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

Geoffrey C Nicholson and Srinivas Kondalsamy-Chennakesavan
Med J Aust 2015; 202 (9): . || doi: 10.5694/mja15.00198
Published online: 18 May 2015

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.


  • University of Queensland, Toowoomba, QLD.


Correspondence: geoff.nicholson@uq.edu.au

Competing interests:

No relevant disclosures.

  • 1. Kondalsamy-Chennakesavan S, Eley DS, Ranmuthugala G, et al. Determinants of rural practice: positive interaction between rural background and rural undergraduate training. Med J Aust 2015; 202: 41-45. <MJA full text>
  • 2. Playford DE, Evans SF, Atkinson DN, et al. Impact of the Rural Clinical School of Western Australia on work location of medical graduates. Med J Aust 2014; 200: 104-107. <MJA full text>
  • 3. Clark TR, Freedman SB, Croft AJ, et al. Medical graduates becoming rural doctors: rural background versus extended rural placement. Med J Aust 2013; 199: 779-782. <MJA full text>

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