Will Australian rural clinical schools be an effective workforce strategy? Early indications of their positive effect on intern choice and rural career interest

Diann S Eley and Peter G Baker
Med J Aust 2007; 187 (3): 166-167. || doi: 10.5694/j.1326-5377.2007.tb01177.x
Published online: 6 August 2007

Analysis revealed no significant differences in responses by sex, age or UQRCS location. Results are presented in aggregate as the 2006 UQRCS cohort (= 28). Surveys were administered on the first (entry) and last (exit) day of their clinical year, but, because of absences, 17 and 27 students completed the surveys, respectively. Most students were male (18), aged 25–29 years (17), and single (19). Eight students reported a rural background.


We measured the effect of the UQRCS on students’ desire to pursue a rural career and found a positive effect on interest from the start to the end of their final year. Furthermore, more than half of the 2006 cohort chose internships in large rural centres rather than in other urban or metropolitan centres.

Our study is limited by its cross-sectional design, using a small cohort of rural clinical school students from one university. It emphasises the need for longitudinal tracking of medical graduates’ careers, in particular from rural clinical schools, to provide evidence for any effect of rural clinical schools on the shortage of rural doctors.

Evidence is mounting in support of a strong relationship between rural educational exposure and an increased interest in pursuing a rural career or selecting a rural internship.4 Students’ choice of internship location (urban hospital versus regional or rural hospital) is an important indication of their desire to pursue rural medicine.

Our cohort reported that rural location was not of the highest importance in their decision to train at the UQRCS. Given the importance of rurality to the rationale underpinning the rural clinical schools program, this may appear disappointing. However, a quality educational program would be expected to attract students, and if clinical training within the UQRCS encourages rural career intentions, the aim of workforce recruitment through rural clinical school placement appears satisfactorily managed.

Most of our cohort was of urban origin, a feature noted in other rural clinical schools or programs with a rural focus.2 There is strong evidence for a relationship between geographical background and predictors of practice locality,5,6 but studies have identified that up to 74% of rural doctors have an urban background.6 This illustrates the important role that rural clinical schools play in developing and encouraging an interest in rural medicine among students of both urban and rural backgrounds.

This report adds to the growing body of evidence that a positive medical education with a rural focus is conducive to an increased interest in a rural medical career.

  • Diann S Eley1
  • Peter G Baker2

  • School of Medicine Rural Clinical Division, University of Queensland, Toowoomba, QLD.


Competing interests:

None identified.

  • 1. Australian Government Department of Health and Ageing. Rural clinical schools program. (accessed Jun 2007).
  • 2. Eley D, Baker P. Does recruitment lead to retention? Rural clinical school training experiences and subsequent intern choices. Rural Remote Health [Internet] 2006; 6: 511. No=6x (accessed Jun 2007).
  • 3. Australian Rural and Remote Workforce Agencies Group. Review of the Rural and Remote Metropolitan Areas Classification System. A submission to the Department of Health and Ageing. Melbourne: ARRWAG, 2005. (accessed Mar 2007).
  • 4. Tolhurst HM, Adams J, Stewart SM. An exploration of when urban background medical students become interested in rural practice. Rural Remote Health [Internet] 2006; 6: 452. No=6x (accessed Jun 2007).
  • 5. Laven G, Wilkinson D. Rural doctors and rural backgrounds: how strong is the evidence? A systematic review. Aust J Rural Health 2003; 11: 277-284.
  • 6. Wilkinson D, Laven G, Pratt N, Beilby J. Impact of undergraduate and postgraduate rural training, and medical school entry criteria on rural practice among Australian general practitioners: a national study of 2414 doctors. Med Educ 2003; 37: 809-814.


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