This study investigated motivations for Appalachian medical students to stay or leave the region weighing postgraduation options. Semi-structured interviews were employed with final year medical students. Transcripts were open-coded and analyzed using the theoretical concept of Gemeinschaft/Gesellschaft. Participants were in continuous negotiation between notions of Gemeinschaft and Gesellschaft in their decisions to stay or leave rural Appalachian communities. Students navigated multiple tensions in their decisions to stay or leave, including: (1) geographic isolation versus place identity and (2) community responsibility versus individual opportunity. Utilization of Gemeinschaft/Gesellschaft provides a novel contribution to the literature on decisions to stay or leave as the majority of participants hedged in their decision-making regarding future practice location. These students tended to employ a Gesellschaft rationale to stay and a Gemeinschaft rationale to leave, expressing complicated ideas about community and individual opportunity.

中文翻译：

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协商Gemeinschaft/Gesellschaft二分法：阿巴拉契亚医学生对实践的看法☆

这项研究调查了阿巴拉契亚医学生留在或离开该地区的动机，权衡毕业后的选择。对最后一年的医学生进行了半结构化访谈。使用 Gemeinschaft/Gesellschaft 的理论概念对成绩单进行开放编码和分析。参与者在决定留在或离开阿巴拉契亚农村社区时，在Gemeinschaft和Gesellschaft的概念之间不断进行协商。学生们在决定留下或离开时面临着多重压力，包括：(1) 地理隔离与地方认同；(2) 社区责任与个人机会。由于大多数参与者在有关未来实践地点的决策中对冲，因此 Gemeinschaft/Gesellschaft 的利用为有关留下或离开的决策的文献提供了新颖的贡献。这些学生倾向于采用“Gesellschaft”理由留下来，“Gemeinschaft”理由离开，表达了关于社区和个人机会的复杂想法。