A Qualitative Inquiry Into the Challenges of Medical Education for Retention of General Practitioners in Rural and Underserved Areas of Iran

Abstract

ObjectivesGeneral practitioners (GPs) retention in rural and underserved areas highly effects on accessibility of healthcare facilities across the country. Education seems to be a critical factor that affects GPs retention. Thus, the present study aimed at inquiry into medical education challenges that limit their retention in rural and underserved areas.MethodsA qualitative approach was applied for the aim of this study. Data were gathered via 28 semi-structured interviews with experts at different levels of Iran’s health system as well as GPs who retained and refused to retain working in rural settings. Interviews mainly were performed face-to-face and in some cases via telephone during 2015 and then coded and analyzed using content analysis approach.ResultsIran’s medical education is faced with several challenges that were categorized in four main themes including student selection, medical students’ perception about their field of study, education setting and approach, curriculum of medical education. According to experts this challenges could results in making GP graduates disinterested for practicing in rural and underserved areas.ConclusionsChallenges that were found could have negative effects on retention. Modification in student’s perception about rural practice could be done via changing education setting and approach and curriculum. These modifications could improve GPs retention in rural and underserved areas.

Physicians’ retention rate and its effective factors in the Islamic Republic of Iran

“…The relation between demographic factors and retention in rural areas is hotly debated in the literature. Certain studies consider demographic factors as predictors of retention in rural areas (21,27), while others report that male physicians have a greater tendency to work in rural settings (22,28). However, our findings indicated that there were no gender differences when considering the tendency to stay in one's place of birth.…”

“…However, low retention rates in less developed rural areas are an important issue that some medical schools are trying to address. While some studies suggested reform in medical education could improve retention in rural areas (21)(22)(23), other factors such as development levels of service and demographic factors are critical, but are rarely addressed in studies (5).…”

Healthcare-seeking behavior and its relating factors in South of Iran

“…As previous studies in Iran have shown, the Iranian population does not trust general practitioners. [16]…”

Influencing factors on the tendency of general practitioners to join in Urban Family Physician Program in Iran

“…In fact, the passive health network, powerful private sector which have conflict of interest with UFPP, population freedom for choosing health provider, and different cultural norms are those factors that make UFPP more different from rural family physician program (4). Some studies conducted in different countries shows that diverse push factors within and outside health system might affect the tendency of human resources to join in the policies (13,14). Results of these studies are also different which clarifies the factors are multi-facetted and complex (14,15) and are mainly categorized into three groups including contextual/ environmental, personal and professional factors (13).…”

“…Some studies conducted in different countries shows that diverse push factors within and outside health system might affect the tendency of human resources to join in the policies (13,14). Results of these studies are also different which clarifies the factors are multi-facetted and complex (14,15) and are mainly categorized into three groups including contextual/ environmental, personal and professional factors (13). In this regard the approach to the study might be different from one study to another study.…”