Rural medicine in Aotearoa New Zealand: a narrative synthesis of the literature with a postgraduate focus.

AIM: This review synthesised Aotearoa New Zealand rural medicine literature on postgraduate training and academic activity to inform the current and future development of the discipline. METHODS: A search of PubMed and Ovid MEDLINE databases was undertaken for articles relating to rural health/medicine and New Zealand. Articles with a focus on medical education or wider academic activity were included in the narrative synthesis. RESULTS: Thirty-six articles described the past 30 years of rural medicine literature in New Zealand, from its early development (1999-2004), through calls for, and establishment of, rural-specific postgraduate training pathways, to developing the academic discipline of rural medicine. Findings include repeated calls for rural medicine to be recognised as a distinct speciality; the need for rural-specific postgraduate pathways, especially for general practice; increased support for academic leadership; rurally based research; and strong community and service partnerships. CONCLUSION: While rurally targeted postgraduate clinical pathways are essential, they alone are insufficient to support the growth of rural medicine as a distinct discipline, suggesting the need for broader strategies to support academic capability, long-term sustainability and rural health equity.