Rural Medical Education Guidebook, Second Edition

The first edition of the WONCA Rural Medical Education Guidebook, published in 2014, was widely downloaded and cited, and remains a useful reference for anyone starting rural medical education in their own setting. It draws together the knowledge of authors from around the world, and offers examples of how rural medical education can be established where it is needed most, in rural sites, by the doctors and staff who understand those communities.

This second edition (2021) supplements the original chapters, which remain contemporaneous and relevant, with a small number of new ones. These cover how to start rural medical education where nothing yet exists, especially in resource-challenged areas, and the wider economic benefit that rural-based medical education brings to the communities where it is established. The new edition also gives more emphasis to gender equity, and addresses social determinants, agricultural health, and mental health within rural contexts. It highlights the work of WONCA's own Rural Seeds, who use social media to establish innovative programmes including mentoring, and explores the evidence for using remote technology to support training.

As Professor Roger Strasser has said, "students cannot be what they cannot see." This resource aims to make the pleasure of rural practice and education more visible, both from centres of learning and from within rural communities.

The full guidebook is available here: Download the Rural Medical Education Guidebook, Second Edition (PDF, 28.3MB).

Chapter by chapter download below.

Requests for permission to reproduce or translate WONCA publications for commercial use or distribution should be addressed to the WONCA Secretariat at [email protected]. World Organization of Family Doctors (WONCA), Avenue des Arts 7-8, 1210 Brussels, Belgium.

Rural Medical Education Guidebook, Second Edition

Table of contents (pdf document)

