Determinants of practice location choices among physicians and medical students in Mali: insights into addressing medical deserts through evidence-based strategies

Abstract The shortage of medical professionals in rural and remote areas is a global issue that significantly challenges equitable healthcare delivery. Worldwide, various studies have examined the motivations of medical professionals in choosing their practice location. However, for Mali, this topic remains underexplored, motivating us to conduct this study to identify factors influencing doctors’ workplace decisions in Mali. We conducted a cross-sectional study targeting doctors and final-year medical students. Using simple random sampling, we selected 358 respondents, 69% of whom were doctors. Approximately 38% of the respondents preferred rural areas for their practice, primarily citing career development and opportunities for continuing education (38%). The likelihood of choosing rural practice was higher (OR = 5.09; CI = [2.52-10.8]) among participants with family residing in rural areas. Conversely, financial incentives, access to technical platforms, and infrastructure favored urban practice. This study elucidates doctors’ motivations and identifies key factors associated with their choice of practice location. Competing Interest Statement The authors have declared no competing interest. Funding Statement The authors received no financial support or funding for the work presented in this article. This study was conducted independently, with no involvement from any funding agencies, commercial entities, or other organizations in any step of the manuscript. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study received ethical approval from the National Ethics Committee for Health and Life Sciences (CNESS) in Mali, under reference number 23/04/MSDS/CNESS. All participants provided informed consent, and the study adhered to the principles outlined in the Declaration of Helsinki to ensure the ethical conduct of research. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data underlying the findings of this study are fully available without restriction.