Abstract
BackgroundAngola is among one of the most deprived countries in the world in terms of medical professionals. In the past decade, the Angolan Government has invested in the expansion of faculties of medicine in the country. We analysed the profiles of medical students in Angola according to four clusters of medical schools: older faculty in the country, private faculties, Cuban sponsored faculties and military faculty; under the assumption that the organizational culture of the different faculties might influence the expectations and decisions towards future professional life of medical students regarding where they want to work (community versus hospital) and in which sector (exclusively public versus not exclusively public).MethodsObservational cross-sectional study. Piloted, standardized questionnaire to final year medical students or higher year of training in the first four-month of 2014 (N = 402). Data were entered into a SPSS v.20 database and descriptive statistics computed. Statistical significance for categorical variables was tested by Pearson chi-square, Fisher exact or likelihood ratio tests as appropriate. Comparison of means was tested with Anova. Backward elimination binary logistic regression was used to test the hypothesis that type of faculty of medicine is an important determinant of future professional practice, i.e., level (hospital vs. community) or sector of practice (exclusive public sector vs. private or private and public), while controlling for confounders.ResultsAfter controlling for age, sex, marital status, place of birth and place of primary and secondary education, type of family and family influence, students were more likely to choose community over hospital practice and to prefer exclusive public practice if attending a Cuba supported faculty of medicine.ConclusionsMedical education cannot be isolated from planning of the medical workforce. Some important and impactful careers choices, like choosing rural over urban practice, public over private sector practice, have deep influences in the medical professionals’ labour market. Some of these decisions are shaped even before the end of the medical training. As such, the monitoring of future professional intentions in medical schools should be done regularly to accommodate both the health system needs and the hopes and dreams of medical trainees.
Highlights
Angola is among one of the most deprived countries in the world in terms of medical professionals
Monitoring of the medical students preferences is important for medical workforce planning
Socio-demographic characteristics of students The mean age of medical students in the study was 29.0 ± 5.4 years, the oldest group belonging to faculties of medicine (FM)-UAN students (31.1 ± 7.1 years of age) and the youngest to FM-D (25.6 ± 1.5); Cuban supported medical faculties (FM-C) and Private medical faculties (FM-P) had very similar averages (28.6 ± 4.1 and 28.4 ± 5.1 respectively) (p < 0.01)
Summary
Angola is among one of the most deprived countries in the world in terms of medical professionals. There are just over 6,000 doctors, more than 900 are foreigners and about 3,000 are in the public sector, making it one of the countries with a severe shortage of medical professionals (18.2 medical doctors per 100 000 inhabitants) [1]. There has been an effort, throughout health workforce severely deprived countries, to address medical workforce shortages, to which Angola is not an exception [3]. In this country, medical education has tried to keep up with the changes and needs in the health care system. With the support of Portuguese and Cuban FM, the Ministry of Defense opened its own medical faculty in 2008 (FM-D) [4,5,6]
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