Geographical narcissism (GN) is a largely under-recognised factor contributing to chronic rural healthcare workforce shortages and subsequent inequitable access to healthcare. Emerging evidence suggests current health policies inadequately address this piece of the jigsaw puzzle, thus limiting growth in Australia’s rural medical workforce.

A qualitative study has used realist evaluation to identify for whom, in what circumstances and why geographical narcissism influences medical learners. Moreover, this research has identified the underlying mechanisms (M) representing the driving force behind a change, the contextual factors (C), which encompass the environment in which the GN ‘intervention’ unfolds and how the combination of the mechanism and context influences an outcome which is identified as the level of interest in future rural medical practice in medical learners.

Previous RMA presentations have confirmed that GN is experienced by medical learners across the continuum of medical education and training. This presentation will show why some learners are more susceptible than others, and which contexts either amplify or dampen GN’s effect. By illuminating these ‘why’ and ‘for whom’ questions, our findings point to policy levers and education interventions that can be better targeted to grow and retain Australia’s rural medical workforce.