Changes in Medical Students’ Perceptions of Family Medicine Following a Clinical Rotation: A Rural–Urban Comparison in Romania

Background/Objectives: Romania faces a shortage of family physicians, particularly in rural areas. Undergraduate Family Medicine rotations may influence students’ perceptions before residency selection, but the contribution of rural versus urban training settings remains insufficiently documented. This study examined differences between post-rotation perceptions and students’ recalled pre-rotation perceptions, and explored whether these differences varied according to placement setting. Methods: This single-centre study used a single-administration retrospective pretest–posttest observational design. After completing the mandatory one-month Family Medicine rotation, 141 sixth-year medical students completed a questionnaire containing recalled pre-rotation and post-rotation ratings on 12 five-point Likert items. Paired comparisons used Wilcoxon signed-rank tests; multiple-testing corrections were applied within the defined item families. A baseline-adjusted model with robust standard errors examined rural placement. Results: The composite score increased from 3.62 ± 0.84 to 4.10 ± 0.74 (mean change 0.483; W = 602.5; Z = −7.990; p < 0.001; r = 0.673). All 12 paired item comparisons remained significant after Bonferroni correction. No rural–urban item comparison remained significant after correction. In the adjusted model, rural placement was not associated with a statistically significant difference in the post-rotation score (β = 0.197, 95% CI −0.002 to 0.397; p = 0.053). Among the 86 rurally exposed students, the mean willingness to practice rurally was 2.87/5. The apparent association with career intention was not retained when excluding the overlapping career-likelihood item (11-item composite: H = 6.695, p = 0.153). Conclusions: Students reported more favourable perceptions after the rotation than they recalled having before it, but their willingness to practice rurally remained limited. The uncontrolled, retrospective design does not permit causal attribution, and the data do not establish a rural-placement advantage or subsequent specialty choice.