Integration and retention of international medical graduates in rural communities: a typological analysis

Many rural communities throughout Australia depend on international medical graduates (IMGs) for the provision of primary health care. To date, however, it is not clear how well they integrate into rural communities or how long they intend to stay in practice there. This study reports the results of in-depth interviews undertaken in 2003 with 57 IMGs practising in rural Victoria with the aim of identifying which factors facilitate or inhibit their integration into rural communities and consequently affect their intention to stay in rural practice. Based on the interview results, four different types of IMGs were identified according to their level of integration into rural communities. They are 'satellite operators' (city-oriented), 'fence-sitters' (affiliated with city fringe areas), the 'ambivalent' (unsure about their future settlement place) and those 'integrated' into rural communities. Recognition of such a typology is useful in assisting to better target support and incentives designed to increase IMG rural retention rates towards those doctors most likely to remain in rural practice on completion of their mandatory period.