A Health Check for Rural General Practice in Scotland

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The problem

:Recruitment and retention of General Practitioners (GPs) in remote and rural areas is in crisis. To maintain this essential service, it is vital to establish the key benefits and drawbacks of living and working rurally as a GP. This study examines what motivates GPs to live and work in rural areas, as well as their personal and professional difficulties and benefits, practical difficulties they face, and future career plans.

The approach

:A previously-piloted online questionnaire was distributed to all GPs working in Scotland’s North, East and West deaneries. The questionnaire contained multiple-choice and free-text questions.


This survey obtained 125 responses, with data collection ongoing for a further 2 weeks. Preliminary results indicate that demographic factors such as growing up in a rural environment and studying at a Scottish university positively affect choosing rural practice. Nearly half of rural GPs (42.6%) had worked in rural practice >20 years, with 6.6% having worked in rural GP for >30 years. In practice demographics, 20% had 1-2 partners and 20% had more than 7 partners. 2 in 3 rural GPs had previously worked as urban GPs, and 1 in 3 had worked in a specialty other than general practice. Over half of respondents had trouble recruiting new applicants, and struggled to get locum cover. In terms of professional development, 30% of rural GPs had been involved in research and 70% had been involved in teaching; free text sections highlighted barriers to participation in both of these activities. With regards to future intentions, 30% of GPs intended to leave rural GP in the next 5 years, and 55% intended to leave rural GP in the next 10 years. A variety of sources, including rural GP electives and student placements, were credited with having inspired respondents to practice in remote and rural areas. Free text sections revealed strong personal and professional benefits to rural practice, as well as identifying professional and personal barriers to rural GP. The section reflecting on ‘if you could change any one thing’ yielded large amounts of qualitative data on how rural primary care can be improved in order to make it more attractive and sustainable in future.


Identifying motivators for GPs in choosing to work rurally, professional and personal benefits and barriers, and challenges in professional development activities such as research and teaching, is key to appropriately predicting and target the issues facing recruitment and retention in rural primary care, and to improve access in rural primary care to professional development activities. Assessing rural GP’s future career intentions gives an important insight into future workforce planning. Having rural GPs identify what first sparked their interest in rural GP identifies recruitment practices that could be used to attract the next generation of rural GPs.


  • Sarah Mills