The estimated population of Aotearoa New Zealand (NZ) (the bilingual name for NZ) as of December 2021 was 5.12 million people [1]. One in four NZ’s live in a rural area, with a greater percentage of children, older people, and Māori (the indigenous people of NZ) living rurally [1]. Approximately 19% of NZ’s population access rural healthcare [1] with 16.3% of NZ’s population is classified as living rurally [2]. 2021 NZ podiatry workforce data indicates approximately 70% of podiatrists work in major or large urban centres as classified by Statistics New Zealand functional rural–urban classification (Urban Rural Experimental Profile 2004; UREP) [2]. However, defining the NZ rural/urban population attributes for research purposes is difficult as there is no consistent agreed definition of rurality [3]. The current UREP classification of urban/rural attributes based upon population size has been criticised as the population defined as “rural” differs from that which actually receives rural health care [4].

In NZ the profession of podiatry is considered as part of the Allied Health workforce. The Allied Health workforce defined as health professionals who are not part of the medical, dental or nursing professions [5]. There are at least 43 professions that are classed as Allied Health professions in NZ. According to Allied Health Aotearoa New Zealand (2017), there are approximately 30,000 individuals who comprise the allied health workforce, making the workforce the second largest clinical professional group across NZ [6].

Workforce recruitment (identifying and filling staffing requirements) and retention (a measure of workforce length of stay) are key issues for the entire NZ rural health workforce (Allied Health professions plus medicine, nursing, and dentistry), and important to the long-term sustainability of NZ rural healthcare system [7, 8]. The ability of the NZ health sector to deliver services rurally is reduced, with health workforce shortages frequently articulated [9, 10]. Workforce shortages result in service gaps, manifesting to create health inequities [11, 12]. In NZ rural communities health inequities between Māori and non-Māori are most evident [13]. Across age groups and health conditions, rural Māori have higher mortality and morbidity, and lower life expectancy [14].

Many NZ health providers find recruitment and retention difficult. For health providers in rural settings the challenges are even greater, with fewer applicants and shorter tenures [15]. Previous work in Australia has shown that sourcing future workers from a rural background, coined the ‘rural background effect’ [16], is a strong predictor of future entry into rural practice [17]. Additionally, a desire for a rural lifestyle, being connected to the community, an enjoyable patient base, and the autonomy offered by the nature of rural work are factors shown to positively influence rural health workforce recruitment and retention [18, 19]. Conversely, poor matching of people to positions, excessive travel, issues with leave and locum access, professional isolation, increased workload, limited access to continuing professional development, limited job opportunities for partners, difficulties in building a social and professional network, and insufficient supervision are factors linked to poor retention within rural health workforces [18,19,20,21,22].

There is currently limited research that has investigated the sustainability of the NZ podiatry workforce. Carroll et al., who analysed the NZ podiatry workforce data between 2015 and 2019 concluded that the NZ podiatry workforce is in crisis and demonstrated there were a smaller number of podiatrists working outside of major urban cities (Auckland, Wellington, Christchurch) [23]. However, this research provided no insight into the rural podiatry workforce. There is currently limited evidence investigating what issues are faced by NZ podiatrists who work in a rural healthcare setting. Accordingly, the aim of this study was to explore the factors which contribute to recruitment and retention of rural podiatrists in NZ.