Association between rural clinical experience and rural career intentions amongst Slovenian medical students: a national cross-sectional study

Abstract

Abstract Background Rural medicine is fundamental to primary healthcare in Slovenia, where an estimated 60% of the population resides in rural areas. Despite rural family physician shortages, little is known about Slovenian medical students’ perceptions and interest in rural practice, factors shaping their career intentions and career choice toward rural medicine. Understanding these influences is essential for informing medical education and workforce policy aimed at strengthening healthcare provision in remote areas. Methods A national cross-sectional survey was conducted amongst Slovenian medical students. A questionnaire assessing demographics, rural clinical experience, perceptions of rural practice, and career preferences was distributed to all enrolled students ( N = 1,952). The questionnaire combined multiple choice, Likert scales and open-ended questions. Data were analysed using descriptive statistics, multivariate logistic regression, Wilcoxon rank-sum tests, and chi-square tests. Results A total of 329 students completed the survey (response rate 19.1%), of whom 37.1% reported rural clinical experience. Students from the University of Ljubljana had substantially more rural clinical experience than those from the University of Maribor (46% vs. 14.9%). rural clinical experience was significantly associated with more positive perceptions of rural physicians and greater interest in working in rural areas (χ² p < 0.001), but not with interest in specialising in family medicine (χ² p = 0.182). Among students interested in rural work, family medicine was the most preferred specialty (42.1%). Students from a rural background had more than twice the odds of interest in family medicine specialty, compared to urban students (OR 2.19, 95% CI 1.31–3.71, p = 0.003). Financial incentives were the strongest motivating factor for rural career choice, selected by 72% of respondents. Conclusions Rural clinical experience during medical education is positively associated with interest in rural practice and shapes students’ perceptions of rural medicine. Differences between the two faculties highlight the role of curriculum design in workforce preparation. Introducing structured rural placements and targeted financial incentive programmes may represent feasible strategies to address rural physician shortages.