Factors related to doctors’ choice of rural pathway in general practice specialty training

Objective To investigate the factors eligible applicants consider in electing for a rural pathway into specialty training. Design Cohort study. Setting Australia. Participants Applicants to the Australian General Practice Training program. Main outcome measures Applicants’ initial preference of either a general or rural pathway to undertake specialty training. Results Of the 2,221 applicants, 45% were Australian Medical Graduates ( AMG s), 27% Foreign Graduates of Accredited Medical Schools ( FGAMS ) and 29% International Medical Graduates ( IMG s). Through government regulation, two thirds (70%) were eligible to train on both general and rural pathways and a third (30%) were required to train rurally. For applicants eligible for general pathway (n = 1552), those with rural background [Odds Ratio ( OR ) = 3.7, 95% CI 2.7–5.2] and rural clinical school experience ( OR  = 2.0, 95% CI 1.5–2.8) were more likely to choose the rural pathway. In addition, FGAMS who were eligible for the general pathway were less likely to choose a rural pathway when compared with IMG s ( OR  = 0.33, 95% CI 0.1 = 0.7). In applicants who changed their training pathway from their initial to revised preference, lower Multiple‐Mini‐Interview ( OR  = 0.54, 95% CI 0.43–0.66) and Situational Judgement Test z‐scores ( OR  = 0.68, 95% CI 0.56–0.83) were associated with a higher probability of changing from a general to rural pathway preference. Conclusion For those eligible for a general or rural pathway, rural background and rural clinical school experience are associated with the decision to elect for rural training. Targeted support for international and foreign graduates of Australia/New Zealand schools may influence them to train rurally.