Dental Graduates' Inclination to Choose Rural Practice Related to Pre-matriculation Origins

Objectives: To explore Oregon dental graduates inclination to choose a rural practice location after graduation in relation to their urban/rural origin at matriculation and to explore whether any secular trends in practice location could be detected in response to an increased focus on rural rotations for senior dental students.
Methods: Seven cohorts of dental graduates graduating from Oregon Health & Science University School of Dentistry (2010-2016; n=519) were included in the study. Residential zip code at matriculation was collected administratively;We merged the initial information with the current dental practice locations of graduates from the American Dental Association masterfile which also served as the source for data on dentists’ current occupation. Urban/rural definitions were established from federal guidelines.
Results: Altogether 408 OHSU graduates were matched. The proportion of students whose zip codes at matriculation were matched with their zip codes after graduation was high, around 81%, but a clear distinction between the two youngest cohorts (70% and 45%) and the older cohorts (average 90%) was obvious, likely due to the uncertain final practice destination for these younger graduates (due to for instance postgraduate studies). 82% of the graduates from Oregon practiced in Oregon. 14% of the graduates from out of state practiced in Oregon. 13% of OHSU dental school graduates were from rural zip codes. 68% of graduates who originated from rural areas practiced in rural areas. 9% of graduates from urban areas practiced in rural areas. Overall, 17% of graduates (68 out of 408) now practiced in rural areas. One out of ten students originating from an urban area chose to practice in a rural area after graduation whereas 7 out of ten students originating from a rural area went on to practice in a rural area after graduation.
Conclusions: Dental graduates originating from a rural area were 7 times more inclined than urban graduates to practice in a rural area. There are early indications of an enthusiastic response from students returning from their community rotations, but more solid evidence should be sought several years after graduation, when the practice pattern is clearer. The significance of improved financial incentives or rural rotations for practice location choice should also be explored.