BackgroundBotswana’s medical school graduated its first class in 2014. Given the importance of attracting doctors to rural areas the school incorporated rural exposure throughout its curriculum.AimThis study explored the impact of rural training on students’ attitudes towards rural practice.SettingThe University of Botswana family medicine rural training sites, Maun and Mahalapye.MethodsThe study used a mixed-methods design. After rural family medicine rotations, third- and fifth-year students were invited to complete a questionnaire and semi-structured interview. Data were analysed using descriptive statistics and thematic analysis.ResultsThe thirty-six participants’ age averaged 23 years and 48.6% were male. Thirty-three desired urban practice in a public institution or university. Rural training did not influence preferred future practice location. Most desired specialty training outside Botswana but planned to practice in Botswana. Professional stagnation, isolation, poorly functioning health facilities, dysfunctional referral systems, and perceived lack of learning opportunities were barriers to rural practice. Lack of recreation and poor infrastructure were personal barriers. Many appreciated the diversity of practice and supportive staff seen in rural practice. Several considered monetary compensation as an enticement for rural practice. Only those with a rural background perceived proximity to family as an incentive to rural practice.ConclusionThe majority of those interviewed plan to practice in urban Botswana, however, they did identify factors that, if addressed, may increase rural practice in the future. Establishing systems to facilitate professional development, strengthening specialists support, and deploying doctors near their home towns are strategies that may improve retention of doctors in rural areas.

Many medical schools currently offer medical students the opportunity to spend time in rural settings as part of their education. . The expectation is that such experience will encourage future interest in rural practice. This approach is supported by studies showing that rural experiences during training can increase the likelihood of students choosing to practise in rural areas after graduation. [1][2][3] The first medical school in Botswana opened at the University of Botswana in 2009 and the first cohort of students graduated in 2014. The school trains doctors in Gaborone, an urban setting, with rural clinical placements in Serowe, Molepolole, Mahalapye and Maun. The teaching curriculum emphasises that the training should take place at all levels of the health system; therefore, the curriculum includes rural training to enhance students' learning and experiences.The curriculum includes exposure to rural healthcare in various formats throughout the 5-year programme. The places where students do rural training are highlighted in Fig. 1. During each of the 1st and 2nd years students complete 4 weeks' training in a public health community, in each of the 3rd and 5th years they complete 8 weeks of family medicine, and in the 4th year they complete 8 weeks of public health. This gives a total of 32 weeks of rural exposure throughout the 5 years. As an example, the curriculum for the family medicine rotation involves problem-based learning sessions, ward rounds and outpatient care, as well as attendance at continuing medical education lectures. Tutorials and practicals focus on patient-centred consultations, the doctor, the patient and environmental factors in consultation, communication skills (e.g. breaking bad news), motivational interviewing and counselling skills.Although the medical students in Botswana are exposed to rural training at different levels, their perceptions of the current rural training are unknown. Exploring students' rural experiences and perceptions of the clinical rural training relevance is important to a newly established school. Understanding their experiences and perceptions can help the Faculty of Medicine to improve future rural development and maximise Background. The curriculum of the Faculty of Medicine at the University of Botswana includes rural community exposure for students throughout their 5 years of training. In addition to community exposure during the first 2 years, students complete 16 weeks of family medicine and 8 weeks of public health medicine. However, as a new faculty, students' experiences and perceptions regarding rural clinical training are not yet known. Objective. To describe the experiences and perceptions of the 5th-year medical students during their rural training and solicit their recommendations for improvement. Methods. This qualitative study used face-to-face interviews with 5th-year undergraduate medical students (N=36) at the end of their family medicine rotation in Mahalapye and Maun villages. We used a phenomenological paradigm to underpin the study. ...