Are Australian rural clinical school students' career choices influenced by perceived opinions of primary care? Evidence from the national Federation of Rural Australian Medical Educators survey

Abstract

Objective To investigate whether perceived opinions of primary care are associated with student career preferences after graduation among a rural clinical school cohort and whether the preferred location of practice moderates these relationships. Design Cross‐sectional study using data from the national Federation of Rural Australian Medical Educators survey. Participants/Setting Medical students across 18 Australian universities who completed a clinical year in a rural setting in 2019. Main outcome measure(s) Career preference in primary care after graduation. Results The survey was completed by 624 students (response rate = 69.9%). A preference for primary care was reported by 35.5% (95% CI: 29.4‐42.0) of students and was more likely among those age 30+ years, with a rural background, or preferring to practise rurally after graduation. Students reported that primary care was more commonly respected by medical academics (66.8%) than peers (24.0%) or junior/hospital doctors (24.0%). In adjusted analysis, none of the perceived opinions were associated with student career preferences. However, among students aiming to work in small rural locations, a career in primary care was associated with more frequent reports that peers had poor opinions of primary care (P = .004). Conclusion Rural clinical school students perceive negative opinions of primary care, particularly among peers and junior/hospital doctors. Students aiming to work in small towns after graduation are more likely to report negative opinions among their peers, suggesting they may be more attuned to negative attitudes. This points to the need for a community of practice of like‐minded peers and clinicians to preserve the career interest of these students.

The pathway to more rural doctors: the role of universities

“…Medical students report that denigration of both rural doctors and general practice is still commonplace in Australia. 31 Attitudes which fail to recognise the expertise of generalists influence students' career choices away from rural practice. Medical schools with strong academic engagement by rural clinicians illustrate the value of rural doctors.…”

“…Traditional medical school teaching is predominantly metropolitan focused and specialist led. Medical students report that denigration of both rural doctors and general practice is still commonplace in Australia 31 . Attitudes which fail to recognise the expertise of generalists influence students’ career choices away from rural practice.…”