Attitude towards working in rural area and self-assessment of competencies in last year medical students: A survey of five countries in Asia

Abstract

BackgroundFive countries in Asia including Bangladesh, China, India, Thailand and Vietnam formed a network called Asia-Pacific Network for Health Professional Education Reforms (ANHER). This network collectively conducted a survey at the national level and at the institutional level (for medical, nursing and public health education). We also undertook an assessment of final year graduates from these schools on their attitudes, competencies and willingness to work in rural areas.MethodsPretested anonymous questionnaire comprised of four sections including demographic data, attitudes towards working in rural area, where to work after graduation and perception about competency of respondents was used. Descriptive and analytical statistics were used for data analyses.ResultsAbout 60 % of students from Bangladesh and Thailand had positive attitude towards working in rural area, 50 % in both China and India and only 33 % in Vietnam. Students’ positive attitudes towards their school in terms of preparing or inspiring them to work in rural areas were low across all five countries. Upon graduation and in the next five years, majority of students wanted to work in public sectors. Interestingly confidence about overall competency was quite low.DiscussionPositive attitude towards working in rural areas varied significantly across five countries in Asia. Medical schools should improve the preparation and inspiration towards working in rural areas for their students.ConclusionMedical schools should put more effort in improving students’ attitude towards working in rural areas.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0719-9) contains supplementary material, which is available to authorized users.

Association between rural clinical clerkship and medical students’ intentions to choose rural medical work after graduation: A cross-sectional study in western China

“…Medical students whose parents were less educated were more likely to have intentions of choosing rural medical work than those whose parents received high-level education. However, a survey among medical students from five countries in Asia by Chuenkongkaew et al reported a contradictory finding that parents’ education was not significantly associated with their attitudes towards working in rural areas [ 11 ].…”

“…Qing et al [ 14 ], Huntington et al[ 5 ], and Van Wyk et al [ 39 ] reported that male students were more likely than female students to practice in rural areas in China, Nepal, and South Africa, respectively. However, Chuenkongkaew et al [ 11 ] found that male students were less positive about rural medical work than female students; Borracci et al [ 24 ], Zhang et al [ 28 ] and Puddey et al [ 12 ] demonstrated an insignificant association between the gender of medical students and their intentions. In addition, age and mother’s education were influencing factors of intentions of medical students with an urban background, whereas they were insignificant for rural medical students.…”

“…A recent systematic review revealed that medical students’ career intentions to work in rural locations were low (10%-20%) in some low- and middle-income countries [ 4 ], such as Nepal [ 5 ], Bangladesh [ 6 ], sub-Saharan Africa [ 7 ], Ethiopia [ 8 ], South Africa [ 9 ], and India [ 10 ]. In addition, a survey of five countries in Asia reported approximately 60% of medical students in Bangladesh and Thailand had positive attitudes towards working in rural areas, followed by 50% in China and India, and 33% in Vietnam [ 11 ]. Furthermore, many determinants contribute to medical students’ career intentions and decision to work in rural locations.…”

“…A rural background (i.e., being brought up in a rural area), training in rural areas with a community-based curriculum, early exposure to the community during medical training, and rural location of the medical school motivated medical students to work in rural areas [ 4 , 13 ]. In addition, gender, personal job concerns, and family factors were identified as associated with medical students’ intentions to engage in rural medical work [ 11 , 14 ]. Bowman et al considered that one significant explanation for why so few medical graduates were willing to work in rural areas was lack of contact with rural communities, people, and practitioners [ 15 ], which marked the importance of early rural exposure before graduation of medical students.…”

Perceived incentives and willingness of university medical students toward working in rural primary healthcare

“…There are rich literatures on the willingness of medical students toward PHC or rural PHC career and associated determinants and motivations, from both developed countries and developing countries including China [9,12,14,15]. Determinants were classified as demographic, personal, social, intrinsic or extrinsic, monetary or non-monetary, experience and educational factors, etc.…”