Perceived Factors Influencing Medical Students' Career Choices Between Rural and Urban Practice in Ghana

Background: The global disparity in the distribution of medical doctors between rural and urban areas remains a significant challenge, particularly in developing countries like Ghana. Despite policies aimed at improving salaries and retention, rural areas continue to face severe shortages of healthcare providers. This study examines the preferences of medical students in Ghana regarding rural versus urban practice and identifies key factors influencing their decisions. Method: A cross-sectional study was conducted among 150 clinical-year medical students at the University of Ghana Medical School. Data were collected using a structured questionnaire, capturing demographic details, rural exposure, career aspirations, and motivational factors. Quota sampling ensured equal representation across clinical years. Descriptive statistics and chi-square tests were employed for analysis, with significance set at p < 0.05. Results: Surprisingly, 60% of respondents expressed a preference for rural practice, though only 18% had rural clinical experience. Good working conditions (78%) and social recognition (77%) ranked higher than salary (67%) as influencing factors. Older students and those in advanced clinical years showed greater rural practice inclination (p = 0.001 and p = 0.023, respectively). Notably, 69.1% planned to pursue speciality training, with only 8.7% opting for general practice. Conclusion: While medical students demonstrate a willingness to work in rural areas, limited exposure and systemic challenges hinder actual retention. Non-monetary factors, such as career development and working conditions, are significant in shaping preferences. Strategies to enhance rural infrastructure, structured clinical rotations, and targeted incentives are recommended to address workforce disparities.