Thailand special recruitment track of medical students: a series of annual cross-sectional surveys on the new graduates between 2010 and 2012

Abstract

BackgroundComprehensive policies for rural retention of medical doctor and other health professional, including education strategy and mandatory service, have been implemented in Thailand since the 1970s. This study compared the rural attitudes, intention to fulfil mandatory rural service and competencies between medical graduates’ from two modes of admission, normal and special tracks.MethodsThree cross-sectional, self-administered questionnaire surveys were conducted in April 2010, 2011 and 2012. The questionnaire was distributed to all new medical graduates in the annual Ministry of Public Health meeting to allocate workplaces for the 3-year mandatory service.FindingsThe majority of students were recruited through the normal track (56 to 77%) from medical schools in Bangkok (56 to 66%), having mostly attended secondary schools in Bangkok. A majority of special track graduates came from secondary schools in provincial cities (76 to 79%). All three batches came from well-educated parents.A slight difference in rural attitudes was observed between tracks. Univariable analysis found statistical associations between the intention to fulfil the 3-year obligation and special track recruitment and attributes on rural exposure. Multivariable analysis showed that graduates recruited through the special track had a 10 to 15% higher probability of fulfilling the mandatory service.Special track graduates scored higher on four out of five competencies, notably procedural skills, but normal track graduates had higher competency on clinical knowledge in major clinical subjects.ConclusionSince special track recruitment resulted in a higher probability of fulfilling mandatory service and competency, increasing the proportion of special track recruitment and improving the effectiveness of policies addressing physician shortage were recommended.

Health workforce contributions to health system development: a platform for universal health coverage

“…17 They also showed longer retention in rural district hospitals. It was noted that 80% and 16% of CPIRD graduates were still serving in such hospitals after three and 10 years, respectively, compared with 70% and 10% of graduates who had been recruited through the normal channel.…”

Retention of doctors in rural health services in Thailand: impact of a national collaborative approach

“…The present study shows that special recruitment of medical students with rural backgrounds followed by clinical teaching in MOPH hospitals in provincial cities of Thailand, seen as early exposure to rural health services, probably has beneficial effects on the number of doctors who started and remained working in rural health services. Previous studies suggest that medical graduates under the special recruitment scheme are more likely than those recruited through a normal track to continue working in rural areas for a longer period after mandatory service 22,23 . As the large majority of graduates under the special rural recruitment track remained working in the provinces to which they were primarily assigned, this approach might also help improve Thailand's doctor maldistribution.…”

Impact of a 20-year collaborative approach to increasing the production of rural doctors in Thailand

“…A conventional recruitment and training of medical students in Thailand, referred to as ‘a normal track’, has solely been operated by the Ministry of Education 4 , 6 . Secondary school students are recruited to one of 19 medical schools based on their academic merits from the national entrance examination.…”

“…All students are required to pass medical school’s comprehensive examination and the national license examination to obtain their medical license. Normal track graduates are subjected to 3-year compulsory service, with 11,300 USD fine imposed for non-compliance 6 , 7 . Their workplace is based on individuals’ choice provided each year’s vacancy availability.…”