Send to

Choose Destination
BMC Med Educ. 2018 Mar 20;18(1):42. doi: 10.1186/s12909-018-1142-1.

Self-efficacy reduces the impact of social isolation on medical student's rural career intent.

Author information

Flinders Rural Health South Australia, Flinders University, PO Box 852, Renmark, South Australia, 5341, Australia.
University Centre for Rural Health, School of Medicine, Western Sydney University, 62 Uralba Street, Lismore, NSW, 2480, Australia.
School of Public Health, Sydney University, 62 Uralba Street, Lismore, NSW, 2480, Australia.
Rural Clinical School, Faculty of Medicine, University of New South Wales, Level 3 Samuels Building, Sydney, Australia.



Social isolation in medical students is a subjective experience that may influence medical career decision making. Rural self-efficacy has been shown to influence rural career intentions following a rural clinical placement, however its impact on social isolation during a rural clinical placement has not been previously modeled. The objective of this study is to explore whether self-perception of social isolation is associated with rural career intent in rural medical students. Secondly, to determine whether self-efficacy influences the association between social isolation and rural career intent.


2015 data, from a cross-sectional survey of the National Federation of Rural Australian Medical Educators (FRAME) study. Among 619 medical students attending rural clinical schools (RCS), rural career intent was assessed. This included intended rural location for either postgraduate medical specialist or generalist training or completion of that training. Self-efficacy beliefs in rural medical practice were based on a validated scale consisting of six questions. Social isolation was measured asking students whether they felt socially isolated during their RCS placement.


31.3% of surveyed students self-reported feeling socially isolated during their rural placement. Social isolation was associated with reduced rural career intent after controlling for gender, rural background, RCS preference, RCS support and wellbeing. In step-wise logistic regression the association between social isolation and rural intent disappeared with the inclusion of rural self-efficacy.


Social isolation during a rural clinical placement is commonly reported and is shown to reduce rural career intent. High levels of rural clinical self-efficacy reduce the effects of social isolation on future rural workforce intentions.


Career intention; Medical student; Rural medical education; Self-efficacy; Social cognitions; Social isolation

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center