Abstract
<title>Abstract</title> <p>Background Health and wellbeing for rural and remote communities rely on a rurally-informed and trained medical workforce. Training-in-place via medical education based in rural communities is seen as a way of creating and sustaining this workforce. Little is known about the roles and responsibilities of rural medical educators, and their motivations and perspectives regarding the future of this speciality. This study of rural medical educators and key informants explored the issues facing rural medical education across Australia. Methods This mixed-methods study used a custom questionnaire to explore rurality, workloads, stressors and burnout in rural medical educators. Medical educators surveyed were those involved in teaching medical students or general practice registrars in rural Australia. Follow-up interviews were conducted concurrent to targeted interviews with medical education leaders. Analysis of qualitative data was via thematic analysis. Quantitative analysis used descriptive statistics to outline the medical educator workforce participant characteristics and outcomes such as burnout and work-life balance scores. Results 79 surveys were completed, along with 20 interviews. Survey respondents were primarily female (n = 39, 49%), in stable relationships and with no intent to leave a medical education role. All were Australian citizens and none identified as Indigenous Australians. Responsibilities included direct feedback to trainees, coaching and assisting trainees to navigate learning systems and requirements. Burnout risk was low and personal accomplishment scored highly. Themes emerging from the interviews were i) The appeal of rural medical education ii) Rural medical educator roles and responsibilities iii) Costs and challenges of rural medical education and iv) Strategies to improved rural medical education. Conclusions Rural medical educators are intrinsically motivated to commence an education role. Creating an appreciation of rural work, giving back to the community and a desire to build rural workforce were key drivers, offsetting both the financial and non-financial costs of the role. Addressing remuneration and system complexity will improve recruitment and increase retention. Increasing First Nations Australian representation in medical education is an important future step for the profession.</p>