Letters
Volume 202 - Issue 9

Determinants of rural practice: positive interaction between rural background and rural undergraduate training

Authors:  Geoffrey C Nicholson and Srinivas Kondalsamy-Chennakesavan

Med J Aust 2015; 202 (9): 477-479. || doi: 10.5694/mja15.00198
Published online: 18 May 2015
In reply: Consider an increase in the proportion of medical students with a rural background
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In reply: We agree that institutional differences may limit the generalisability of the findings of our recent study.1 However, direct comparison of the results of our study with those of earlier studies2,3 is problematical because the studies differ in many ways, including definition of rural background, outcome measures, adjustment for confounders, and statistical methods and power. Importantly, neither study collected and tested for interactions among all variables that could potentially confound the results. However, the Western Australian study did note that the dual exposure of rural background and rural clinical school (RCS) placement was the strongest predictor of rural practice.2 The Sydney study did not show an association between rural background and their rural workforce outcome,3 a result inconsistent with most extant data.

We did not recommend “restricting” RCS placements to rural background students but that an increase in the proportion with rural background be considered. The results of our study, and in fact the Western Australian study, support such a consideration. We note that Arnold does not object to our proposals for longer RCS placements and recruitment of students with longer rural background.

Authors

  • Geoffrey C Nicholson PhD, FRACP, FRCP1
  • Srinivas Kondalsamy-Chennakesavan MB BS, MPH, FRSPH1
  • 1. University of Queensland, Toowoomba, QLD.

Correspondence: geoff.nicholson@uq.edu.au

Competing interests

No relevant disclosures.

References

View this article on Wiley Online Library