The role of personal characteristics in shaping medical careers in rural and medically underserved areas: A scoping review

Abstract

Purpose: Personal characteristics are important predictors of doctors’ career trajectories and career locations. Although many reviews focus on factors influencing the intent to practice in rural areas, few studies explore personal characteristics linked to retention. This scoping review aimed to investigate the personal characteristics associated with choosing and retaining medical careers in rural or medically underserved areas. Methods: This scoping review employed the PRISMA-ScR framework. Database searches were conducted in Medline via Ovid, Scopus, ERIC, PsycINFO, CINHAL and Google Scholar, covering articles from 1975 to August 2023. The search strategy captured publications discussing personal characteristics of doctors or medical students in rural and underserved areas. Two authors were involved in the screening and data extraction process. Data were extracted using a standardised form, and thematic analysis was conducted. Findings: Of 1,373 articles, 35 articles met the inclusion criteria: 19 studies involved medical doctors, and 16 involved medical students. Although recruitment-related findings also emerged in some studies, the majority of the included literature focused on retention in rural contexts, with limited evidence available from underserved communities. A key personal characteristic noted in most doctors’ studies was a sense of belonging or personal connection to the place and community, fostering long-term commitment and integration; however, this was not found among medical students. A range of other characteristics, including service orientation, commitment to social justice, self-efficacy beliefs, adaptability and intrinsic motivation, were identified as desirable for rural retention. Conclusion: Sense of belonging, social justice, self-efficacy and grit were important personal characteristics that contribute to retention and foster job satisfaction for doctors in rural and underserved areas. Among the medical students, rural career intentions were consistently associated with self-efficacy, resilience, self-directness, persistence and adaptability, highlighting the role of personal characteristics in shaping career intentions. This review also highlights key definitions for personal characteristics research, as these are often described using multiple terms in medical education literature.