Ten reasons why every junior doctor should spend time working in a remote and rural hospital

Optimal training of the future workforce is essential if we are to deliver effective healthcare in all situations and circumstances. Doctors will need to have the appropriate knowledge and skills to work in their chosen environment. However, additionally they will need to have contentment, by having made the right career choices, and resilience if they are to avoid burnout, which represents a clear threat to service provision.1,2 Undertaking training in a remote and rural environment provides direct relevance for those planning a career in remote and rural medicine. Having spent time working in a remote and rural environment, we have become persuaded of its value as part of all junior doctors' clinical development. Increasingly, junior doctors are seeking to take a break in their training progression, and a remote and rural placement may represent a valuable option with the potential to recruit those doctors to remote and rural practice.3 This paper was developed using an iterative conversation with a convenience sample – the junior and senior staff of the Balfour Hospital, NHS Orkney. The hospital serves a population of 25,000 people and visitors of the Orkney Islands, an archipelago off the north coast of Scotland, with no land connection to the mainland. Non-consultant grade staff include early-year junior doctors, hospital practitioners and general practitioner (GP) trainees, but no registrars. Email was used to invite contributions and create a provisional list. This was supplemented with one-to-one conversations with junior and senior staff. The ‘10 reasons’ were identified and then iteratively revised through further communications and conversations. ### You are exposed to the complete spectrum of medicine Large and particularly urban hospitals no longer offer a true general medical take. For very good reasons, acute myocardial infarction and stroke are hived off to subspecialty services.4 In a wider context, major trauma, oncology, paediatrics and obstetrics are often not co-located …