Keywords: Medical staff, Healthcare professionals, Doctors, GPs, Students, Rural, Remote, Recruitment, Retention, Intervention, Strategies, Incentives
Background:
The global shortage of healthcare professionals in rural areas is a growing issue, resulting in poor health outcomes for rural communities and increased workload for healthcare staff. Despite extensive research on strategies for recruiting and retaining medical staff in rural areas of N. America and Australia; Europe remains underexplored, with no systematic reviews synthesising European strategies.
Aim of the study:
To identify and explore the effectiveness of interventions to recruit and retain medical healthcare staff in rural and remote settings across the European continent.
Methodology:
We conducted a systematic review by searching the following databases: PubMed, CINAHL, Web of Science, and Cochrane. Peer-reviewed studies reporting quantitative and/or qualitative data on medical healthcare staff recruitment and retention interventions in rural and/or remote European settings were included. We followed PRISMA guidelines, tabulated an overview of the interventions, used MMAT for quality assessment, and performed a thematic synthesis.
Results:
3,389 articles were screened; 15 met the eligibility criteria and were included in the results. Five themes were identified through analysis: (1) Educational and Professional Development (e.g., establishment of medical schools and postgraduate training/ education opportunities in rural regions). (2) Personal factors (e.g., mentorship/ supervision, career aspirations opportunities, proximity with family). (3) Financial factors (e.g., salaries, financial schemes, funding packages). (4) Working environment (e.g., supporting workload, working hours and conditions). (5) Rural exposure (e.g., rural origin/ background and exposure to rural settings. While financial factors can improve initial recruitment, they are insufficient for long-term retention. Interventions related to education/professional development and rural exposure were more likely to lead to higher recruitment and retention.
Conclusions:
Interventions that improve education and training opportunities, enhance the work environment, and enable rural exposure (e.g. rural placements) during training are to be prioritised to facilitate short and longer-term medical staff recruitment and retention in rural and remote settings.
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