Background: This paper examines factors influencing physicians' decisions to practise in rural communities as well as the results of a programme focused on rural recruitment and retention.

Methods: Data from two sources were analysed and discussed: 1) telephone interviews with 20 of 33 (61%) recently located rural physicians regarding practice and community factors influencing their practice decisions and 2) a database of 107 graduates of a rural medical education programme who have been in practice for at least three years to examine specialty choice and practice location(s), including moves from their original practice sites.

Results: Most rural physicians in this study decided to practise in rural areas because of family ties. Eighty per cent of the physicians participating in the interviews mentioned no negative personal or family factors related to their community of practice. Outcome data on graduates from the rural medical education programme are encouraging. Over 70% opt for primary care and rural practice. Over 80% have remained in their original rural practice location.

Conclusion: Keys to success in rural physician retention seem to include identifying and recruiting medical students of rural origin and focusing on a healthy practice environment. Policy makers need to work with local government, schools and employers to offer programmes that provide information on health careers in rural areas and begin to identify local youth for induction in rural health care.