Effects of public hospital clerkship in rural and underserved areas in South Korea on medical students’ perceptions and career intentions: a pre–post study

Abstract

PURPOSE: This study examined the short-term effects of a 2-week clinical clerkship program in rural and underserved public hospitals on medical students' perceptions of public healthcare and their intentions to work in non-metropolitan public hospital settings. METHODS: The Public Hospital Clinical Clerkship Program (PHCCP) was implemented for fifth- and sixth-year medical students from five medical schools in South Korea during 2023 and 2024. The program included clinical observation, mentoring by public hospital physicians, and exposure to community-based healthcare services. Students completed self-administered questionnaires before and after the program assessing perceptions of public hospitals and intentions to work in rural or underserved areas. Post-program satisfaction with program structure and components was also evaluated. Pre-post changes were analyzed using paired t-tests. RESULTS: Paired pre- and post-program analyses included 24 students from the 2023 cohort and 36 students from the 2024 cohort. Students showed significantly increased intentions to work in public hospitals and rural or small-city settings after the program in both cohorts (all p<0.05). Positive changes were also observed in perceptions of public healthcare roles and support for public hospital careers. Overall satisfaction with the program was above average, particularly for mentoring, program structure, and educational value. CONCLUSION: A structured, short-term clinical clerkship in rural and underserved public hospitals can positively influence medical students' perceptions of public healthcare and their intentions to work in non-metropolitan settings. Programs such as the PHCCP may represent a feasible educational strategy to enhance exposure to public and regional healthcare within existing medical curricula.