Rural clinical school outcomes: what is success and how long do we wait for it?

To the Editor: Do we sense a touch of frustration in the letter from Adam and colleagues1 in describing the outcomes of their rural clinical school (RCS) program? Career choices within medicine are influenced by many factors, and we agree with their comment that it is impossible to compel and unreasonable to expect all RCS graduates to enter rural practice. However, a factor that they have not taken into account is that of rural student recruitment, which has been shown by numerous studies, together with a positive rural exposure during training, to be a major factor in rural career decision making.2-5 If, as they suggest, currently only half of RCS graduates can be expected to choose a rural career, with the present requirement for medical schools to admit 25% of their intake from a rural background, is it time for this requirement to be reviewed upward?