Rural origin and rural medical exposure: their impact on the rural and remote medical workforce in Australia

Australia, like many countries, finds it difficult to recruit enough medical practitioners to live and work in rural and remote communities. Over the last decade the Australian Commonwealth Government has invested in a national strategy to train its medical workforce to encourage recruits to rural and remote general practice. This strategy is based on overseas experience that rural origin students, and those experiencing early and repeated rural exposure during training, are more likely to practise in a rural location. The importance of rural origin as a predictor of rural practice is well documented in the literature. More recent studies have tended to focus on rural exposure during both undergraduate and early postgraduate years, and on developing rural curricula in a multifaceted approach to medical training. All 11 medical schools in Australia have modified their selection criteria to encourage students from rural and remote locations, and have, to a varying degree, encouraged rural exposure in parallel with developing uniquely rural content in their curricula. Many of these initiatives are quite recent and have not yet been thoroughly evaluated against their success in addressing shortages in the rural and remote medical workforce. The aim of the review is to explore how the relationship between rural origin and rural exposure during undergraduate and postgraduate training and choice of practice location has underpinned initiatives in medical education in Australia in the years 1990-2003.