Medical schools in rural areas - necessity or aberration?

Introduction: There is major maldistribution of physicians in the Democratic Republic of the Congo (DRC). While 70% of Congolese live in rural areas, relatively few doctors practice there. Of the 25 medical schools in the DRC (14 public and 11 private) only one private medical school is located in a rural area. The purpose of this article was to analyse and compare the graduates of an urban-and a rural-located university in DRC. Methods: The 6 first classes of the Catholic University of Graben (UCG) Medical School at Butembo (rural) and Universite Evangelique en Afrique (UEA) at Bukavu (urban) (43 and 120 graduates, respectively) were compared according to their rural or urban employment, among other variables. Results: In total, 97.7% of graduates from the rural-located medical school were employed in the province where they trained, the majority (81.4%) in rural areas. In contrast, 40.0% of graduates from the urban-located school were employed in the province where they trained, with 23.7% working in a rural area. Over 55% of all graduates worked 78 km of their training medical school. Only 2.5% of the rural-school graduates entered residency programs, compared with 15.2% for urban-school graduates. Conclusions: The results support the policy of establishing medical schools in rural areas, and also provide indications of approaches likely to increase the number and expertise of rural-located physicians.