Acronyms

Preface to the second edition

• Theme 1Overview: Framing and Resourcing of Rural Medical Education and Practice
  • 1.1Theory, Values and Social Accountability
    • 1.1.1'What brings us together': The values and principles of rural medical educationSteve Reid, Paul Worley, Roger Strasser, Ian Couper, James Rourke
    • 1.1.2Integrating public health and medicineDenise Donovan
    • 1.1.3From the village to the globe: The social accountability of rural health practitionersRobert F Woollard
    • 1.1.4The challenges of health systems in developing countriesVictor Inem
    • 1.1.5Attaining rural health equity in AfricaIan Couper & Jannie Hugo
    • 1.1.6Attaining rural health equity in AsiaFortunato Cristobal & Ian Couper
  • 1.2Resourcing Rural Health: Funding and Human Resources
    • 1.2.1The socio-economic benefits of rural medical educationRoger Strasser
    • 1.2.2Resourcing rural health - how to start rural training where none existsIan Couper& Marietjie de Villiers
    • 1.2.3Health systems and funding of rural-based medical educationMichael Jong
    • 1.2.4Balancing medical education and the needs of the rural health serviceIan Couper
    • 1.2.5Addressing rural health workforce shortages: The pipeline conceptTom E Norris
    • 1.2.6Recruiting students to rural medical careersBlaire Schoales
    • 1.2.7Establishing a rural curriculum from an urban academic medical centreTom E Norris
    • 1.2.8Health outcomes and the balance of primary care physicians vs specialistsTom E Norris
  • 1.3Gender and Cultural Considerations in Rural Practice
    • 1.3.1Intercultural competence in rural medical practiceLeonardo Vieira Targa
    • 1.3.2Gender and culture in agricultural communitiesSusan Brumby
    • 1.3.3Developing gender and cultural awareness for rural practiceSusan P Phillips
    • 1.3.4Women and rural medical practice: The importance of doing it differently in the 21st centuryJo Wainer
    • 1.3.5Indigenous cultures and health in Canada: A primer for rural physicians and health care professionalsDarlene Kitty
    • 1.3.6The interface between orthodox and traditional health practiceChris Ellis
• Theme 2Medical Education in Rural Settings
  • 2.1Rural Medical Schools and Colleges
    • 2.1.1Foundations of a rural medical school: People, places and patientsTarun K Sen Gupta
    • 2.1.2Operating a multi-site rural-based medical schoolRoger Strasser
    • 2.1.3Developing a new rural medical school in North AmericaRoger Strasser
    • 2.1.4Developing rural medical schools: The history of Tromso and Northern NorwayIvar J Aaraas & Peder A Halvorsen
    • 2.1.5Rural medical education in Sabah, MalaysiaOsman Ali & Muhammad Tauffik Mohd Noor
    • 2.1.6Setting up Delta State University Medical School, NigeriaVictor Inem
    • 2.1.7Developing a rural medical school in AustraliaRichard Hays
    • 2.1.8The ACRRM: Advancing the discipline of rural and remote medicine in AustraliaThomas Doolan & David Prideaux
  • 2.2Teaching, Learning and Assessment in Rural Medical Education
    • 2.2.1Rural areas: Valuable learning contexts for medical studentsWendy Graham
    • 2.2.2Making medical education practical in rural settingsDawn DeWitt
    • 2.2.3Academic service learning and rural educationJannie Hugo
    • 2.2.4Building capacity for integrated clinical learning in rural settingsSue Berry, Marion Briggs & David C Marsh
    • 2.2.5Assessment in rural medical educationTim Wilkinson
    • 2.2.6Assessment in rural medicine: How to measure and motivate achievement of abilitiesRichard Murray & Tarun K Sen Gupta
  • 2.3Personal Support and Social Considerations in Rural Health Practice
    • 2.3.1Teaching the rural determinants of healthSteve Reid
    • 2.3.2Teaching and learning in agricultural healthScott Kitchener
    • 2.3.3Teaching mental health care in rural communities in CanadaMichael Jong
  • 2.4Clinical Research in Rural Settings
    • 2.4.1Boundaries and balance: Managing relationships in rural practiceLeslie Rourke & James Rourke
    • 2.4.2The art of mentoring learners in rural health settingsBarbara J Doty & David Schmitz
    • 2.4.3Mentor-mentee programme: mentoring in areas without established rural training pathwaysKarine Kersting Puls, Veronika Rasic, Amber Wheatley & Mayara Floss
    • 2.4.4Addressing personal difficulties during rural placementsSuzanne Allen
    • 2.4.5Enhancing the integration of medical students into rural communitiesLisa McFayden & W Ian Cameron
    • 2.4.6Supporting the spouse of the rural doctor and integrating the learner's family into rural settingsAnne Chater
  • 2.5Clinical Research in Rural Practice
    • 2.5.1Clinical research in rural practiceLen Kelly
    • 2.5.2Clinical randomised controlled trials in rural primary care settingsAthina Tatsioni & Christos Lioni
• Theme 3Professional and Technical Support for Rural Medical Educators
  • 3.1Professional Support and Development for Rural Medical Educators
    • 3.1.1Rural clinical educator supportPaul Worley
    • 3.1.2Teaching rural clinical educatorsJane Greacen
    • 3.1.3Growing academics: faculty development in rural and remote contextsSarah Strasser
    • 3.1.4Professional development and support for clinical educatorsCon O'Maonaigh
  • 3.2Technical Support for Rural Medical Educators
    • 3.2.1Rural medical training via distance education and remote supervisionPatrick Giddings & Jeanette McLaren
    • 3.2.2Teleconferencing in rural and remote medical educationKristian Krogh, Katherine Gray & Debra Nestel
    • 3.2.3E-learning: A basic approach for rural clinical educatorsPeter G Baker
    • 3.2.4Web-based networking: A case studyPeter Hutten-Czapski
    • 3.2.5Enhancing rural medical education through web-based access to librariesPatty Fink
• Theme 4Undergraduate Medical Education
  • 4.1Overview of Undergraduate Rural Medical Education
    • 4.1.1Excellence in 'bush medical schools': The value of rural educationJ Campbell Murdoch
    • 4.1.2Optimising rural medical learningAlan Bruce Chater & Janine Wyatt
    • 4.1.3Undergraduate medical teaching in rural and remote settingsSarah Strasser
    • 4.1.4Developing rural undergraduate medical education in WalesMartin Green
    • 4.1.5Multinational medical student clubsIan Cameron
    • 4.1.6Rural seeds: innovation and rural health careMayara Floss, Andressa Cavalcante Paz e Silva, Karine Kersting Puls, Ana Julia de Araujo, e Marcela Araujo de Oliveira Santana, Paola Iana Fucks da Veiga, Amber Wheatley, Veronika Rasic
  • 4.2Undergraduate Student Recruitment and Selection
    • 4.2.1Medical school admissions policies targeting rural studentsPamela Stagg
    • 4.2.2Recruiting medical students from rural areasSue Page
    • 4.2.3Promoting rural practice through student selectionTarun K Sen Gupta & Louise Young
  • 4.3Undergraduate Curriculum and Models of Delivery
    • 4.3.1Models for undergraduate rural health placementsJane Doherty
    • 4.3.2Short-term rural placements for medical studentsIan Couper
    • 4.3.3The community-oriented clinical clerkship: Short-term student placements in rural primary health careTheodoros Vasilopoulos
    • 4.3.4Parallel consulting in rural medical educationLucie Walters
• Theme 5Postgraduate Medical Education
  • 5.1Postgraduate Training and Professional Development
    • 5.1.1'Training in place': The evidence for effective remote clinical supervisionEwen McPhee & David Farlow
    • 5.1.2Training in family medicine for rural practice in CanadaMaureen Topps
    • 5.1.3Training in family medicine for rural practice in the USADavid Schmitz & Barbara J Doty
    • 5.1.4Health service management training for rural doctorsIan Couper
    • 5.1.5Implementing a professional development framework for rural and remote doctorsDi Wyatt
    • 5.1.6Postgraduate pathways to rural medical practiceTarun K Sen Gupta & Andrew McKenzie
    • 5.1.7Professional development programmes for rural doctorsJames Douglas
    • 5.1.8Credentialing and re-certification of rural doctorsJane Greacen
  • 5.2Advanced Clinical Skills Training
    • 5.2.1Supporting rural procedural practiceAlan Bruce Chater
    • 5.2.2Maintenance of emergency skills in rural practiceDavid Campbell
    • 5.2.3Advanced clinical skills: The use of simulation for the development and maintenance of skills for rural practitionersDebra Nestel, Leanne Rogers, Kirsty Freeman, Kathy Brotchie & Marcus O Watson
    • 5.2.4Advanced skills training for rural doctorsJames Douglas
    • 5.2.5The making of a rural general surgeonG William N Fitzgerald