Rural internship in medical education: a scoping review on professional retention and career intentions in rural practice

Early Abstract:

Background: Rural internship is a fundamental stage in medical education, contributing to the development of clinical skills and a broader understanding of the social determinants of health and the specifics of Primary Health Care in vulnerable contexts. 
Objectives: This scoping review aimed to identify and synthesize the literature on the educational, professional, and service-related effects of rural internships undertaken during undergraduate medical education, including their reported contribution to healthcare delivery in rural communities.
Eligibility criteria: Studies addressing rural internships during undergraduate medical education were included, with evidence from participants with direct experience and other relevant stakeholders. Eligible publications were in Portuguese, English, or Spanish.
Sources of evidence: In May 2024, the following databases were searched: PubMed, Biblioteca Virtual em Saúde (BVS), Education Resources Information Center (ERIC), and Scientific Electronic Library Online (SciELO). The search strategy used the Descritores em Ciências da Saúde/Medical Subject Headings (DeCS/MeSH) system descriptors: Medical Internship AND Rural Population AND Medical Education. A total of 716 studies were identified.
Charting methods: The selection process followed the Joanna Briggs Institute (JBI) methodology and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Reviewers conducted the selection independently, and the extracted data were synthesized descriptively and organized into thematic categories. After removing 195 duplicates, 521 studies remained. These were screened based on titles (451 excluded) and abstracts (42 excluded), leaving 28 for full-text review. Ultimately, 21 studies were included in the final analysis. Reviewers conducted the selection independently, and a consensus was reached on the included studies.
Results: The included studies suggested that rural internships may positively influence career intentions toward rural practice, strengthen autonomy and engagement with Primary Health Care, and support learning in resource-limited settings. Perceived contributions to healthcare delivery in rural communities were also reported, although evidence on direct impacts remained limited and methodologically heterogeneous.
Conclusions: Rural internships represent a relevant educational strategy for training socially committed physicians and improving health care in rural areas.
Keywords: internship and residency, medical education, rural population health, rural health services.