Objective: To examine the factors affecting the rural retention of medical graduates in lower northern Thailand.

Material and Method: A mixed method study was applied to examine factors affecting the rural retention of medical graduates in the lower northern Thailand. Target groups under the study were physicians graduated between 2002 and 2011 from Naresuan University under the Collaborative Project to Increase Production of Rural Doctor (CPIRD) and the One District One Doctor Project (ODOD). A cross-sectional survey to a stratified random sample of medical graduate was done, involving the collection of quantitative data, presented in frequency, percentage, mean, standard deviation. A qualitative research was done on 17 physicians who worked at community hospitals and 9 physicians who had left community hospitals using in-depth interview. Content analysis was done with qualitative data.

Results: Response rate for quantitative survey was 66.3%. Factors affecting rural retention of medical graduates with high scores were the practice factors (good relationship between manager and peer), community factors (community growth and security), personal factors (rural background), education factors (admission of students from rural areas), financial factors (payment for on-call and after-hour work), and regulator factors (privileges for continuing education). In-depth interviews confirmed enabler factors such as career development and continuing education opportunity. Respondents raised the issues of future training specialties that were appropriated for Thai rural hospitals in the future, the adverse effect of Universal Coverage Scheme, and communication problem in the referral system.

Conclusion: Factors influencing the rural retention of medical graduates of lower northern Thailand was good relationship between manager and peer. Universal coverage scheme and society changes were also important factors for rural retention.

Keywords: Factors affecting, Rural retention, Medical graduates