Abstract
The rural health system in India has long been disadvantaged by a shortage of health staff, including doctors. Providing medical students with a rural clinical placement has been suggested as one strategy to overcome this shortage. This study examined the attitudes of and inclination to rural healthcare careers among medical students. A cross-sectional study was performed on 201 students (147 males and 54 females) from two medical colleges in the National Capital Region (NCR) of India. A pre-tested semi-open-ended questionnaire was used to obtain information about students' socio-demographic characteristics and their views about a rural health career. Students' open-ended responses were collated and coded into broad categories. Of the respondents, 160 (79.6%) had a rural background. The current status of rural health services in India was rated as unsatisfactory by 178 students (88.6%). In total 110 (54.7%) indicated an interest in working in a rural area after graduation with 68 (33.8%) willing to set up their practice in a rural area. Students with a rural background were more likely to be willing to practice in a rural area. Those whose parents were highly qualified (postgraduate education or higher) were significantly less likely to practice in a rural area (p=0.004). Potential benefits of working in a rural area included 'health services for the poor/ benefit for the nation', and 'gain of knowledge about rural people and their diseases'. Potential drawbacks included 'lack of infrastructural facilities', 'less salary' and 'low standard of living'. A majority of the students believe the undergraduate medical curriculum needed modification to improve student awareness of rural needs. The medical students surveyed had a positive view of the importance of rural health care. However, factors such as infrastructure and salary were perceived as potential barriers to a career in rural health. The findings are a starting point to understanding the attitude of medical students towards rural health care and designing specific strategies to overcome the shortage of rural doctors in India.
Highlights
The rural health system in India has long been disadvantaged by a shortage of health staff, including doctors
Identifying the attitudes of and intentions towards rural health care among current medical students in India is an important exercise, for they are the health workforce of the near future. This will assist in identifying strategies to increase the quality and quantity of healthcare human resources available to underserved regions of the nation. This cross-sectional study was performed with undergraduate student participants from two medical colleges in the National Capital Region (NCR) of India: the University College of Medical Sciences in Delhi, and the Pt BD Sharma PGIMS, Rohtak in Haryana State
In total 110 (54.7%) indicated an interest in working in a rural area for some time after graduation; the majority (74; 66.4%) were only willing to work in rural areas for a few months to 2 years
Summary
The rural health system in India has long been disadvantaged by a shortage of health staff, including doctors. Providing medical students with a rural clinical placement has been suggested as one strategy to overcome this shortage. Conclusion: The medical students surveyed had a positive view of the importance of rural health care. Factors such as infrastructure and salary were perceived as potential barriers to a career in rural health. The findings are a starting point to understanding the attitude of medical students towards rural health care and designing specific strategies to overcome the shortage of rural doctors in India. Providing medical students with a rural clinical placement has been suggested as one strategy to familiarize future health professionals with the rural workplace[3]. The Medical Council of India in consultation with the health ministry devised an alternative model of medical education open only to students who had completed all their school education in villages[3]
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