Factors associated with rural doctors’ intention to continue a rural career: A survey of 3072 doctors in Japan

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Abstract
To show the relationship between the personal and educational backgrounds of rural doctors and their intention to continue a rural career. Nationwide postal survey. Public clinics or hospitals in municipalities that are classified as 'rural' by the national government. A total of 4896 doctors working for 828 public clinics and hospitals. A questionnaire was mailed. The questionnaire inquired about the subject's age, sex, hometown, exposure to rural practice in undergraduate education, postgraduate training, continuing medical education, current position and affiliation status with a medical school, as well as his or her intention to continue a rural career. Response rate was 64%; 26% answered that they intended to continue a rural career. Postgraduate training in general internal medicine, general surgery, anaesthesiology, paediatrics and gastroenterology were positively related with the intention to continue a rural career (odds ratio = 2.045, 1.59, 1.30, 1.48, 1.38). Rural background, undergraduate exposure to rural practice, multispecialty-rotation in postgraduate training and current administrative position had positive correlations with the intention to continue in logistic regression analysis (odds ratio = 1.80, 2.47, 1.54, 2.17). Affiliation with a medical school department was negatively related with the intention to continue (odds ratio = 0.45). In addition to the rural background of physicians, some undergraduate and postgraduate factors were independently associated with the intention to continue a rural career.