Attitude of medical students toward serving in rural areas and its determinants: a cross-sectional study from Uttarakhand

Abstract

public health indicators and/or weak infrastructure. Uttarakhand is one of these. The first contact of village community with a medical officer occurs at a primary health center (PHC). The PHCs were envisaged to provide an integrated curative and preventive health care to the rural population with emphasis on preventive and promotive aspects of health care. The PHCs are established and maintained by the state governments under the Minimum Needs Programme/Basic Minimum Services (BMS) program. As per minimum requirement, a PHC is to be manned by a medical officer supported by 14 paramedical and other staff. It acts as a referral unit for six subcenters and has 4-6 beds for patients. The services provided through PHCs are curative, preventive, promotive, and family welfare services. [1] These services cannot be provided in an efficient and effective manner to the rural population without the presence of a medical officer. Background: As 70% of population of India resides in rural areas, there is need of providing effective health care to people in these areas. Health care system in rural areas faces the challenge of shortage of doctors. Understanding of perceptions and attitudes of medical students toward working in rural areas can help in addressing the problem of shortage of doctors in these areas. Objective: This study aimed to determine the attitude of medical students toward serving in rural areas and the determinants of such attitude. Material and Methods: A cross-sectional study was conducted among 115 medical students of final year and internships of a government medical college. A pretested self-administered structured questionnaire was used for data collection. Descriptive statistics such as percentages, mean, and standard deviation were used for data summarization and presentation. Results: The overall average of the total score of respondents' attitudes toward the working in rural areas was 45.20 and the SD was 7.76, indicating a slightly negative attitude toward the working in rural areas. Students belonging to rural areas had more favorable attitude to working in rural areas in comparison to students from urban background. Conclusion: Medical students had positive attitude regarding the importance of working in rural areas, but their overall attitude toward working in rural areas was found to be not favorable.

Attitude towards compulsory rural health services among interns of RajaRajeswari Medical College and Hospital, Bengaluru

“…In the present study, only 14% of interns showed positive attitude towards compulsory rural health services whereas in a study done by Gaikwad et al it was 44%. 4 In the present study, the most common reasons for positive attitude being that it provides a good exposure for general practice and an opportunity for independent working which were similar to the findings observed by Singh et al 2 The most common reasons for negative attitude observed in the current study were, isolation from family and relatives, inadequate hospital infrastructure and poor connectivity with cities whereas in a study done by Dutt et al the reasons were lack of clinical guidance, poor basic needs, no career growth and heavy work load. 1 Present study observed that interns staying in rural locality had a more positive attitude towards rural services than those staying in urban locality and this association was found to be statistically significant…”

“…(p=0.03) which is similar to the findings observed by Singh et al2 No association was found between gender and attitude towards rural health services in the present study and similar findings were observed by Deressa et al6 …”

“…1 As on March 2012, 20.4% of the sanctioned posts of doctors were vacant at PHCs of India. 2 Among many medical graduates, the desire for postgraduate specialization dissuades them from entering the job market and there by from the possibility of rural posting in the public sector. 4 In majority of countries including India, the health situation report suggests that medical students should be provided with a rural clinical placement to make them familiar with the rural workplace.…”

Medical student’s attitude towards serving rural areas: A cross sectional study in Maharashtra, India

“…Rural background and primary education at rural areas were identified as the strong variable associated with the retention of health professionals in rural communities by various literatures. 7,10,13,14 This can be explained by the familiarity of medical students with rural setting and cultural norms. We observed that medical students with well-educated parents had less favourable attitude towards working at rural areas similar to study conducted by Saini et al 7 and Singh et al 14 Medical students from I st and II nd years of undergraduation showed more willingness to work in rural area may be because of poor knowledge regarding working conditions in rural area.…”

“…7,10,13,14 This can be explained by the familiarity of medical students with rural setting and cultural norms. We observed that medical students with well-educated parents had less favourable attitude towards working at rural areas similar to study conducted by Saini et al 7 and Singh et al 14 Medical students from I st and II nd years of undergraduation showed more willingness to work in rural area may be because of poor knowledge regarding working conditions in rural area. 14 For the medical students who were interested to work in rural area, the major reason for that decision was to provide service to the poor/underprivileged (social service) as there is scarcity of health care facilities in rural area.…”