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.

Going country: Rural student placement factors associated with future rural employment in nursing and allied health

“…2,3 Against a general background of negative urban attitudes to rural practice, 4 rural placement programs effectively promote positive attitudes and career plans for students of all health disciplines. [5][6][7][8][9][10][11] Longitudinal studies of medical students that have explicitly linked rural placements with students' actual career choice have had inconsistent results. 2,[12][13][14][15][16][17] These studies are complicated by the fact that most medical students spend two to six years post graduation in urban hospitals to gain vocational experiences and qualifications.…”

Students’ opinions on working in rural practice in Slovenia

“…Evidence of the highly praised role of rural practices is also found by other studies, in which students agreed that the delivery of health care in rural areas is important [12]. A positive attitude towards health care services in rural areas was presented in a study by Azer et al [13].…”

“…The Australian study by Azer et al identified similar advantages of a rural environment, e.g. greater appreciation by patients, a friendly environment, less pressure and stress [13].…”

“…The Australian study by Azer et al identified similar disadvantages, e.g. lack of facilities, afterhours workload, lack of consultation [13].…”

What do beginning students, in a rurally focused medical course, think about rural practice?

“…Curriculum and rurally based clinical opportunities have been found to positively influence perceptions of rural practice [19, 20]. Current JCU graduate outcomes indicate rural experiences have a positive impact on both intent and reality of practising in rural locations.…”