Abstract
Introduction: Rural medicine is shaped by geographic distance from resources and specialist care, requiring broad generalist practice. International evidence supports rural-targeted postgraduate training, clinical-academic integration, and a dedicated evidence base. Progress in Aotearoa New Zealand (NZ) has been constrained by underinvestment, workforce shortages, and persistent inequities.
Aim: This study aimed to explore postgraduate rural medicine stakeholder perspectives on the current status of rural medicine as a speciality in NZ and what is needed to strengthen it.
Methods: We conducted a qualitative study using semi-structured interviews. Thematic analysis was undertaken using a framework-guided rapid analysis approach. Interviews explored key patterns relating to clinical practice, postgraduate training, academic capacity, and system-level influences.
Results: Interviews with 31 participants (including trainees, clinicians, educators, academics, and institutional leaders) identified two themes. The first described postgraduate rural medicine development to date, including the importance of rural-targeted training, emerging career pathways, and ongoing invisibility. The second highlighted future priorities, including a rural-specific general practice pathway, stronger rural leadership, and greater collaboration and institutional investment.
Discussion: Strengthening rural-specific postgraduate pathways, together with stronger support for rural educators and researchers, is essential for improving visibility and fostering clinical-academic career development. A coordinated, nationwide strategy is also needed to strengthen the academic standing of rural medicine, ensure its long-term sustainability, and advance rural health equity in NZ.