Factors promoting willingness to practice medicine in rural regions and awareness of rural regions in the university's catchment area - cross-sectional survey among medical students in central Germany.

Aim: Many universities offer rural medical internships for medical students. The present survey was designed to show how rural medical work is perceived by students, whether these perceptions are associated with origin and previous experience, and how well medical students know rural regions in the vicinity of their university. In addition, students were asked how to support and inspire medical students to later work in a rural region. Methods: This cross-sectional study was based on an anonymous online survey of medical students at the Universities of Halle-Wittenberg and Leipzig. The evaluations included descriptive statistics, statistical group comparisons, and qualitative content analysis of free text answers. Results: A total of 882 students took part in the survey. Students who had grown up in a rural region or had lived there for a longer time (71.7% of the respondents) rated the work-life balance better (p<0.01) and the patient variety in the countryside slightly higher (p<0.05) than their fellow students from the big city. Students who had worked in a rural practice or hospital before (62.2%) rated patient diversity (p<0.001) and work variety (p<0.001), as well as workload (p<0.01), slightly higher in rural areas than students with no prior experience. On average, the specified rural model regions were still unknown to more than 60% of the students. The suggestions for attracting medical students to later work as rural physicians included financial incentives and, above all, better information about life as a rural physician and the rural regions. Conclusion: Thus, the medical faculties of the universities as well as the counties threatened by medical undersupply should further expand the transfer of knowledge and experience regarding rural physician life for the students.

When and why do medical students drop out of extracurricular longitudinal general practice tracks? A cross-sectional study from two German medical faculties.

OBJECTIVES: To explore when and why undergraduate medical students drop out of longitudinal extracurricular general practice (GP) tracks and to describe their future career plans. DESIGN: Cross-sectional online survey and descriptive analysis of routine data. SETTING: GP tracks at two German medical faculties, data collection took place between September 2020 and April 2021. PARTICIPANTS: Of 111 students who had taken part in one of the two GP tracks and dropped out prematurely, 101 were contactable via email. Overall, the response rate was 72.3% with 73 completed questionnaires and 75.3% of the participants were female. PRIMARY AND SECONDARY OUTCOME MEASURES: Reasons for leaving the GP track (closed and free-text answers), attitudes towards a career in GP and future career plans. RESULTS: Students left the tracks predominantly during the first 2 years of study. Students most frequently stated that structural reasons such as the distance to the GP teaching practice (74.2%), interest in another medical discipline (66.1%), private reasons (58.1%) and the GP mentor (53.1%) influenced their decision to drop out. However, 87.1% of the students indicated that their exit could not have been prevented by the project administration. CONCLUSIONS: Reasons for dropping out differ between GP tracks and not all reasons are within reach of programme design and staff. Addressable issues include student selection with regard to career plans, support and strengthening of student-mentor relationships, the location of GP practices, and/or travel and accommodation support.

How to increase the attractiveness of undergraduate rural clerkships? A cross-sectional study among medical students at two German medical schools.

OBJECTIVES: While literature provides substantial evidence that undergraduate rural clerkships may contribute to attract medical students to rural careers, so far little is known about how to convince medical students to choose rural teaching sites for their clerkships, which is usually optional. Thus, this study aimed to investigate students' preferences and perceptions regarding different rural teaching and clerkship formats, important side conditions and suitable communication strategies to promote rural clerkships. DESIGN: Cross-sectional study based on a quantitative survey among medical students in advanced study years. SETTING: Two German medical schools (Leipzig and Halle-Wittenberg). PARTICIPANTS: Medical students in third to fifth year (of six). RESULTS: Response rate was 87.1% with n=909 analysable questionnaires. Participants' mean age was 25.0 years and 65.2% were women. For 97.9% of the students completing some kind of rural clerkship was imaginable, for 90.8% even participation in a rural clerkship of 4 weeks and longer. Nearly half of the students (48.0%) specified that a rural clerkship 4 weeks and longer was 'absolutely imaginable'. Younger age, having grown up in a rural or small-town region, being able to imagine future working in a small-town or rural area, and general practice as favoured, or at least conceivable career option were independently associated with a higher willingness to complete longer rural clerkships. Financial and organisational issues including remuneration of the clerkship, cost absorption for travelling and accommodation, and accessibility by public transport were the most important side conditions to increase the attractiveness of rural clerkships. Experience reports by fellow students, social media and informational events were stated to be the most suitable ways to advertise rural teaching offers. CONCLUSIONS: The majority of the students are open-minded regarding even longer rural clerkships. This study adds new insights into measures that should be taken to convince them to actually chose this option.

LeiKA: an optional German general practice teaching project for first-semester medical students: who is taking part and why? A cross-sectional study.

OBJECTIVES: This study investigates students' adoption of LeiKA, a new extracurricular longitudinal general practice (GP) teaching project. LeiKA aims to attract a broad range of students, not only those who are already planning to become GPs. This study compares participants' and non-participants' characteristics, career preferences and job-related value orientations to assess the programme's initial potential to increase the number of students subsequently entering GP careers. Additionally, students' motives for taking part in the programme were explored. DESIGN: We analysed administrative data and data from a cross-sectional questionnaire survey for the first three cohorts. LeiKA participants were compared with non-participants regarding baseline characteristics, career intentions and attitudes associated with GP careers. There was also a qualitative analysis of the reasons for taking part. SETTING: Faculty of Medicine, University of Leipzig, Germany. PARTICIPANTS: First-semester medical students in the years 2016-2018. RESULTS: In the first 3 years, 86 of 90 LeiKA slots were taken, 9.0% (n=86/960) of those eligible to apply. LeiKA participants were a mean of 0.6 years older (LeiKA: 21.5 vs whole cohort: 20.9 years, p<0.001) and slightly more interested in long-term doctor-patient relationships (3.6 vs 3.3, scale from 1 'unimportant' to 5 'very important', p=0.018), but did not differ regarding other characteristics and attitudes. Although more participants definitely favoured a GP career (13.1% vs 4.9%, p=0.001), it was a possible option for most students in both groups (78.6% vs 74.0%). Early acquisition of skills and patient contact were the main motives for taking part, stated by 60.7% and 41.7% of the participants, respectively. CONCLUSIONS: The extracurricular programme was taken up by a broad range of students, indicating its potential to attract more students to become GPs. The reasons for taking part that we identified may guide the planning of other similar projects.