Original Research
Medical students’ experiences of compulsory rural service in Guatemala: a qualitative study
AUTHORS
Anita Chary1 MD, PhD, Staff Researcher and Physician * 
Jessica Hawkins2 BA, Research Fellow
David Flood3 MD, MSc, Staff Researcher and Physician
Kirsten Austad6 MD, MPH, Staff Researcher and Physician
AFFILIATIONS
1, 2, 3, 4, 5 Wuqu' Kawoq, Maya Health Alliance, Barrio Patacabaj, Tecpán, Chimaltenango, Guatemala
6 Wuqu' Kawoq, Maya Health Alliance, Barrio Patacabaj, Tecpán, Chimaltenango, Guatemala. Present address: Boston Medical Center, Boston, MA, USA
ACCEPTED: 16 March 2022
Now published, see the full article 
Early Abstract:
Objectives: Compulsory rural service is one method of addressing limitations in health care access in marginalized areas of low- and middle-income countries, including Guatemala. This study aimed to explore Guatemalan medical students’ experiences of compulsory rural service and its impact on their professional development.
Methods: Qualitative semi-structured interviews were conducted with 40 medical school graduates who completed compulsory rural service between 2012-2017. Interview transcripts were coded for dominant themes using an inductive approach.
Results: The majority of interviewees felt that rural service contributed to their professional development by increasing their clinical autonomy, awareness of social determinants of health, and humanistic practice. Interviewees identified limited supervision as a key challenge during the rotation. The majority found rural service rewarding.
Conclusions: Guatemalan medical students felt that rural service contributed to their professional and personal development. Rural rotations build primary care skills and may increase awareness of health inequity among clinical trainees. Given ongoing healthcare worker shortages in Guatemala, innovative approaches to improving professional supervision and rural health mentoring are needed.