Shortage of doctors in remote and sparsely populated areas: Ways to improve the situation

Abstract

A shortage of physicians and a rural-urban imbalance in the distribution of health professionals are widespread problems nowadays. Medical graduates are considered as a next generation of doctors, but many of them do not choose medical career after graduation, particularly in the regions with low population density and severe climate. This study was conducted to find possible options to prevent further shortage of primary care physicians in remote areas based on the medical graduates’ opinions, and search the factors that influence their decision to work in practical medicine positively. A cross-sectional study provided full coverage of 720 final year medical students using an anonymous questionnaire in Krasnoyarsk, Russia. Data were analyzed using SPSS Version 22 by the following methods: descriptive statistics, decision trees analysis, and χ2-test. Most of the graduates reported their intension to work in practical medicine after graduation. Less than half of the participants considered an opportunity to work in rural hospitals. The main motivating factors to work there were increase in salary, better working conditions and hospital equipment, and free housing. Students who more inclined to work in rural hospitals mostly came from rural areas, live in dormitory or rental housing, and have an employer-sponsored type of education. An appropriate comprehensive admission process to medical schools, including personality tests and adequate government support for medical university applicants, as well as offers of special conditions of work for young specialists in rural hospitals, could be significant steps to improve the shortage of doctors in remote areas.