Can a Rural Medical Education be a Better Education?

Paul Worley, David Prideaux, Roger Strasser, Chris Silagy, Robyn March

Background:
Many medical schools have acknowledged the long-term workforce of allowing students to undertake a rurally based term. However, most have been reluctant to place too much emphasis on these terms due to concerns for academic quality. Is this concern justified?

This paper presents new evidence on the academic achievement of medical students at Flinders University who volunteered to undertake their major clinical year in one of three locations - an urban tertiary referral hospital, a remote secondary referral hospital, or a rural general practice.

Methods:
Two hundred and eight students undertook the 3rd year of a four-year graduate-entry medical program during the period, 1998-2000. 58 students volunteered for the rural/remote locations and the remaining 150 students were located at the tertiary hospital. All students undertook an identical examination at the end of their 2nd year (pre-intervention) and another identical examination at the end of their 3rd year (post-intervention). Results were compared sing an analysis of variance of the mean difference in score and rank for each of the groups.

Results:
Students in the rural/remote locations improved their examinations score by 2.8% (F=6.64, p=.01), and their rank by 6.5 positions out of 70 (F=.84, p=.006) compared to their peers at the tertiary hospital.

Implications:
These data can be a source of reassurance to medical schools that wish to engage in significant rural and remote clinical teaching, and challenge the assumption that urban tertiary hospitals remain the gold standard for undergraduate medical education.

Why a Preceptorship Is Better

Quality in Rural Medical Education

www.ruralmedicaleducation.org