# Assessing the Willingness to Work in Rural Areas and Associated Factors Among Medical Students at King Saud University in Riyadh, Saudi Arabia

## TL;DR

This study finds that most medical students at King Saud University are unwilling to work in rural areas due to poor infrastructure, lack of training, and low financial incentives.

## Contribution

The study identifies specific factors influencing medical students' willingness to work in rural Saudi Arabia, including age, rural experience, and financial incentives.

## Key findings

- Only 11.3% of medical students expressed willingness to work in rural areas, with 81.2% preferring urban practice.
- Poor clinical infrastructure and lack of training were the main deterrents to rural practice.
- A 30% salary increase and improved infrastructure were the most effective incentives for rural work.

## Abstract

Background: Maldistribution of the health workforce remains a major barrier to equitable healthcare access, particularly in rural areas. Medical students represent the future physician workforce, and their career intentions are critical for addressing rural healthcare gaps.

Objective: To assess the willingness of medical students and interns at King Saud University (KSU) to work in rural areas and to identify factors associated with this willingness.

Methods: A cross-sectional study was conducted among medical students and interns at KSU using a structured self-administered questionnaire. Data collected included sociodemographic characteristics, educational background, rural exposure, career motivations, and willingness to work in rural areas. Data were analyzed using descriptive statistics and logistic regression analyses to identify factors associated with willingness to work in rural settings.

Results: A total of 372 students participated. Only 42 (11.3%) expressed a positive intention to work in rural areas, while 302 (81.2%) preferred urban practice. The most significant deterrents to rural practice were poor clinical infrastructure (44, 14.3%), lack of training opportunities (41, 13.4%), limited career progression (32, 10.4%), and insufficient financial incentives (27, 8.7%). The most influential incentives included a base salary increase of 30% or more (223, 59.9%), a supportive workplace and management (172, 46.2%), and improved infrastructure and medical supplies (171, 46.0%). Multivariable logistic regression showed that senior academic year was negatively associated with willingness, while older age (25-34 years) and prior rural residential experience were positive predictors.

Conclusion: Medical students at KSU demonstrate very low willingness to work in rural areas. Addressing professional, infrastructural, and financial barriers, along with early rural exposure and decentralized training opportunities, may help improve rural workforce distribution in Saudi Arabia.