Immersion to impact: does one or three years of rural immersion influence graduate clinical practice intentions and locations?

Background: Addressing rural healthcare workforce shortages requires evidence-based strategies in medical education. Extended rural immersion programs offer a potential solution, but the optimal duration for fostering long-term regional and rural practice remains unclear. Methods: This retrospective study evaluates the impact of one-year versus three-year rural immersion experiences at the University of Melbourne's Rural Clinical School (RCS) on graduate clinical practice locations of the 2016-2023 graduating cohorts. Using logistic regression analysis, we assessed key predictors of regional and rural practice, including rural immersion duration and intent to practice regionally or rurally. Results: Graduates who completed the three-year rural immersion program were significantly more likely to practice in Modified Monash Model (MMM) 2-7 areas than those with only one year of rural immersion. Intent to practice regionally or rurally and completing a regional/rural internship emerged as strong predictors of regional/rural practice. However, regional/rural intent did not appear to be a strong indicator for students who only completed 1-year of rural immersion. This highlights the importance of the duration of immersion. Conclusion: The study demonstrates the effectiveness of extended rural immersion in increasing regional and rural workforce retention. Findings support further investment in rural medical education, including end-to-end rural training models, which integrates rural exposure across the entire medical education journey. Future research should examine long-term workforce retention and strategies for sustaining rural career pathways.