increased funding for immersive rural placements, and promotion of orbiting and longer-term job share practice modalities.