OBJECTIVE: To explore the strategies used by rural recruitment programs and their perceived influence on medical students.

DESIGN: Two original questionnaires delivered electronically, one to medical students and the other to recruiters in rural Ontario communities.

SETTING: Ontario, Canada.

PARTICPANTS: All 525 medical students enrolled in the Schulich School of Medicine & Dentistry at the University of Western Ontario in London and physician recruiters in 71 rural communities in Ontario were invited to participate in the study.

MAIN OUTCOME MEASURES: The factors that influence medical students to consider rural practice, strategies used by recruiters, and student perceptions of the ethical appropriateness of both.

RESULTS: The questionnaire was completed by 42.1% of medical students. Lifestyle considerations were an important influence for 93.1% of students. Themes from the qualitative analysis included the ethical appropriateness of financial considerations, economic forces, perceived disadvantages of rural practice, competition between communities, and lack of altruism. Responses were received from recruiters in 43.7% of communities; of those, 92.9% offered financial incentives to attract prospective physicians.

CONCLUSION: Financial and lifestyle considerations are important influences on medical students' choice to practise in rural communities. Most medical students felt incentive programs offered by rural communities were ethically appropriate.