BackgroundBotswana’s medical school graduated its first class in 2014. Given the importance of attracting doctors to rural areas the school incorporated rural exposure throughout its curriculum.AimThis study explored the impact of rural training on students’ attitudes towards rural practice.SettingThe University of Botswana family medicine rural training sites, Maun and Mahalapye.MethodsThe study used a mixed-methods design. After rural family medicine rotations, third- and fifth-year students were invited to complete a questionnaire and semi-structured interview. Data were analysed using descriptive statistics and thematic analysis.ResultsThe thirty-six participants’ age averaged 23 years and 48.6% were male. Thirty-three desired urban practice in a public institution or university. Rural training did not influence preferred future practice location. Most desired specialty training outside Botswana but planned to practice in Botswana. Professional stagnation, isolation, poorly functioning health facilities, dysfunctional referral systems, and perceived lack of learning opportunities were barriers to rural practice. Lack of recreation and poor infrastructure were personal barriers. Many appreciated the diversity of practice and supportive staff seen in rural practice. Several considered monetary compensation as an enticement for rural practice. Only those with a rural background perceived proximity to family as an incentive to rural practice.ConclusionThe majority of those interviewed plan to practice in urban Botswana, however, they did identify factors that, if addressed, may increase rural practice in the future. Establishing systems to facilitate professional development, strengthening specialists support, and deploying doctors near their home towns are strategies that may improve retention of doctors in rural areas.

BackgroundFamily Medicine (FM) training is new in Botswana. No previous evaluation of the experiences and opinions of residents of the University of Botswana (UB) Family Medicine training programme has been reported.AimsThis study explored and assessed residents’ experiences and satisfaction with the FM training programme at the UB and solicited potential strategies for improvement from the residents.MethodsA descriptive survey using a self-administered questionnaire based on a Likert-type scale and open-ended questions was used to collect data from FM residents at the UB.ResultsEight out the 14 eligible residents participated to this study. Generally, residents were not satisfied with the FM training programme. Staff shortage, inadequate supervision and poor programme organisation by the faculty were the main reasons for this. However, the residents were satisfied with weekly training schedules and the diversity of patients in the current training sites. Residents’ potential solutions included an increase in staff, the acquisition of equipment at teaching sites and emphasis on FM core topics teachings. They had different views regarding how certain future career paths will be.ConclusionsDespite the general dissatisfaction among residents because of challenges faced by the training programme, we have learnt that residents are capable of valuable inputs for improvement of their programme when engaged. There is need for the Department of Family Medicine to work with the Ministry of Health to set a clear career pathway for future graduates and to reflect on residents’ input for possible implementation.

Potential for the specialty of Family Medicine in Botswana: A discussion paper

BackgroundThe study aimed to determine the proportion of each priority level of patients, time of performance in each priority level, and the reliability of the South African Triage Scale (SATS) tool at the Mahalapye District Hospital - Emergency Department (MDH-ED), a setting where the majority of the nurses were not formally trained on the use of the SATS.MethodsThis was a cross-sectional study using case records in MDH-ED from 1 January 2014 to 31 December 2014. A panel of experts from the Mahalapye site of the Family Medicine Department, University of Botswana, reviewed and scored each selected case record that was compared with the scores previously attributed to the nurse triage.ResultsFrom the 315 case records, both the nurse triage and the panel of expert triage assigned the majority of cases in the routine category (green), 146 (46%) and 125 (40%), respectively, or in the urgent category (yellow), they assigned 140 (44%) and 111 (35%) cases, respectively.Overall, there was an adequate agreement between the nurse triage and the panel of expert triage (k = 0.4, 95% confidence interval: 0.3–0.5), although the level of agreement was satisfactory.ConclusionFindings of the study reported that the profile of the priority-level categories in MDH-ED was made in the majority of routine and urgent patients, only the routine and the emergency patients were seen within the targeted time and they had a satisfactory level of reliability (between 0.4 and 0.6).

No abstract available.