Factors affecting medical students' interests in working in rural areas in North India-A qualitative inquiry

Sonu Goel; Federica Angeli; Nonita Dhirar; Garima Sangwan; Kanchan Thakur; Dirk Ruwaard

doi:10.1371/journal.pone.0210251

Factors affecting medical students' interests in working in rural areas in North India-A qualitative inquiry

Sonu Goel^*, Federica Angeli, Nonita Dhirar, Garima Sangwan, Kanchan Thakur, Dirk Ruwaard

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background and Objective

The shortage of doctors, especially in rural areas, is a major concern in India, which in turn affects the effective delivery of health care services. To support new policies able to address this issue, a study was conducted to determine the discouraging and encouraging factors affecting medical students' interests towards working in rural areas.

Methods

This cross-sectional, descriptive qualitative study has been conducted in three states of North India. It comprised six focus group discussions, each consisting of 10-20 medical students of six government medical colleges. The verbatim and thematic codes have been transcribed by using a 'categorical aggregation approach'. The discussions were thematically analyzed.

Results

Ninety medical students participated in the study. The discouraging factors were grouped under two broad themes namely unchallenging professional environment (poor accommodation facilities and lack of necessary infrastructure; lack of drug and equipment supplies; inadequate human resource support; lesser travel and research opportunities) and gap between financial rewards and social disadvantages (lower salary and incentives, social isolation, political interference, lack of security). Similarly, the encouraging factors were congregated under three main themes namely willingness to give back to disadvantaged communities (desire to serve poor, underprivileged and home community), broader clinical exposure (preferential admission in post-graduation after working more than 2-3 years in rural areas) and higher status and respect (achieving higher social status).

Conclusions

This qualitative study highlights key factors affecting medical students' interest to work in rural areas. A substantial similarity was noted between the factors which emerge from the current study and those documented in other countries. These findings will help policy-makers and medical educators to design and implement a comprehensive human resource strategy that shall target specific factors to encourage medical students to choose job positions in rural areas.

Original language	English
Article number	0210251
Number of pages	14
Journal	PLOS ONE
Volume	14
Issue number	1
DOIs	https://doi.org/10.1371/journal.pone.0210251
Publication status	Published - 10 Jan 2019

Keywords

DEVELOPING-COUNTRIES
HEALTH
RECRUITMENT
CHALLENGES
RETENTION

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10.1371/journal.pone.0210251Licence: CC BY

Cite this

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title = "Factors affecting medical students' interests in working in rural areas in North India-A qualitative inquiry",

abstract = "Background and ObjectiveThe shortage of doctors, especially in rural areas, is a major concern in India, which in turn affects the effective delivery of health care services. To support new policies able to address this issue, a study was conducted to determine the discouraging and encouraging factors affecting medical students' interests towards working in rural areas.MethodsThis cross-sectional, descriptive qualitative study has been conducted in three states of North India. It comprised six focus group discussions, each consisting of 10-20 medical students of six government medical colleges. The verbatim and thematic codes have been transcribed by using a 'categorical aggregation approach'. The discussions were thematically analyzed.ResultsNinety medical students participated in the study. The discouraging factors were grouped under two broad themes namely unchallenging professional environment (poor accommodation facilities and lack of necessary infrastructure; lack of drug and equipment supplies; inadequate human resource support; lesser travel and research opportunities) and gap between financial rewards and social disadvantages (lower salary and incentives, social isolation, political interference, lack of security). Similarly, the encouraging factors were congregated under three main themes namely willingness to give back to disadvantaged communities (desire to serve poor, underprivileged and home community), broader clinical exposure (preferential admission in post-graduation after working more than 2-3 years in rural areas) and higher status and respect (achieving higher social status).ConclusionsThis qualitative study highlights key factors affecting medical students' interest to work in rural areas. A substantial similarity was noted between the factors which emerge from the current study and those documented in other countries. These findings will help policy-makers and medical educators to design and implement a comprehensive human resource strategy that shall target specific factors to encourage medical students to choose job positions in rural areas.",

keywords = "DEVELOPING-COUNTRIES, HEALTH, RECRUITMENT, CHALLENGES, RETENTION",

author = "Sonu Goel and Federica Angeli and Nonita Dhirar and Garima Sangwan and Kanchan Thakur and Dirk Ruwaard",

note = "Funding Information: The study is funded by Indian Council of Medical Research. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: {\textcopyright} 2019 Goel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

