Aust. J. Rural Health (2002) 10, 220–228 Blackwell Science Asia 54 University Street, PO Box 378, Carlton South, Victoria 3053 Australia AJR The Australian Journal of Rural Health 1038-5282 © 2001 National Rural Health Alliance Inc. 9 3 Feburary 2001 319 AUSTRALIAN JOURNAL OF RURAL HEALTH RURAL ACTIVITY AND CURRICULUM CONTENT: APELAIDE UNIVERSITY MEDICAL SCHOOL: C. LAURENCE ET AL. 10.1046/j.1038-5282.2001.00408.x Original Article 0 Graphicraft Limited, Hong Kong INCREASING RURAL ACTIVITY AND CURRICULUM CONTENT IN THE ADELAIDE UNIVERSITY MEDICAL SCHOOL Caroline Laurence, 1,2 Jonathan Newbury 2 and David Wilkinson 1 1 South Australian Centre for Rural and Remote Health, Adelaide University and University of South Australia, Whyalla and Adelaide, and 2 Department of General Practice, Adelaide University, Adelaide, South Australia ABSTRACT: This study aimed to document the level of rural activity and curriculum content in the Adelaide University Medical School. A questionnaire was distributed to all heads of departments within the Medical School and additional information was obtained from reports and discussions with key personnel. There has been an increase in the proportion of students with a rural background enrolled from 9% in 1994 to 22% in 2000. There has also been an increase in the number of weeks available for rural placements from 12 (mostly optional) to 29 weeks (some mandatory), and an increase in the number of departments offering rural placements. There has also been improved academic support to rural practitioners and many departments directly provide services in rural communities. A new combined University Department of Rural Health (UDRH)/Rural Clinical School associated with the Adelaide University Medical School aims to provide at least half of all clinical training to 25% of all medical students of Australian origin. KEY WORDS: curriculum development, medical school, rural health. INTRODUCTION Recruiting and retaining an adequate number of rural doctors is a problem faced by many countries. 1,2 Research from Australia and overseas has identified several factors that impact on a doctor’s decision to choose rural prac- tice. Rural exposure is associated with subsequent rural practice. 3–6 Rural exposure can be divided into three levels: living in a rural area as a child; 7–15 placement in a rural practice during undergraduate or postgraduate training; 6,16–18 and studying medicine in a rural location. 13,19–22 Location of undergraduate education and residency programs seems to influence location of practice. Medical schools clearly have a substantial impact on the career decisions of medical students through their selection, training and socialisation processes. 19,22-24 Medical schools in North America vary greatly in the extent that their graduates select rural practice, with schools located in rural areas more likely to produce rural graduates. 25 However, interest in rural practice wanes as medical education progresses. 24 Options to maintain interest include sensitising faculty and staff to rural values and needs; orienting students to the school’s rural interests/ goals; developing early rural preceptorships; organising rural societies/clubs; assisting students to volunteer time to rural health services; and including the spouse/partner in rural activities. Curriculum reform also signals the school’s recognition that rural medical careers are valid. 26 In Australia, the most concerted effort to increase undergraduate exposure to rural practice has been through the General Practice Rural Incentive Program’s Rural Undergraduate Support Steering Committee (RUSC) initiatives. Following the 1994 report on reforming under- graduate medical education for rural practice, $1.74 m has been provided annually to the 10 medical schools to implement initiatives that reform the undergraduate curriculum to include more rural content and experience Correspondence: Professor David Wilkinson, SACRRH, University of South Australia, Whyalla Campus, Nicolson Avenue, Whyalla, South Australia 5608, Australia. Email: david.wilkinson@unisa.edu.au Accepted for publication May 2001.