The Indian healthcare sector is facing a critical shortage of doctors. Most medical institutes encourage or mandate budding doctors to serve in rural communities as part of their education. However, young doctors don’t prefer to work in rural areas, which represent 70% of the population. In a recent study, researchers from the Post Graduate Institute of Medical Education and Research, Chandigarh and Maastricht University, The Netherlands, have tried to understand the reasons behind why budding doctors from North India shun rural postings. The study was funded by the Indian Council of Medical Research and was published in the journal PLoS ONE.
The researchers conducted their study among the final year students and interns from the six government medical colleges from Himachal Pradesh, Haryana, and Punjab. The participants included 90 students in the age group 20-27 years, who were asked their opinions about serving in a rural set-up and the possible challenges and advantages associated with it.
“This is the first qualitative study from the northern part of India, which explored the factors influencing medical students’ interest to work in rural areas”, say the authors.
The respondents listed several factors that play a part in their decision to work in rural areas. Factors like an unchallenging professional environment loaded with issues like lack of proper accommodation and infrastructure, shortage of equipment and drugs, inadequate human resource support and limited opportunities for travelling and doing their research were among the challenges. They also felt that the financial rewards for a rural posting are not satisfactory and are loaded with the burden of isolation from their families, lack of security and undesirable political interference.
However, the desire to serve the poor and underprivileged people was a potential driving force for many. According to the respondents, rural postings could help them in getting a preference for admission into postgraduate courses, a better clinical experience while practising on the diverse groups and a better status and respect than in urban areas.
The researchers opine that the current approaches to increase the number of doctors in rural areas are not satisfactory, and understanding the perception of medical students about rural postings could change that. Adequate remuneration for doctors with satisfactory living conditions, opportunities to socialise with professional peers and local communities, upgrading the necessary infrastructure of health services and review of the medical curriculum to prioritise the health needs of the whole country might help, they say. The researchers feel that a preferential selection of students from rural areas in medical studies followed by their placements in those places might also be useful.
The present study tries to understand what young medical students thought of working in rural areas and gathered their feedback about this aspect, which can be used to design policies for rural healthcare.
“These findings will help policymakers and medical educators to design and implement a comprehensive human resource strategy that shall target specific factors to encourage medical students to choose job positions in rural areas”, conclude the authors.