Rural temperament and character-ELEY 1 Rural temperament and character: A new perspective on retention of rural doctors Diann Eley , Louise Young, Thomas R Przybeck, INTRODUCTION Rejuvenating the rural health workforce remains a challenge to governments and stakeholders and innovative methods are required to help improve this situation. Revisiting the investigation of personality traits to better understand medical disciplines may provide a greater understanding of traits that are conducive to that discipline. No research to date has investigated the ‘rural doctor’, a profession that is increasingly recognised as an entity in itself. Although acknowledged by anecdotal narrative 1 , the unique personality and lifestyle of doctors in rural and remote locations worldwide has received little attention. In two successive studies, the temperament (mildly heritable)and character (influenced by socio- cultural learning) trait profiles of established rural and urban doctors were explored and compared to better understand the traits that retain them in or out of rural medicine. The first largely exploratory study aimed to identify a psychobiological profile for rural general practitioners (GPs). Building on these findings the aim of the second study was to extrapolate further to differences within the speciality of general practice and consider location or context as a defining characteristic. Specifically our research questions asked; 1) are the profiles of GPs working in rural/remote environment different to GPs working in an urban/metropolitan context, and 2) are there certain demographic variables along with the dimensions of temperament and character that may be predictive of practice location? The overall aim of this research is to describe how individual profiles (levels and combinations) of temperament and character traits are beneficial to GPs who flourish or fail in rural medicine. METHODS A mixed method, cross sectional design employed qualitative and quantitative methods. Study 1 : A purposive sampling logic ensured participants were relevant to the research aim. Rural GPs (n=13) with 7 to 40 years (mean = 23.1) experience in RRMA 5-7 practice in Central and Southern Queensland were recruited. All completed a demographic questionnaire and the TCI-R140 2, 3 to identify the levels and profiles of the seven basic dimensions of temperament and character. These are Novelty Seeking (NS), Harm Avoidance (HA), Reward Dependence (RD), and Persistence (PS), Self-Directedness (SD), Cooperativeness (CO) and Self-Transcendence (ST). Semi- structured interviews provided in-depth information on what brought them to and kept them in rural practice. Triangulation of the data sources described the findings. Study 2 : The same research materials were posted to 286 rural GPs and 258 urban GPs to compare the individual levels and combinations of temperament and character traits of both GP cohorts. Descriptive, frequency, Chi Square and ANOVA statistics were generated for comparison of TCI scores with demographics and population norms and between rural and urban GPs using SPSS version14. Logistic regression was used to first predict rural or urban practice from the temperament and character dimensions and repeated while controlling for salient covariates. Ethical approval was obtained the University of Queensland. RESULTS AND DISCUSSION Study 1 : TCI results showed that our sample of rural GPs are highly self-directed (SD), cooperative (CO), objective (ST) and persistent (PS) in character and also very caring (RD) in temperament. Interview analyses highlight findings that concur with the literature 4, 5, 6, 7 and lend credence to the argument that rural general practice may differ from urban general practice. However, individual variations are evident in the temperament dimensions of Harm Avoidance (HA) and Novelty Seeking (NS). In particular, GPs who intended to leave rural practice had significantly