Do Medical Graduates from a Rural Longitudinal Integrated Clerkship Work in Similar Rural Communities?

(1) Background: Medical graduates who have undertaken longitudinal rural training have consistently been found to be more likely to become rural doctors and work in primary care settings. A limitation of such findings is the heterogeneous nature of rural medical education and contested views of what constitutes ‘rurality’, especially as it is often reported as a binary concept (rural compared to metropolitan). To address the identified gaps in workforce outcomes for rural medical training and to demonstrate accountability to the communities we serve, we investigated whether Longitudinal Integrated Clerkship (LIC) graduates are practicing in communities with similar rural classification to those where they trained. Within an LIC, students learn the curriculum in an integrated, simultaneous manner. (2) Material and Methods: A retrospective cohort study analysing variables associated with working in smaller rural communities. (3) Results: LIC graduates who undertook an additional year of rural training were five times more likely to work in communities of similar rurality to the program’s training footprint. (4) Conclusions: The duration of rural training alone did not lead to optimal rural workforce outcomes. However, graduates who had trained in a combination of rural settings, an LIC, and block rotation were the most likely to practice in communities of similar rurality to the clerkship’s training footprint. This highlights the impact of both the training duration and setting inclusive of an LIC on fostering positive rural workforce outcomes and the need to develop innovative solutions to expand these models of training in smaller rural communities.