The big city by-pass: Origin is important in medical students’ preference for future practice in regional cities and large towns

Abstract

Background: Rural clinical placement during medical training has been identified as important in addressing workforce mal-distribution in Australia. The University of Wollongong (UOW) medical school is unique in Australia in that all students undertake a 12-month continuous longitudinal-integrated-clerkship (LIC) placement in rural or regional NSW, or in the non-capital city urban centre where the university main campus is located. This paper investigates whether origin is important in medical students’intentions and preferences for future practice. Methods: Between 2010 and 2015, rural clinical school (RCS) students from Australian medical school programmes, including UOW, completed the same survey. The responsesfrom UOW students were compared to other students. The main outcome measuresinvestigated were preference for location of future practice and training, and careerpreferences. These were investigated with respect to location of origin of students. Results: UOW students preferred regional city/large town locations for future practicecompared to other RCS students. This finding strongly correlated with the non-capital city origin of UOW students. General practice/rural medicine was the career preference for one third of UOW students compared to one quarter of other students. Generalist specialist was the preference for almost half of other students. Skills developmentexperiences and outcomes were similar in both groups. Conclusions: Many students who have experienced a LIC placement in a regional or rural setting during training prefer smaller regional cities, towns or rural locations for future practice. Augmenting the rural clinical experience by affirmative action in preferential selection of students of non-capital city origin can result in more medical graduates wanting to “by-pass” the big cities.