Influence of rural background and rural medical training on postgraduate medical training and location in New Zealand.

Objective: To evaluate the influence of the Otago Medical Programme's rural entry pathway and rural immersion programme on postgraduate medical training and location.

Methods: Retrospective cohort study of 2008-2011 medical school graduates. Rural background/training included students gaining preferential entry to medical training based on rural residence or schooling, and/or those who spent a year training in a rural setting. Postgraduate medical training and location were obtained from the NZ Medical Register in December 2013.

Results: 112/733 students (15.3%) had rural background/training. Significantly more students with rural background/training were training in rural hospital medicine or general practice after graduation. Multiple logistic regression identified both variables (rural background and rural training) as independently statistically significant (Odds Ratios (95%CI); rural background OR 2.1, 95%CI 1.2-3.6; rural training OR 2.5, 95%CI 1.4-4.5; p=0.002). Almost twice as many students with rural background/training were working in non-Major Urban Centres.

Conclusions: These findings are similar to international reports on the influence of medical schools' rural initiatives on postgraduate training choices and practice location. University policies aimed at increasing the proportion of medical graduates practising in rural areas appear to be working as intended.