“We learnt it, then we lived it”: Influencing medical students’ intentions toward rural practice and generalist careers via a socially-accountable curriculum

Abstract

Objective

The James Cook University (JCU) medical school has a mission to produce graduates committed to practising with underserved populations. This study explores the views of final-year students regarding the influence of the JCU medical curriculum on their self-reported commitment to socially-accountable practice, intentions for rural practice, and desired postgraduate training pathway.

Methods

Cross-sectional survey of final year JCU medical students (n = 113; response rate = 65%) to determine whether their future career directions (intentions for future practice rurality and postgraduate specialty training pathway) are driven more by altruism (commitment to socially accountable practice/community service) or by financial reward and/or prestige.

Results

Overall, 96% of responding students reported their JCU medical course experiences had cultivated a greater commitment towards 'socially-accountable' practice. A commitment to socially-accountable practice over financial reward and/or prestige was also significantly associated with preferring to practise Medicine in non-metropolitan areas (p = 0.036) and intending to choose a ‘generalist’ medical discipline (p = 0.003).

Conclusions

The findings suggest the JCU medical curriculum has positively influenced the commitment of its graduating students towards more socially accountable practice. This influence is a likely result of pre-clinical teachings around health inequalities and socially-accountable medical practice in combination with real-world, immersive experiences on rural and international placements.

Keywords:

• Undergraduate
• medicine
• community-oriented
• ethics/attitudes
• medical education research

Acknowledgements

The authors would like to thank the 2019 cohort of Year 6 JCU medical students for participating in this study.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article

Additional information

Notes on contributors

Torres Woolley

Torres Woolley, PhD, is the Evaluation Coordinator for the College of Medicine and Dentistry at James Cook University in Townsville, Australia. He is an active researcher trained in both quantitative and qualitative methodologies.

Simone Ross

Simone Ross, MDR, is a Senior Lecturer for the JCU College of Medicine and Dentistry and Project Manager for The Training for Health Equity Network. Simone has research and teaching interests across social accountability in health professional education, medical leadership and management, and the mental health of health students.

Sarah Larkins

Sarah Larkins, MBBS, BMedSci, MPHTM, PhD, FRACGP, FARGP, is a general practitioner and Professor, Health Systems Strengthening at James Cook University. Her interests are participatory interventions to help health systems meet the needs of rural, remote, Indigenous and tropical populations, and training a fit-for-purpose health workforce.

Tarun Sen Gupta

Tarun Sen Gupta, MBBS, PhD, FRACGP, FACRRM is a Professor and Head of the Townsville Clinical School at the JCU College of Medicine and Dentistry, and has previously worked as a rural doctor.

Donald Whaleboat

Donald Whaleboat, MPubHealth, BAHealthSc holds the position of Senior Lecturer within the JCU College of Medicine & Dentistry, and plays a role in the planning, development and delivery of Indigenous health subjects as part of the MBBS program.