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

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To the Editor: The rural clinical school (RCS) initiative is acknowledged as a successful policy response to the rural–urban medical workforce imbalance.1 Kondalsamy-Chennakesavan and colleagues’ article regarding the location of practice of Commonwealth-supported alumni from the University of Queensland Rural Clinical School (UQRCS) concludes that there appears to be a compounding effect of RCS experience on a background of “rurality”, when compared with metropolitan students undertaking similar rural placements.2

These results differ from those of the University of Sydney RCS3 and the University of Western Australia RCS,4 the former of which was not referenced by the authors. These earlier articles suggest that long-term RCS placements change the likelihood of all students’ uptake of rural internships3 and rural practice in general,4 not simply those of rural origin versus metropolitan origin students.

Australian universities operating RCSs employ differing admission criteria for undergraduate and postgraduate courses, course durations and pedagogical constructs in their curricula; both rural and metropolitan students are subject to differing personal or financial circumstances.