"We learnt it, then we lived it": Influencing medical students' intentions toward rural practice and generalist careers via a socially-accountable curriculum

How immersion in remote Aboriginal communities influences medical students’ career intentions

The term 'Aboriginal' in this text has been used when referring to Aboriginal peoples living on the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands. The term 'Aboriginal and Torres Strait Islander' has been used when referring to the broader community.

BACKGROUND

This project investigated how cultural immersion in remote Aboriginal communities influenced medical students' career intentions.

METHODOLOGY

An academic GP registrar (AB) interviewed 15 medical students who participated in the Adelaide Medical Students' Society Anangu Pitjantjatjara Yankunytjatjara (APY) Exchange. This program was coordinated by medical student volunteers in collaboration with the Ngaanyatjarra Pitjantjatjara Yankunytjatjara Women's Council (NPYWC). The following questions were specifically addressed: 'How does being a guest in a remote Aboriginal community influence medical students' attitudes towards Aboriginal and Torres Strait Islander health care?' and 'Does exposure to Aboriginal communities increase medical students' willingness to pursue careers in Aboriginal and Torres Strait Islander health, rural and remote medicine and/or general practice?'.

RESULTS

Interest in Aboriginal and Torres Strait Islander health care increased from 73% of participants pre-trip to 100% post-trip, in rural and remote medicine from 40% to 100%, and in general practice from 33% to 67%. The experience also challenged pre-conceptions and increased understanding of the bio-psycho-socio-spiritual aspects of Aboriginal health.

CONCLUSION

Being a guest in remote Aboriginal communities enhanced students' personal and professional motivation to work in Aboriginal and Torres Strait Islander health, remote health and general practice.

Examining students' perception of rural practice following an educational strategy aimed at preparing postsecondary students for rural careers: a systematic review protocol for qualitative studies

INTRODUCTION

Rural areas are widely acknowledged as being at a workforce disadvantage when compared with urban populations. One of the factors contributing to this disparity is the paucity of workforce professionals who live and practice in rural areas. Educational strategies used to train these workforce professionals may help better prepare students for rural careers and thus increase retention. The purpose of this systematic review is to examine students' perceptions of rural practice following an educational strategy used to prepare students for rural careers.

METHODS AND ANALYSIS

Searches will be conducted in the following databases: Medline (Ovid), CINAHL (Ebscohost), ERIC (Proquest), Social Services Abstracts (Proquest), PsycINFO (Proquest) and IEEE Xplore. The literature search will be limited to articles published in English in the last 20 years. Data will be extracted for author(s), year of publication (2001-2021), country of origin, research question, research design, participants, where the study takes place (eg, classroom, community), educational strategies used, theoretical approach and findings related to the research question (ie, student perceptions). Methodological validity will be assessed using standardised tools. Two independent reviewers will conduct data extraction and quality appraisal, and any disagreement will be adjudicated by discussion or with a third reviewer. Results will be presented in tabular and narrative formats.

ETHICS AND DISSEMINATION

This review does not require formal ethical approval as it does not involve direct student contact or student-identifiable data. The final systematic review will be submitted to a peer-reviewed journal.

Programs to encourage working as a general practitioner in rural areas: why do medical students not want to participate? A cross-sectional study

BACKGROUND

In many countries, not enough students are interested to work as general practitioners in rural areas. To solve this problem, several, sometimes partly extracurricular, programs have been developed. Most of these programs are based on continuity, which means that students stay in a rural region for an extended period of time, by completing clerkships. Although the effects of these programs are positive, it is often difficult to motivate students to participate. The purpose of the present study is to get insight into the reasons why students choose not to participate in these programs.

METHODS

We carried out a questionnaire study among medical students in the clinical phase of the Technical University of Munich in Germany. First, we asked the students whether they actively informed themselves about the program which aims to reduce the shortage of general practitioners in rural areas in Bavaria. Furthermore, the questionnaire focused on the reasons for not participating in this program.

RESULTS

Based on the answers of 442 students from study years 3-6, the most frequently chosen reason for not participating in the program is "identification with another discipline" with 61.0%, directly followed by "not willing to commit long-term" (56.1%). In third place is "personal connections to another region" with 30.5%. In the open comments, we find the same reasons: many students do not want to commit to a certain direction too early. In addition, students indicate that the number of regions where this program is offered is too limited for them.

CONCLUSIONS

Offering programs to prepare and motivate students for work as general practitioners in rural areas can contribute to increasing the pool of future general practitioners. To encourage students to participate in such a program, it is important to consider the motives of students. Many students who might be interested in general practice do not choose to take part in such a program because they do not want to commit to a particular specialty or region at an early stage. It is important to take these insights into account when designing and implementing these programs.