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| LETTER TO THE EDITOR |
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| Year : 2013 | Volume
: 26
| Issue : 1 | Page : 68 |
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Career intentions of medical students
Viroj Wiwanitkit
Visiting Professor, Faculty of Medicine, University of Nis, Serbia and Hainan Medical University, China
| Date of Web Publication | 31-May-2013 |
Correspondence Address:
Viroj Wiwanitkit
Wiwanitkit House, Bangkhae, Bangkok, Thailand
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1357-6283.112807
How to cite this article:
Wiwanitkit V. Career intentions of medical students. Educ Health 2013;26:68 |
Dear Sir,
The recent report on "Career Intentions of Medical Students Trained in Six Sub-Saharan African Countries" is interesting. Burch et al. concluded that "The career intentions of African medical students are not aligned with the continent's health workforce needs". [1] Similar problems can be seen in many developing countries. For example in Thailand, a developing tropical country in Southeast Asia, insufficient numbers of rural physicians is still a major public health threat. The number of physicians in rural and non-rural areas is still in imbalance, where 90% of Thailand is rural but only 40% of physicians practice in rural areas. [2] To help overcome the shortage of physicians in rural areas, the implementation of rural community medicine experiences as pre-requisite for graduation has been implemented for over 40 years. [2],[3] Five main courses are included in the Thai medical curriculum: (a) health and demographic survey; (b) analysis of community health programmes; (c) planning of community health care; (d) clerkship in community health and (e) internships in community health. [3] Additionally, newly graduated medical students are required to perform 3 years of service in rural areas, or they have to pay an 'exception'. [2],[4] Despite this mandatory system for rural placement, the problem still persists. According to a recent study of medical student attitudes, those who mentioned "do not want to work in rural or community areas" increased from 25.0% in 2008 to 29.7% in 2010. [5]
The interesting question is how to promote the social service intention of medical students. Whether the present medical curriculum needs adjustment to promote more positive attitudes of medical students remains a question. Mandatory rural service for healthcare workers might be a possible continuing response for the problem of insufficient medical personnel in several countries. [2] However, usually rural placement alone is not enough for retention and long-term impact. For example in Thailand, the rate of newly graduated physicians leaving rural after three-year mandatory rural work is extremely high, reflective of the failure of the present mandatory system to retain new physicians in rural areas. [2] In addition to promoting service intention, Kanchanachitra et al. proposed that "retention strategies need to be integrated into ongoing efforts to strengthen health systems". [6] Other solutions that might be tried include special track salary promotion for rural physicians, local medical training programmes [7] and rural track recruitment and training. [8] It is a complex problem requiring multiple approaches for solution.
| References | |  |
| 1. | Burch VC, McKinley D, van Wyk J, Kiguli-Walube S, Cameron D, Cilliers FJ, et al. Career intentions of medical students trained in six Sub-Saharan African countries. Educ Health (Abingdon) 2011;24:614. 
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| 2. | Wiwanitkit V. Mandatory rural service for health care workers in Thailand. Rural Remote Health 2011;11:1583.
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| 3. | Wray JD. Motivation medical students in the Ramathibodi Community Health Program. Stud Fam Plann 1974;5:134-9.
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| 4. | Chartikavanij K, Hemachudha C, Rosenfield AG. National health programs in Thailand. Ekistics 1976;41:231-4.
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| 5. | Thira W, Patarawan W. Assessment of prospective physician characteristics by SWOT analysis. Malays J Med Sci 2012;19:60-4.
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| 6. | Kanchanachitra C, Lindelow M, Johnston T, Hanvoravongchai P, Lorenzo FM, Huong NL, et al. Human resources for health in southeast Asia: Shortages, distributional challenges, and international trade in health services. Lancet 2011;377:769-81.
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| 7. | Landry M, Schofield A, Bordage R, Bélanger M. Improving the recruitment and retention of doctors by training medical students locally. Med Educ 2011;45:1121-9.
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| 8. | Stearns JA, Stearns MA. Graduate medical education for rural physicians: Curriculum and retention. J Rural Health 2000;16:273-7.
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