I read the article with great interest and certainly it supports evidence that medical students with rural background are more likely to practice in rural areas. However, it is still not clear how many of practitioners in rural areas actually had or still have desire to go abroad or practice in urban areas where there are more facilities. Working in rural area by will in one thing and being forced to practice due to other circumstances in life is another thing. How many of those remained back actually took USMLE, PLAB or other qualifying exam and failed ?

Is there any co-relation between worsening political situations and migration of doctors?

Another important question to ask would be how many of those doctors who are practicing in Nepal actually went abroad and came back to finally settle down in Nepal.

I think migration of doctors is a complex issue and various factors determine an individual's intent to emigrate. As study has pointed out, the migration of doctors have increased in recent years which goes along very well with decade long civil war and political instability in post conflict period.

However, I absolute agree that people from rural background are more likely work in rural area.

Competing interests: I worked as a consultant with Nick Simon Institute for a brief period of time in 2007.