CPIRD: A successful Thai programme to produce clinically competent medical graduates

Abstract

The programme titled “Collaborative Project to Increase Production of Rural Doctors” (CPIRD) is a rural medical education project launched in 1994 in Thailand. This study aimed to compare the academic performances in medical study over five years and the pass rates in national medical license examinations (MLE) between students enrolled in CPIRD and two other tracks.Grade point average (GPA) over five years and results of MLEs for four cohorts of students enrolled from 2003 to 2006 in Prince of Songkla University were collected from the registration department. A longitudinal analysis was used to compare the GPA over time for medical students enrolled in CPIRD and those from the national and direct regional tracks through generalized estimating equation (GEE) models. The MLE pass rates were compared using chi-square and fisher's exact tests as appropriate.Female students dominated the CPIRD group. GPAs in the first three years in the CPIRD group were significantly lower than those of the other two groups, this disparity narrowed in the fourth and fifth years. For step one of the MLE (basic sciences), cohorts 2003 and 2006 of the CPIRD group had a significantly lower pass rate than the other two groups but there was no significant difference in cohort 2004 and cohort 2005. The CPIRD step two and three MLE pass rates were not significantly different from the national track in all cohorts and lower than the direct track only for step two in cohort 2003 and step three in cohort 2006. The step three pass rate of the CPIRD group in cohort 2004 was significantly higher than the other two tracks.Despite weaker competency in basic science, the CPIRD was successful in forming clinical competency.

Perception of educational environment among medical students in Thailand

“… 33 Previous studies suggests that medical teaching in service hospitals may also help equip students with better clinical competency as compared to teaching in large university hospitals. 33 - 35 Training in real healthcare services may provide students with hands-on experience on clinical practice and procedures, which are more relevant to their future career practice. Many authorities have suggested that doctors should be produced in real health service system with enhancing community-oriented competencies such as teamwork skills and being a change agent.…”

Early outcomes of a rural-oriented physician education programme against rural physician shortages in Guangxi province: a prospective cohort study

“…Extremely high proportions of graduates practising in rural sites and successfully passing NMLE exhibited that the RTME-GXMU programme has achieved positive early outcomes consistent with other medical education programmes with similar commitment requirements in the USA, 13 14 Australia, 15 16 Japan 17 and Thailand. 18 The above-mentioned foreign medical education programmes have obtained success at different extents in promoting recruitment and retention of the rural physician workforce in their own countries.…”

A Checklist for Implementing Rural Pathways to Train, Develop and Support Health Workers in Low and Middle-Income Countries

“…If they did, the strategic directions were often confined to one health worker type or targeted at a particular community health issue like maternal health (22,23). The evidence of integrated rural pathways strategies was most developed in Thailand and the Philippines for medical doctors, including at University and early graduate levels (24)(25)(26)(27)(28). There were also examples of step-wise models included Community Health Worker training in Ethiopia (29,30) and international partnerships to boost intelligence and resources for building rural pathways (31).…”