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Rural longitudinal integrated clerkships: lessons from two programs on different continents.

Ian Couper¹, Paul S Worley, Roger Strasser

¹Wits Medical School, Centre for Rural Health University of the Witwatersrand, Parktown, South Africa. ian.couper@wits.ac.za

Rural and Remote Health

|April 1, 2011

Summary

Rural longitudinal integrated clerkships positively impact medical students and clinicians. Key factors for success include careful site selection, faculty development, IT integration, managing student expectations, and strong postgraduate training.

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Published on: January 9, 2026

Area of Science:

Medical Education
Rural Health
Longitudinal Integrated Clerkships

Background:

The Parallel Rural Community Curriculum at Flinders University (since 1997) and the Northern Ontario School of Medicine (NOSM) (since 2007) are rural longitudinal integrated clerkship programs.
An external evaluation of both programs was conducted in 2006 and 2008.

Purpose of the Study:

To analyze similarities and differences between the Flinders and NOSM rural clerkship programs.
To identify key factors for developing similar rural medical education programs.

Main Methods:

A cross-sectional descriptive study using focus groups and individual interviews with students, faculty, preceptors, health service managers, and community representatives.
Grounded theory approach for analyzing emerging themes from interviews.
Comparison and contrast of themes from both sites.

Main Results:

Participants reported that the programs produce confident and skilled students.
Educational value stems from continuity of care, longitudinal exposure, relationship development, mentoring, teamwork, and participatory learning.
Common concerns included standardization, specialist exposure, communication, support, isolation, personal issues, and site selection.

Conclusions:

Rural longitudinal integrated clerkships positively impact students and clinicians across different international sites.
Five key factors for program development: careful site selection, collegiate faculty development, IT integration, managing student expectations, and strong postgraduate training.