How many doctors should we train for Sri Lanka? System dynamics modelling for training needs

Abstract

Over the years, Sri Lanka has achieved remarkable health gains for the money spent on health. Currently about 1450 doctors enter the health system annually. While some advocate opening up of new medical schools to address an apparent shortage of doctors in the country, others argue against it. To identify the number of doctors Sri Lanka need. System dynamics, an analytical modelling approach and a methodology for studying complex feedback systems was used. Two sub models of “need” and “supply” were developed and simulated for a period of 15 years from 2017 to 2032 At present the doctor to population ratio is 1:671 and 91% of the need has been met. This study shows that currently there is a shortage of doctors in the country. However, the supply will match the need by 2025/26. Increasing the number of doctors, will result in oversupply of doctors towards the latter part of the next decade. There is no acute necessity to open up new Medical Schools. However comprehensive health workforce analysis needs to be done once in 5 years and the number of doctors to be trained, decided accordingly.