21st WONCA World Rural Health Conference, 10-13 April 2026: Read More – WONCA 2026 | Home
When the University of Otago launched the Rural Medical Immersion Programme (RMIP) in 2007, it was a bold experiment. Could a small group of medical students really learn just as much, if not more, by spending a year in rural communities, far from the teaching hospitals of New Zealand’s main centres?
Eighteen years on, the answer is clear. RMIP has become a cornerstone of New Zealand’s rural medical education, producing confident junior doctors and feeding a much-needed pipeline of future rural GPs and hospital generalists.
The programme was the vision of the late Dr Pat Farry, a Wakatipu GP who spent decades championing rural medicine and medical education. He believed that embedding students in rural communities would both encourage more doctors into rural practice and strengthen bonds between health professionals and their communities.
RMIP began in Queenstown and Greymouth with just six students. Today, it has grown to nine sites across the South and lower North Islands, hosting up to 35 fifth-year medical students each year.
Unlike short hospital rotations, RMIP is what’s known as a longitudinal integrated clerkship: students live and learn in rural communities for a full academic year, mainly based in rural general practices and rural hospitals.
For Dr Janine Lander, Otago’s RMIP programme lead, it’s the continuity of place and people that makes rural training distinctive.
“Our students become a part of their rural communities and valued members of our healthcare teams’ she says They have opportunities to see patients on multiple occasions and in different health provider and community settings, following them through diagnosis and management aspects of their care, seeing the roles different health professionals play to support them through that and seeing the health system from the patient’s side. They experience the ‘why’ and ‘how’ of continuity of patient care, which is the most rewarding part of practising medicine for many of us, exemplified best and needed most in our rural communities.”
This model means students are more than observers. Working in small teams, with direct supervision from rural GPs and hospital doctors, they develop clinical skills early and gain confidence managing a wide variety of cases.
The evidence for RMIP’s value is now robust. Research using 2022 workforce location data from the Medical Schools Outcomes database, presented in 2025 by Queenstown GP and PhD candidate Dr Katelyn Costello, herself an ex-RMIP student, shows RMIP students are nearly six times more likely to return to rural practice than peers who followed the traditional campus-based pathway.
That impact isn’t just visible in workforce numbers, but in education and leadership.
“Over the years we’ve seen many of our RMIP graduates come back to our rural areas as GPs, hospital doctors, and teachers,” says Dr Lander. “Seven of our current teaching staff are ex-RMIP students themselves. They understand the value of the programme, and it creates opportunities for their own career development. That’s not only strengthening the workforce but sustaining it for the future.”
The need for that pipeline is urgent. Around 19 percent of New Zealanders live rurally, yet access to primary care is under pressure, with a large proportion of rural GPs nearing retirement. Programmes like RMIP, and the introduction of Auckland’s parallel RMIP in 2025, are now seen as vital workforce strategies.
At its heart, though, RMIP is about more than numbers. Students consistently describe their year as transformative, citing not only the breadth of medicine they encounter but also the sense of connection to community.
And even for those who ultimately choose urban practice, says Dr Lander, the experience leaves a mark:
“Students carry that understanding of rural patients and rural health systems into the rest of their careers. They become advocates, whether they’re working in a small town or in a tertiary hospital.”
With Otago’s long-standing leadership and Auckland’s new investment, RMIP is entering a new chapter. Together the programmes will offer placements in 13 communities across the motu, training up to 35 students each year in Otago’s programme alone.
Next in the Series
RMIP’s story is best told not just through statistics but through the people who have lived it. One of them is Dr Hannah Lawn, now the programme’s Lead Academic Coordinator at the University of Auckland. As a former RMIP student herself, she’s seen first-hand how a year in rural practice can change the trajectory of a career. In our next piece, we’ll step into the present, meeting Hannah and one of this year’s students to see how RMIP continues to shape New Zealand’s next generation of rural doctors.
