University figures released under the Official Information Act showed the number of applicants to the medical school for the bachelor of medicine and bachelor of surgery course through the rural pathways scheme dropped from 79 in 2021 to 39 this year.
However, the university said it could not be sure there had been an actual drop in rural numbers, saying it tightened the criteria last year to make sure students who went through the pathway were genuinely from rural backgrounds.
WellSouth Primary Health Network clinical director Dr Carol Atmore said the lower application numbers were surprising.
"The biggest workforce challenge for us is for rural GPs.
"There’s really good evidence from overseas that if you train rural students in health professions, particularly in medicine, there is a high likelihood that they’ll go back to a rural area — even if it’s not their own."
Dr Andrew Wilson, who has general practices in Oamaru and Wānaka, said the quality of students who came through the rural pathways programme was excellent.
However, retaining rural doctors remained a real issue.
"You have young doctors coming through the rural sector — the trouble is retaining them.
"They have their reasons for leaving. The most common reason is they’re moving to a bigger city or hospital, or their partner is unable to find a job."
Dr Wilson said rural GPs were on the cusp of change in terms of the scope of practice.
"We’re seeing rural GPs take up a lot more of the secondary care from hospitals, and I expect that to increase."
Of those who applied through the scheme, the minimum average academic score to receive an offer in 2021, when 41 applicants were admitted, was 73%, while in 2024, when 28 were accepted, it was 79%.
The drop in numbers now comes at a time when access to GPs in rural areas has been highlighted and the University of Waikato is looking to establish a medical school with a focus on rural health.
A priority pathway for students from rural backgrounds, as well as those of Maori and Pasifika descent, was part of Otago University’s "mirror on society" policy created in 2012 and retained a decade later in a subsequent policy.
However, Centre for Rural Health director Prof Garry Nixon said the university could not be sure there had been an actual drop in rural numbers.
"One of the reasons we cannot be certain is because students from rural backgrounds can enter medicine via different pathways.
"For example, if a student is Maori and from a rural area they are entered as a Maori equity group applicant.
"Our own research suggests that students who grow up in large cities are twice as likely to enter medical school as those who grow up in rural areas.
"Though, again, research shows that much of this is outside the control of the universities and may need intervention at the rural secondary school and community level."
Prof Nixon said the apparent drop in numbers was likely associated with the fact the university had adopted the geographic classification for health for the 2023 intake.
"This is a tighter but much more robust way of classifying rural and does a much better job of capturing only those students who are genuinely rural."
The university’s schools liaison team carried out the most in-person visits to secondary schools of any university in the country, Prof Nixon said.
"Staff specifically promote the rural entry pathway to our health professional programmes and encourage young people to think about health professions as a career.
"The university is well aware of the need for more rural doctors and has an extensive programme in rural health education, training and research in a bid to help grow the number of doctors who go on to choose rural medicine as a career.
"We would like more people from rural areas applying to enter both medicine and all of our health professional programmes."
