Medical students: where have they come from; where are they going?

AIMS: There remain shortages of doctors in rural areas. This study aimed to describe the location and size of New Zealand medical students' hometowns over the past decade; to document changes in intended practice location between entry and graduation; and to explore the relationship between background and intended location of practice. METHODS: All commencing and graduating students from one New Zealand medical programme from 2006-2015 were invited to complete a career intention survey. Students' reported background and practice location intention at entry were compared with intention at exit. RESULTS: Response rates were 92% for entry and 84% for exit surveys. On average, 21% of medical students were from regional-rural (RR) backgrounds, with no significant change over time (p=0.4036). Most were admitted via a designated rural entry pathway. Students from RR backgrounds were four times more likely at entry, and nearly three times more likely at exit, to have an RR intention than urban students. Those with an RR intention at entry were three times more likely to have an RR intention at exit than students with an urban intention. CONCLUSION: Medical students from an RR background, or with RR intention at entry to medical school, are more likely to indicate a RR intention upon graduating. Yet students of an urban background with an RR career intention are important to consider. Future research might explore factors which help consolidate RR career choices in both groups.