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

In developed countries, including the United States, Canada and Australia, a fifth to a third of the population live in rural areas yet the number of medical practitioners employed per 100 000 population in those areas is about half that of major cities.14 It has long been recognised that rural doctors are more likely to have a rural background and to have had some medical training (undergraduate or postgraduate) in rural areas,516 although the effect of undergraduate rural exposure has been questioned.17 Other factors associated with rural practice include being single, having children, having a partner with a rural background, rural primary and secondary education, intention or desire to practise rurally, sex, age, having a bonded scholarship, and medical school attended.1820

From the early 1990s, the Australian Government introduced national initiatives aimed at encouraging rural practice. This included funding medical schools to increase enrolment of students with a rural background and provide short-term undergraduate rural exposure.21,22 In…