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Rural Australian Medical Undergraduate Scholarships (RAMUS) provide$10 000 per annum to selected medical students with a rural background. Eligibility criteria include having lived in a rural community for five consecutive or eight cumulative years. We sought to validate the above-specified criterion using data from the Australian National Rural Background Study.National case control study stratified by jurisdiction.Two thousand four hundred and fourteen Australian-trained rural and urban general practitioners (GPs).Whether the RAMUS rural background criterion was met or not.Doctors who met the RAMUS rural background criterion were more likely to be in rural practice (odds ratio = 2.50; 95% confidence interval, 1.97–3.18) than those who did not. This was true for all jurisdictions (except for the Northern Territory) and ranged from 1.95 for South Australia to 3.57 for Victoria.Rural GPs are more likely to fulfil the RAMUS rural background criterion, supporting the existence of the RAMUS scheme. [ABSTRACT FROM AUTHOR]

We sought to summarise the evidence for an association between rural background and rural practice by systematically reviewing the national and international published reports. A systematic review. A search of the national and international published reports from 1973 to October 2001. The search criteria included observational studies of a case-control or cohort design making a clear and quantitative comparison between current rural and urban doctors, this resulted in the identification of 141 studies for potential inclusion. We systematically reviewed 12 studies. Rural background was associated with rural practice in 10 of the 12 studies, in which it was reported, with most odds ratios (OR) approximately 2–2.5. Rural schooling was associated with rural practice in all 5 studies that reported on it, with most OR approximately 2.0. Having a rural partner was associated with rural practice in 3 of the 4 studies reporting on it, with OR approximately 3.0. Rural undergraduate training was associated with rural practice in 4 of 5 studies, with most OR approximately 2.0. Rural postgraduate training was associated with rural practice in 1 of 2 studies, with rural doctors reporting rural training about 2.5 times more often. There is consistent evidence that the likelihood of working in rural practice is approximately twice greater among doctors with a rural background. There is a smaller body of evidence in support of the other rural factors studied, and the strength of association is similar to that for rural background. It is widely perceived that doctors with a rural background are more likely to return to work in rural areas and major policy initiatives in Australia rely on this assumption. It is recognised that other factors such as location of primary and secondary education, rural medical training and spouse or partner background may also be influential. In order to determine the strength of the evidence for an association between rural background and rural practice we did a systematic review of the published reports. This systematic review provides good evidence that doctors with a rural background are about twice as likely to work as rural doctors, compared with those with an urban background. Rural background seems to be an important factor that can be employed in policy and practice, however, the problem of increasing the number of rural doctors is multifactorial and so is the solution. [ABSTRACT FROM AUTHOR]

Objective To determine the association between rural undergraduate training, rural postgraduate training and medical school entry criteria favouring rural students, on likelihood of working in rural Australian general practice. Methods National case–control study of 2414 rural and urban general practitioners (GPs) sampled from the Health Insurance Commission database. Participants completed a questionnaire providing information on demographics, current practice location and rural undergraduate and postgraduate experience. Results Rural GPs were more likely to report having had any rural undergraduate training [odds ratio (OR) 1·61, 95% confidence interval (CI) 1·32–1·95] than were urban GPs. Rural GPs were much more likely to report having had rural postgraduate training (OR 3·14, 95% CI 2·57–3·83). As the duration of rural postgraduate training increased so did the likelihood of working as a rural GP: those reporting that more than half their postgraduate training was rural were most likely to be rural GPs (OR 10·52, 95% CI 5·39–20·51). South Australians whose final high school year was rural were more likely to be rural GPs (OR 3·18, 95% CI 0·99–10·22). Conclusions Undergraduate rural training, postgraduate training and medical school entry criteria favouring rural students, all are associated with an increased likelihood of being a rural GP. Longer rural postgraduate training is more strongly associated with rural practice. These findings argue for continuation of rural undergraduate training opportunities and rural entry schemes, and an expansion in postgraduate training opportunities for GPs. [ABSTRACT FROM AUTHOR]