TY - JOUR
T1 - Why do doctors work in rural areas in high-income countries? A qualitative systematic review of recruitment and retention
AU - Holloway, Patrick
AU - Bain-Donohue, Suzanne
AU - Moore, Malcolm
N1 - Publisher Copyright:
© 2020 National Rural Health Alliance Ltd.
PY - 2020/12
Y1 - 2020/12
N2 - Objective: To identify and assess the drivers and barriers to recruiting and retaining doctors in rural communities of high-income countries. Design: A systematic review and thematic analysis. Setting: Publications were sourced from medical and scientific databases online. Participants: Qualitative, mixed-methods and review studies from peer-reviewed journals published since 2000 that discussed recruitment or retention of doctors to rural areas in high-income countries. Main outcome measures: Identification and assessment of themes in the literature pertaining to recruitment and retention of rural doctors. Recurrent themes were assessed for relevance and applicability to current rural shortages. Results: A thematic analysis was completed on 41 papers assessed as in scope of the review. Papers were scrutinised for relevance to established rural recruitment and retention strategies. Key themes were rural background, education and training, personal and professional circumstances, and integration with the community. Conclusion: While rural origin has long been promoted as the key factor for recruiting rural doctors, initiatives targeting only these individuals ignore a potentially larger cohort of future rural doctors. Rurally focused medical education and training need to encompass students and doctors from all backgrounds. The major barriers to rural recruitment are family-unit considerations for partners and children, concerns over isolation and a poor perception of rural practice. Attracting doctors to practise rurally is only half the challenge however, and strategies to retain rural doctors need a greater focus on personal and professional support networks and community integration. Additional strategies are needed to retain international and bonded doctors restricted to rural areas.
AB - Objective: To identify and assess the drivers and barriers to recruiting and retaining doctors in rural communities of high-income countries. Design: A systematic review and thematic analysis. Setting: Publications were sourced from medical and scientific databases online. Participants: Qualitative, mixed-methods and review studies from peer-reviewed journals published since 2000 that discussed recruitment or retention of doctors to rural areas in high-income countries. Main outcome measures: Identification and assessment of themes in the literature pertaining to recruitment and retention of rural doctors. Recurrent themes were assessed for relevance and applicability to current rural shortages. Results: A thematic analysis was completed on 41 papers assessed as in scope of the review. Papers were scrutinised for relevance to established rural recruitment and retention strategies. Key themes were rural background, education and training, personal and professional circumstances, and integration with the community. Conclusion: While rural origin has long been promoted as the key factor for recruiting rural doctors, initiatives targeting only these individuals ignore a potentially larger cohort of future rural doctors. Rurally focused medical education and training need to encompass students and doctors from all backgrounds. The major barriers to rural recruitment are family-unit considerations for partners and children, concerns over isolation and a poor perception of rural practice. Attracting doctors to practise rurally is only half the challenge however, and strategies to retain rural doctors need a greater focus on personal and professional support networks and community integration. Additional strategies are needed to retain international and bonded doctors restricted to rural areas.
KW - professional development for rural health practitioners
KW - remote health
KW - rural medicine
KW - rural workforce development
KW - rural/remote GP and rural medicine education
UR - http://www.scopus.com/inward/record.url?scp=85096682995&partnerID=8YFLogxK
U2 - 10.1111/ajr.12675
DO - 10.1111/ajr.12675
M3 - Review article
SN - 1038-5282
VL - 28
SP - 543
EP - 554
JO - Australian Journal of Rural Health
JF - Australian Journal of Rural Health
IS - 6
ER -