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What influences doctors to work in rural locations?

Student background and clinical education act synergistically

We are fortunate that there is increasing evidence available on which to base policy decisions for building the rural medical workforce. The concept of the rural pipeline1 provides a framework in which to consider who we admit to medical programs, where we can best deliver medical education that is motivating towards rural practice and why graduates then choose to work in rural locations.

Two new sources of evidence are helping to address the “who” and “where” considerations. The Medical Schools Outcomes Database and Longitudinal Tracking (MSOD) Project has provided evidence of medical student career intentions on commencement and completion of undergraduate education, and data on location of practice in the early postgraduate years. In this issue of the Journal, Hays and colleagues describe their analysis of national MSOD data to determine where full-fee paying (FFP) students intend to practise.2 They conclude that FFP students are significantly more likely to practise in an urban area.

Their findings should cause us to pause and reflect on the question of who to admit. If we no longer have a shortage of medical practitioners in Australia (compared with other OECD [Organisation for Economic Co-operation and Development] countries