Rural Medicine and Longitudinal Integrated Clerkships

This Editorial celebrates the contribution of rural programs to the longitudinal integrated clerkship (LIC) movement by examining the contributions of articles published online in Rural and Remote Health to the LIC discourse.

When universities decide to move substantial medical education programs out of urban tertiary centres and into rural community settings, new methods need to be found that take advantage of the unique characteristics of the new setting. This article describes one such approach in rural Australia. Could this be useful where you live?

A successful rural medical education model may receive much attention, but it takes more than a few individuals each year to impact on regions or nations. Once the original is replicated successfully, not only will others join in, but policies can encourage development of such programs. This article describes the replication process and is useful for those involved in development and evaluation of rural experiences.

The results of this study suggest that an opportunity to acculturate students into the rural lifestyle is lost when students' placements are insufficiently long for them to put down roots. Does this echo your experience?

Moving health professional education into rural regions is an internationally accepted strategy to assist in improving rural health professional recruitment. This short Personal View provides helpful insights from an important recent innovation in regional Australia.

Rural medical practices are increasingly taking on a major undergraduate teaching role. But could you sustain five students studying for the whole year in your practice? Experience from South Australia suggests you can!

Current rural clinical school students who have chosen to spend an exciting time during their clinical training in the bush are among the best advertisements for a career in rural Autralia. This positive study might present a "rose tinted" view of life in the country as a Western Australian medical student, but it does provide more evidence and data to encourage future students to "go rural".

The rural clinical schools in Australia have led the way to developing alternative models of medical education in small rural communities. These medical educators have used RCS principles to develop a community based medical education program in the medium sized city of Darwin, in Australia's remote 'Top End'.

The one-year Flinders University program for undergraduate education located in rural general practices has set the standard for medical education in Australia and internationally. This results of this study suggest that half of these graduates are on a rural pathway. The article considers why the other half is not, applying unique typology that includes 'The Frustrated' and 'The Metro Docs'.

Highly centralized and subspecialized training is a prestigious line of work with a long and glorious tradition of failing to provide the workforce needed for rural areas worldwide. Common sense indicates that training specific to rural workforce would focus on training longitudinally in rural locations. Two of these models have captured rural medical student and rural clinician impressions for review.

The Ateneo de Zamboanga University School of Medicine experience in the Philippines suggests a cost-effective model of producing rural doctors to work in under-served rural communities. This is the first in-depth report from the innovative and socially accountable medical school located in one of the most difficult places in the world for physicians to work.

It is accepted now that rural undergraduate educational experience has a positive impact on rural workforce recruitment. For Australian medical students this means long-term rural GP clerkships - but are these students a financial liability or significant contributors to the practice? This Australian study analysed qualitative data from their GP supervisors, and financial and patient activity data from participating New South Wales medical practices to find out.

Motivated by a mix of social, community and governmental accountability, many medical schools involve rural community members in the undergraduate student selection process. These Flinders University researchers investigated the motivation and more of a sample of South Australian community members who make this pro bono contribution.

This research from the University of Western Sydney adds to the medical education evidence for long-term rural placements. The authors place their own results in the context of recent, similar Australian studies.

James Cook University's School of Medicine was established with a mission to address the health needs of rural, remote and tropical Australia. Does early evidence on the first six cohorts' career outcomes support this?

Changes to continuity for longitudinal curricula represent challenges for rural physicians, staff, and sites. What should developers anticipate and how can they convey the long term gains?

Innovative integrated clerkships for medical students offer rural healthcare services an opportunity to really integrate education with service. Perspectives from a multi-disciplinary group of stakeholders confirm the significant clinical exposure, skill and teaching capacity in these previously unrecognised placements but caution that realising the potential of health services needs careful management.

There are numerous initiatives to address recruitment and retention of health care providers in rural areas. This article reports on a rural track program among students to ascertain their experiences. Using photovoice participatory research increased understanding of the students' experiences

This article examines the history of rural training track residency programs in the United States over the past 30 years. This account reveals the significance of a community of practice for ongoing support and development of these programs.

Exposure to undifferentiated patient presentations is increasingly common in medical education, particularly in longitudinal integrated placements. This research, from an international research workshop attended by clinician teachers and medical educators who work in rural primary care, explored clinicians' perspectives of how students develop their clinical reasoning: by learning from patients; from their supervisors; and by understanding the context of their clinical interactions.   

‘Socially accountable, community-engaged’ health professional education (SAHPE) has contributed to increased medical coverage across rural and/or economically disadvantaged areas in two Philippines regions. The extensive community-based medical student placements associated with SAHPE likely play a significant role in graduates choosing to practice in rural and/or economically disadvantaged communities.

This scoping review examines the literature on decentralised training platforms (DTPs) for medical education, with particular attention to rural context. Findings highlight DTP strategies and models as well as areas for further research to examine DTP impact on health services and human resources outcomes.