Interestingly, foreign grads and older physicians:

The markers included an increased likelihood for international medical graduates. It is important to note that this in not a reflection of these doctors knowing less, but a reflection of the culture and environment of where they were trained and what disease patterns might be like there. In other words, if the international doctor came from an environment where most diseases were bacterial rather than viral, that bias and belief would come forward as s/he moved to this environment and would influence prescribing patterns.

In addition, physicians with a high practice volume and those who had practised longer were also more likely to prescribe antibiotics inappropriately. This might reflect several things. It might reflect a doctor becoming “softened,” as the authors state, to patient pressure and expectations. It might also reflect the pressure of time and the physician avoiding time-consuming education to a patient.