Table 2.

Themes

Theme	Description	Quote
Tension 1: Clinical caution versus clinical courage	To stay safely within one’s current level of professional efficacy or to use first principles and cover ‘red flags’	I learnt so much doing ICU. They said, ‘oh, it's useless. There’s no ICUs out in the west’. I said, ‘well, I wouldn’t mind doing it anyway’. I tell you what, its just been great. It teaches you how to deal with critically ill people and that’s what you need when you’re going rural. T1
		I think some people want everything to come to a neat conclusion immediately, order a test, get a result, know the answer. I think that you have to be happy to not always know what the answer is and know that you may never know.T7
		You’ve basically got to step back, try and look at it from a broader view from that and say, right I’ll tackle this with the first principles, you always revert to your first principles, you make sure that you’ve got your red flags covered, your ‘what ifs’. T18
Tension 2: Flexibility versus persistence	To work persistently towards professional goals while knowing when to re-evaluate and change goals	So there you need to learn to just let things go. So you learn these skills as time goes by” T16
		If something goes wrong and you re-evaluate and go, well that didn’t work, but how are we going to get towards the goal? T5
Tension 3: Reflective practice versus task-focussed practice	To reflect on own and other experiences while getting the job done	Practical examples that would make you go into their shoes and feel like, well, you know, this is something that is very very horrible. How would I react if I was put in that situation? I’d probably break down. But what is it about this person that I can learn from and develop their strength, their inner strength to resist that kind of temptation of being worse off than I think I would be?T2
		… having that ability to pull your poker face out buys you a lot of time and that you still then react to it appropriately later, but at the time you don’t have the luxury of doing that, … you kind of you do what you have to do and at the end of the day you can sit down and go, wow, that was kind of massive. In scenarios like that everyone seems to talk, which is good because people automatically do that. T4
Tension 4: Personal connections versus professional commitment	To be sustained by others or to draw meaningfulness from clinical work	I think really good family support has really helped me. Sometimes if you have had a bad situation at work or sometimes you play it up to more than what it is, talking to family, especially those who are in the field and kind of understand how things tick I’ve found really helpful. T10
		Well yeah the rural generalist program is one that really like and it really suits me and in some ways you could say it was designed for me….. and it’s a small little hospital where you had open access for the undifferentiated patients that presents with a problem and it’s got a significant emergency, significant outpatients segment. It’s got obstetrics and a huge indigenous population. It suited me. T8