Rural generalism rises in medical students’ preferences

New data has shown the next generation of medical students still prefer general practice as their top specialty, but concerns have been raised that an increase in rural generalists could reflect a decline in community GPs.
 
According to the latest Medical Deans Australia and New Zealand data, released on Tuesday, general practice was the first preference for around 10.5% of medical students in 2023, down from 13% the previous year. 
 
However, a career as a rural generalist is proving more popular than ever, with 7% of students choosing it as their first preference last year, up from 5.8% in 2022.
 
The Medical Schools Outcomes Database report added rural generalism as a sub-specialty of general practice in 2021, with 4.6% of students listing this as their preference in its first year.
 
Combined, the two pathways now account for 18% of medical students.
 
‘Again in 2023, together the two options for general practice specialty – general practice and its sub-specialty of rural generalism – has overtaken adult medicine/internal medicine/physician as the most preferred choice for future discipline,’ the report said.
 
RACGP Vice President and Rural Chair Associate Professor Clements told newsGP it is encouraging to see more students selecting rural generalism, ‘which has at its core primary care and general practice’.
 
‘This is good news in terms of serving rural and remote communities with a wide variety of skill,’ he said.
 
‘The RACGP is very proud of our uptake offerings in this space in the last 12 months and we have seen a significant increase in the number of RACGP trainees choosing that pathway.’
 
Associate Professor Clements said the RACGP currently has more than 300 students in rural generalism training.
 
The report shows that domestic students are more likely to choose a rural pathway than their international counterparts – 7.9% compared to 0.4% respectively. 
 
It also reveals that 27% of the domestic 2023 students consider themselves as coming from a rural background, the highest in five years.
 
Rural practice was preferred by these students with rural experience, with 64% wanting a future career working outside a metropolitan area, compared with only 20% of respondents from a non-rural background.
 
But Associate Professor Clements said this shift towards rural generalism still reflected an overall decrease of interest in primary care, given that 54% of rural generalists practiced in hospitals according to Queensland Government data.
 
‘This reinforces the need for the Federal Government to respond to incentives and programs that aim to support general practice in the community,’ he said.
 
The RACGP has long been asking the general practice profession to be made more attractive to students, with an analysis by the Deloitte consultancy firm predicting a shortfall of 11,392 full-time equivalent GPs by 2032.
 
The college says GPs in training must be given parity to their hospital counterparts, including study and parental leave – one of its key Federal Budget asks.
 
The report reveals the top factor influencing a students’ choice of most preferred area of medicine is alignment with personal values, followed by atmosphere or work culture typical of the discipline, and experience of specialty as a medical student.
 
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