Picking your clinical rotations can be a challenging time, especially when you may be unsure of what speciality you would like to pursue in the future or even what your interests might be. Rural terms or full rural years may seem a daunting experience to pursue – moving away from your support networks into an area that is far away  and where you are expected to meet new people as well as learn the ropes of clinical placement. This thinking is so prevalent in city based students, but hear me out on why I think you should pursue a rural term and I'll also debunk some common myths about rural placement.

1. Huge Diversity of Experience

Some students have a preconceived idea that a rural experience is very generalised, with no exciting emergency situations and limited surgical experience. Let me tell you – it is quite the opposite. Rural health is a diverse and ever changing situation, with a myriad of presentations coming into the hospital at all hours of the day. As a medical student in the country, it is common to complete ED on call shifts, where you experience a great diversity of acute medicine – from bowel obstructions, to chest pain, to illicit substance overdose, all the way to an emergency C-section. These are wonderful experiences, and although you are working within a certain sub-specialty, you get a great diversity of experiences which equip you with malleable skills that allow you to thrive in a large variety of clinical situations.

In addition to acute medicine, the continuity of care within rural GP is second to none. Due to a relatively smaller subset of patients, rural GPs may be more inclined to see their patients on a regular basis, allowing students to see progress of health, and how interventions impact on health outcomes. Finally, visiting surgeons are a common occurrence in regional areas, which allows students to experience surgery. These surgeries are variable, including orthopaedic, gynaecological, general, urology, vascular and obstetric. This variety is immensely valuable as many city counterparts do not get to experience a diverse surgical list, usually it’s limited to one speciality. 

2. Better teaching

Working in rural health for clinical rotations provides unique learning opportunities for students. Although there are less doctors, there are also less students per doctor, which creates much more intimate learning opportunities. Usually in a large hospital team, you do your ward round with a consultant, registrar, intern, and 4th and 3rd year students, while in rural areas, it is just you and the GP.  This means increased opportunity to practice practical skills, including writing admission notes and ward round notes. This also makes you feel like you’re offering a valuable contribution to the rural healthcare team, which gives you increased satisfaction as a student. 

Your relationship with your supervisor is unique in rural settings as you spend so much time with them, and very early on they have high expectations for you in terms of being a valuable member of the team. At the beginning of my rural year, I had never catheterised a patient, had limited cannulation experience, and I had never sutured on a patient before— the only experience I had was using oranges and sponges. I remember the first laceration I sutured was on the sole of someone’s foot— probably not the best to start with as the skin is very thick. Luckily, though, it was on the sole of the foot, as my hands were shaking and it wasn’t the prettiest suture job. Four months on, and the GP was allowing me to suture from start to finish, completing the initial assessment, injecting the local anaesthetic, cleaning and debriding wounds, completing internal sutures and then closing. 

I have also been lucky enough to close on a few C-sections this year which is not something many of our city counterparts have done. Another great skill has been completing initial work ups and admissions of hospital patients. Over the year you develop the autonomy to decide initial management (with the GPs final approval of course), which is a very satisfying experience. 

But for me, the most exciting thing this year has been obstetrics. Having only yourself, the midwife and GP at a woman’s birth allows for a fantastic hands on experience. As much as the birth itself is amazing, getting the woman to the pushing stage is where the true value in this learning experience comes from. Reading CTGs (monitoring baby’s heart and mum’s contractions), seeing complicated deliveries with vacuums and forceps, as well as ending up in emergency caesarean sections as the first assist, have all been huge highlights over the year. Being in the rural placement, makes this experience more rewarding as quite often you have been following these women over the course of their antenatal care, and form great relationships with them and their partners.

3. Rural communities

I think rural communities are what make rural placements, and future rural work so rewarding. The patients you see in the clinic and at the hospital are the same people who serve you at the supermarket, that you play sport with on the weekends, or who you see when you are walking down the street. This rapport you develop within the community may not be as common with a shorter rural term, but with a full rural year, you feel part of it all. This helps with overcoming any feelings of loneliness or disconnection you may be experiencing, as a result of being away from your home base. The welcoming community spirit is one of the big reasons people come back to work in rural areas, it feels good to serve people who are so gracious, down to earth and thankful for your work. 

Fresh fruit and vegetables are commonplace gifts from patients, who appreciate your time listening to their stories and concerns. On the other hand, working in these smaller communities also comes with its challenges. I remember once a rural GP told the story of organising and prescribing palliative care for one of her good friends with a terminal diagnosis. Although it was extremely taxing and emotionally exhausting, she recalls the huge privilege she felt to be able to provide such comfort to a close friend. 

As students and aspiring doctors, we all have empathy, which is driven and fostered by the experiences of our patients. This is made even more rewarding when you know the patients on a personal level. 

Although in rural areas we may not have the most niche surgeries, or the best new treatments, but that fact that you are exposed to the basics creates a great foundation for successful clinical years. I can guarantee that if you are prepared to push yourself out of your comfort zone and pursue a rural placement, you will become a more competent student and may even come to love these rural communities as much as I have.