Medical student characteristics predictive of intent for rural practice.

Introduction: The shortage of physicians in rural areas of the USA has led medical schools to focus on recruiting and selecting students who will choose to work in non-urban settings. The purpose of this study was to examine the effect of student characteristics previously correlated to choosing rural practice (ie being older, being male, being raised in a rural community, having a spouse or significant other who was raised in a rural community, having a spouse or significant other whose parents live in a rural community, having parents with high school education or less, and graduating from a smaller college) on osteopathic medical students' intent to practice in a rural setting. This study also examined the correlation between personality type and intent for rural practice using the Myers Briggs Type Indicator (MBTI). Finally, this study examined factors that would increase interest in practicing in a rural setting, such as financial assistance and students' opinions about physicians who choose to practice in rural areas.

Methods: The study participants were students in a new osteopathic medical school with an enrollment of 225. Cross-sectional survey data were collected on background characteristics and intent for rural practice. Retrospective data were collected from MBTI assessments previously completed as part of routine career planning educational sessions. Data were analyzed using descriptive statistics such as frequencies, percentages and inferential statistics such as χ² and logistic regression.

Results: A total of 141 students participated, a 63% response rate. Factors associated with intent to practice rural medicine included being raised in a rural area for more than half of one's life (p<0.05) and having a spouse or significant other who had lived in a rural area (p<0.05). Age, sex, race, and size of undergraduate college were not associated with intent to practice rural medicine. Students categorized as Extraverted based on the MBTI were more likely to have intent for rural practice even when other factors were controlled. Students reported that financial incentives and wage guarantees may increase interest in rural practice.

Conclusion: The results of this study support past research showing that medical students with a rural background and with spouses or significant others having a rural background are more likely to have intent for rural practice. This study also found that students' personality types may be correlated with intent to practice in a rural area. In order to provide physicians who will serve the population living in rural areas of the USA, it is imperative that medical schools select students who are most likely to practice in a non-urban setting. Financial incentives are important to students, suggesting that programs such as loan forgiveness may be useful in recruiting students to rural practice. Medical students may benefit from career counseling utilizing the MBTI to facilitate an understanding of personality type and how it may impact their preference for rural practice.