Medical education program with obligatory rural service: Analysis of factors associated with obligation compliance

Kajii, Eiji

doi:10.1016/j.healthpol.2008.09.004

Cited by 21 publications

(25 citation statements)

References 27 publications

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“…Or more likely, the effect of the interventions can be the major cause of the 'return to normal' phenomenon of PPR seen in Japan, when taking into account the fact that competition-based diffusion was not observed by past Japanese studies [3,5]. In Japan, such interventions are, for example, a policy of egalitarian distribution of public medical schools called the 'one medical school in one prefecture policy' [26], including the establishment of a medical school solely for producing rural physicians [20,27], and massive financial support of local and national governments for management of rural medical facilities, particularly for a physician's salary in such areas [28,29]. Some of these interventions reportedly brought about substantial results [20,27,30].…”

Section: Discussionmentioning

confidence: 99%

Physician scarcity is a predictor of further scarcity in US, and a predictor of concentration in Japan

et al. 2010

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Section: Discussionmentioning

confidence: 99%

Physician scarcity is a predictor of further scarcity in US, and a predictor of concentration in Japan

et al. 2010

Self Cite

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“…These findings are in contrast to many studies that found that training in rural settings can influence future career choice of the trainee. 2,3,5,7,11,12 The differences in findings in this study were due to factors including negative perceptions and unpleasant experiences that medical interns encountered and the different work culture of rural practitioners in Indonesia. Therefore the rural medical internship program may not help to improve the medical workforce for rural areas over the long term.…”

Section: Discussionmentioning

confidence: 73%

Indonesian Rural Medical Internship: The Impact on Health Service and the Future Workforce

Dasman

Mwanri²,

Martini³

2018

Ind. Jour. of Publ. Health Rese. & Develop.

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Background: Studies have shown a shortage of medical practitioners in rural areas, and that graduate doctors are reluctant to practice in the rural areas. To address this shortage and reluctance, the Government of Indonesia implemented a rural medical internship program with the aims of preparing medical graduates for primary medical practice, and attracting them to rural areas. The purpose of this study was to understand the experience of medical interns in the rural medical internship program, and to identify the barriers and enablers to achieving the program aims. Method: A purposive sample of 38 medical interns (70.4%) from five districts of West Sumatera Province, participated in focus group interviews. The interviews were recorded and transcribed verbatim. Data was coded and categorized before thematic analysis for experiences in rural setting specifically to identify factors important for retention of the doctors. Results: The medical interns indicated that their exposure to rural practice did not influence their decision to practice in rural area in the future, with most interns reporting that they did not intend to undertake clinical practice as rural doctors. The main reasons expressed were due to interpersonal issues with senior clinicians, nurses and hospital staff, which resulted in their autonomy and decision making processes being undermined; and a perceived lack of professional and financial reward for practicing as rural doctors. Overall, the study found that the program improved access to medical services in the five districts, but may not improve the shortage of medical practitioners in rural areas on a long term basis Conclusion: A rural medical internship program improves rural medical services. However, the program alone will not address the long term goal of improving rural workforce shortage. Providing incentives for rural doctors and structural change are needed in order to make rural practice more attractive.

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“…One issue was the medical students’ lack of exposure to general medicine. In Japanese undergraduate medical education, rural medicine, primary care, and general medicine education are mandatory . However, medical students may not be able to learn enough about them in the present system, even in other countries .…”

Section: Discussionmentioning

confidence: 99%

Students’ perceptions of general medicine following community‐based medical education in rural Japan

Ohta¹,

Ryu²,

Katsube³

et al. 2019

J of Gen and Family Med

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Background Japan's population is rapidly aging, and at the same time, the number of medical students interested in general or family medicine is declining. Community‐based medical education (CBME) programs may be used to promote interest and competencies in general medicine among medical students. Method This mixed‐method study investigated the perceptions of fifth‐ and sixth year undergraduate medical students who completed a two week CBME course in Unnan, a small city in rural Japan. The participants completed two survey questionnaires: (a) The achievement questionnaire administered pre‐ and posttraining, and (b) the curriculum content questionnaire administered posttraining. To understand the students’ perceptions about general medicine further, semistructured interviews were conducted with each participant post‐CBME training. Results The participants’ ratings on the achievement survey improved significantly from pre‐ to posttraining. The average ratings for the curriculum content survey indicated that the educational objectives were met in all but one area. A qualitative analysis of the interview data revealed that the participants had little exposure to general medicine at their university hospital, and there was a lack of understanding in other medical professionals regarding the roles of general medicine physicians. Conclusion This study demonstrates that there are educational gaps between medical universities and community hospitals regarding general medicine. Increased exposure, early exposure, and a clarification of the competencies were noted as areas to improve the students’ understanding of general medicine. Undergraduates should be exposed to general medicine more frequently and from early training stages through effective collaborations between universities and hospitals.

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Medical education program with obligatory rural service: Analysis of factors associated with obligation compliance

Cited by 21 publications

References 27 publications

Physician scarcity is a predictor of further scarcity in US, and a predictor of concentration in Japan

Physician scarcity is a predictor of further scarcity in US, and a predictor of concentration in Japan

Indonesian Rural Medical Internship: The Impact on Health Service and the Future Workforce

Students’ perceptions of general medicine following community‐based medical education in rural Japan

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