What evidence-based undergraduate interventions promote rural health?

AIMS: This article identifies published reports of medical undergraduate rural programmes from international medical schools and investigates the features making these programmes successful in recruiting and retaining rural physicians.
METHOD: Literature review.
RESULTS: Ten successful programmes were identified. Common features included selective admission, curricular focus on primary care/family medicine, community-based teaching, and community/rural preceptorship. A strong association exists between rural background of the student and choice of both a rural career and a career in primary care. Medical students of rural origin with an initial interest in a generalist career are significantly more likely to enter rural practice. Community preceptorship with its high staff:student ratio has been effective in influencing students' career choices.
CONCLUSIONS: The effectiveness of a medical undergraduate rural programme in preparing and recruiting physicians for rural practice does not occur with one isolated strategy but with a chronological sequence of interventions. The most effective programmes consider both pre-medical school and medical school educational factors. Medical schools would need to implement a combination of these strategies when designing a programme to maximise success.