Abstract
Background: The north-east (NE) region of Sri Lanka observed a critical health workers’ shortage after the long-lasting armed conflict. This study aimed to explore medical students’ attitudes towards working in the NE and to identify factors determining such attitudes. Methods: A semi-structured, self-administered questionnaire survey was conducted in two medical schools, one in the NE and the other near the capital, in October 2004. Data were qualitatively analysed using the framework approach. Results: Three main themes were identified: 1) Professional motives and career plans; 2) Students’ perceptions of the healthcare situation in the NE; and 3) Students’ choice of the NE as a future practice location. It was found that familiarity with the difficulties faced by the NE people was a major motivation for medical students to work in the NE in the future. For NE students, familiarity was linked to their sense of belonging. For non-NE students, their personal experience of the NE familiarized them with the difficult situation there, which positively influenced their willingness to work there. Demotivations to work in the NE were poor working and living conditions, fewer opportunities for postgraduate education, language differences, insecurity, and fear of an unpleasant social response from the NE communities. Conclusions: NE local medical students had a sense of belonging to the NE and compassion for the Tamil people as members of the ethnic group. They were willing to work in the NE if their concerns about difficult working and living conditions and postgraduate education could be solved. Non-NE students who were familiar with the NE situation through their personal experience also showed a willingness to work there; thus, early exposure programmes in medical education might help to increase the health workforce in the NE. It is also expected that non-NE physicians working for the NE people would facilitate reconciliation and the rebuilding of trust between two ethnic groups.
Highlights
A shortage of physicians has often been observed as one of the deleterious consequences of the armed conflict. [1] Medical personnel flee from the affected area, and those from outside do not want to work there
Sri Lankan medical students have the potential to fill such a shortage of physicians in the future; it is important to know whether or not they are willing to work in the NE in their future and what factors contribute to that willingness
The findings of the study suggested that the students who were familiar with difficulties faced by the NE people were willing to work in the NE
Summary
A shortage of physicians has often been observed as one of the deleterious consequences of the armed conflict. [1] Medical personnel flee from the affected area, and those from outside do not want to work there. For non-NE students, their personal experience of the NE familiarized them with the difficult situation there, which positively influenced their willingness to work there. Conclusions: NE local medical students had a sense of belonging to the NE and compassion for the Tamil people as members of the ethnic group. They were willing to work in the NE if their concerns about difficult working and living conditions and postgraduate education could be solved. Non-NE students who were familiar with the NE situation through their personal experience showed a willingness to work there; early exposure programmes in medical education might help to increase the health workforce in the NE. It is expected that non-NE physicians working for the NE people would facilitate reconciliation and the rebuilding of trust between two ethnic groups
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