Programs to encourage working as a general practitioner in rural areas: why do medical students not want to participate? A cross-sectional study

BACKGROUND: In many countries, not enough students are interested to work as general practitioners in rural areas. To solve this problem, several, sometimes partly extracurricular, programs have been developed. Most of these programs are based on continuity, which means that students stay in a rural region for an extended period of time, by completing clerkships. Although the effects of these programs are positive, it is often difficult to motivate students to participate. The purpose of the present study is to get insight into the reasons why students choose not to participate in these programs. METHODS: We carried out a questionnaire study among medical students in the clinical phase of the Technical University of Munich in Germany. First, we asked the students whether they actively informed themselves about the program which aims to reduce the shortage of general practitioners in rural areas in Bavaria. Furthermore, the questionnaire focused on the reasons for not participating in this program. RESULTS: Based on the answers of 442 students from study years 3–6, the most frequently chosen reason for not participating in the program is “identification with another discipline” with 61.0%, directly followed by “not willing to commit long-term” (56.1%). In third place is “personal connections to another region” with 30.5%. In the open comments, we find the same reasons: many students do not want to commit to a certain direction too early. In addition, students indicate that the number of regions where this program is offered is too limited for them. CONCLUSIONS: Offering programs to prepare and motivate students for work as general practitioners in rural areas can contribute to increasing the pool of future general practitioners. To encourage students to participate in such a program, it is important to consider the motives of students. Many students who might be interested in general practice do not choose to take part in such a program because they do not want to commit to a particular specialty or region at an early stage. It is important to take these insights into account when designing and implementing these programs.