Medical education in Chilean rural primary care contexts

contrasts with hospital and urban environments experiences

Abstract

Introduction: Internships represent a key component of the undergraduate’s medical training. In rural settings, it promotes rational use of resources and students' contact with diverse realities, contrasting with their experiences in urban clinical settings. Objective: To portray medical students’ perceptions about the rural internship´s contributions to their training as health professionals. Methods: Qualitative research based on 15 semi-structured interviews with medical students in their last year of undergraduate training at North Campus of the University of Chile in 2016. An analysis of the narrative content was performed. Results: The contributions of the rural internship that students considered valuable for their professional education revolved around three main areas. (1) A personal dimension, that comprises strengthening of clinical skills, autonomy and their social role as physicians. Here they also refer to their future careers, alternative lifestyles and recognition of other people's needs. (2) In terms of their relation to patients and families, students emphasize the importance of an adequate provider-patient relationship and the influence of social determinants on patient’s health. (3) Related to working with communities, interviewees refer to the value of community organization and the importance of a patient's environment, although motivations are more related to their professional role as such than to the rural context. Conclusions: The rural internship experience contributes to the personal professional training and to the doctor-patient-family-community relationship. It fosters a critical appraisal of the medical practice, the physician's role and the health system.