Original Articles

There is a major shortage of doctors in rural areas in South Africa. An example is Mount Frere district, where the doctorto-population ratio is 1:30 000. About 46% of the population in South Africa live in non-urban areas. Achieving equity in the distribution of health workers between urban and rural areas is an important priority for the Department of Health. In other countries with large rural populations it has been shown that increasing the number of medical students from rural areas can alleviate the shortages. Examples include the Physician Shortage Area Program at Jefferson Medical College in the USA, and the Illinois Rural Medical Education Program. The two most significant predictors of practice in a rural area have been found to be a rural background, and a specialty choice in family medicine. In Norway the former is called ‘the hypothesis of the homecoming salmon’. In Australia medical schools enrol a quota of rural students because the latter are more likely to practise in rural areas.