Predictors of rural family medicine practice in Canada.

Objective: To examine the attributes of Canadian medical students at matriculation that predicted later practice in a rural location, with the goal of enhancing evidence-based approaches to increasing the numbers of rural family physicians.

Design: Demographic, attitudinal, and career choice data were collected from medical students at matriculation. Students were followed prospectively, and these data were linked to postresidency practice location.

Setting: Eight Canadian medical schools.

Participants: Study participants were 15 classes of medical students entering medical school between 2002 and 2004.

Main Outcome Measures: Backward stepwise logistic regression analysis was used to identify the entry characteristics that predicted postresidency practice as a rural family physician.

Results: Data from 1542 students were analyzed. A strong association was found between career interest in rural family medicine at entry into medical school and postresidency rural practice as a family physician. Logistic regression analysis that did not include entry career interest found older age, being in a relationship, having completed school in a rural community, having a societal orientation, and expressing a desire for a varied scope of practice to be predictive of practising in a rural location. When entry career interest in a rural setting was included in the multivariate model, only this variable and older age predicted postresidency rural family practice.

Conclusion: This study identified a number of demographic and attitudinal variables at medical school entry that predict postresidency practice in a rural setting. These results suggest multiple potential areas where the pipeline to rural family practice can be further supported in order to address the shortage of rural family physicians.