The impact of rural rotations on urban based postgraduate learners: A literature review

Background/Objective: The rural physician shortage remains an international crisis. Rural rotations are commonly used to address the issue. This review assesses the published evidence of the impact of rural rotations on urban-based postgraduate learners. Methods: The OVID Medline database was searched for eligible articles published in peer-reviewed academic journals between 1980 and 2017. Data were extracted and analyzed to draw inferences about the impact of rural rotations on urban-based postgraduate learners. The methodological quality of included articles was assessed with the Medical Education Research Study Quality Instrument (MERSQI). Results: The search identified 301 articles; 19 studies met inclusion criteria (mean MERSQI score 11.95). Of the various rural rotation characteristics reported, duration was most consistently associated with the eventual rural practice. No consensus of impact was found for other characteristics. Our review provided indications of the cumulative effect of the postgraduate rural rotation, rural origin, and rural intent on rural practice decisions. Conclusions: The importance of rural rotations during urban postgraduate training for the outcome of rural practice is apparent. However, the reliance of medical educational systems on the rural rotation, specifically duration, does not accurately reflect the complexity of the choice to practice in a rural community.