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AU - Goel, Sonu

AU - Angeli, Federica

AU - Dhirar, Nonita

AU - Sangwan, Garima

AU - Thakur, Kanchan

AU - Ruwaard, Dirk

N1 - Funding Information: The study is funded by Indian Council of Medical Research. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2019 Goel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2019/1/10

Y1 - 2019/1/10

N2 - Background and ObjectiveThe shortage of doctors, especially in rural areas, is a major concern in India, which in turn affects the effective delivery of health care services. To support new policies able to address this issue, a study was conducted to determine the discouraging and encouraging factors affecting medical students' interests towards working in rural areas.MethodsThis cross-sectional, descriptive qualitative study has been conducted in three states of North India. It comprised six focus group discussions, each consisting of 10-20 medical students of six government medical colleges. The verbatim and thematic codes have been transcribed by using a 'categorical aggregation approach'. The discussions were thematically analyzed.ResultsNinety medical students participated in the study. The discouraging factors were grouped under two broad themes namely unchallenging professional environment (poor accommodation facilities and lack of necessary infrastructure; lack of drug and equipment supplies; inadequate human resource support; lesser travel and research opportunities) and gap between financial rewards and social disadvantages (lower salary and incentives, social isolation, political interference, lack of security). Similarly, the encouraging factors were congregated under three main themes namely willingness to give back to disadvantaged communities (desire to serve poor, underprivileged and home community), broader clinical exposure (preferential admission in post-graduation after working more than 2-3 years in rural areas) and higher status and respect (achieving higher social status).ConclusionsThis qualitative study highlights key factors affecting medical students' interest to work in rural areas. A substantial similarity was noted between the factors which emerge from the current study and those documented in other countries. These findings will help policy-makers and medical educators to design and implement a comprehensive human resource strategy that shall target specific factors to encourage medical students to choose job positions in rural areas.

AB - Background and ObjectiveThe shortage of doctors, especially in rural areas, is a major concern in India, which in turn affects the effective delivery of health care services. To support new policies able to address this issue, a study was conducted to determine the discouraging and encouraging factors affecting medical students' interests towards working in rural areas.MethodsThis cross-sectional, descriptive qualitative study has been conducted in three states of North India. It comprised six focus group discussions, each consisting of 10-20 medical students of six government medical colleges. The verbatim and thematic codes have been transcribed by using a 'categorical aggregation approach'. The discussions were thematically analyzed.ResultsNinety medical students participated in the study. The discouraging factors were grouped under two broad themes namely unchallenging professional environment (poor accommodation facilities and lack of necessary infrastructure; lack of drug and equipment supplies; inadequate human resource support; lesser travel and research opportunities) and gap between financial rewards and social disadvantages (lower salary and incentives, social isolation, political interference, lack of security). Similarly, the encouraging factors were congregated under three main themes namely willingness to give back to disadvantaged communities (desire to serve poor, underprivileged and home community), broader clinical exposure (preferential admission in post-graduation after working more than 2-3 years in rural areas) and higher status and respect (achieving higher social status).ConclusionsThis qualitative study highlights key factors affecting medical students' interest to work in rural areas. A substantial similarity was noted between the factors which emerge from the current study and those documented in other countries. These findings will help policy-makers and medical educators to design and implement a comprehensive human resource strategy that shall target specific factors to encourage medical students to choose job positions in rural areas.

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KW - HEALTH

KW - RECRUITMENT

KW - CHALLENGES

KW - RETENTION

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DO - 10.1371/journal.pone.0210251

M3 - Article

C2 - 30629641

SN - 1932-6203

VL - 14

JO - PLOS ONE

JF - PLOS ONE

IS - 1

M1 - 0210251

ER -

Factors affecting medical students' interests in working in rural areas in North India-A qualitative inquiry

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Keywords

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