There are any factors that contribute to the inaccessibility of proper health care for individuals residing in rural areas, including geographical distance, shortage of local well-educated health-care workers and the costs of travelling to well equipped urban health centres.
It is challenging to address many of these issues, especially since they are tied to other considerations involving the family’s financial well-being, regulatory environment, and poorly formed health system, among others. Nevertheless, it is possible to establish a sufficient and sustainable rural healthcare workforce through the commitment and collaboration of governments, communities and medical schools.
suggest that medical education has a huge role to play in addressing the issue of shortage of properly trained healthcare workers in rural areas by influencing their recruitment and retention.
Unfortunately, most medical schools across the world are located in large urban centres, where students are only exposed to the influence of the city. These students do not receive medical training in the rural context, and are consequently unfamiliar with the healthcare needs of rural folk. This, in turn, can limit their practice area to large cities.
To counteract this effect, some medical schools situated in large cities have introduced specific programmes aimed atgiving students rural experience through key placement programs.
Additionally, there are a few medical schools situated in small towns within large rural areas that focus on enrolling students from those regions, who can serve their communities upon graduating.
While this has solved part of the issue, there are still many medical graduates who study in rural areas of developing countries and end up working in rural areas of developed countries. As such, studies recommend that medical schools initiate and operate under a social accountability framework that makes them responsible to their areas.
4 Approaches towards a Solution
In this regard, studies propose the following four approaches to enhance the ability of medical schools to educate, recruit, and retain rural physicians in their regions and similar environs:
1. Create opportunities for students from rural areas to enroll in medical schools
Studies claim that most of the physicians working in rural regions come from a rural background. This suggests that the medical workforce in these areas could be increased if there were more students from rural regions enrolling in medical programs.
Considering the competitiveness of these programs, especially with wealthy and educated parents pushing their children to pursue such courses, rural students are quite disadvantaged in landing spots in medical learning institutions to get the necessary education. To address this concern, governments and medical learning institutions should come up with cohesive strategies that make medical school accessible and affordable to rural students.
Such strategies include:
- formulation of admission policies that acknowledge the diversity of geographic backgrounds
- pre-medical school outreach (education preparatory) courses
- tuition and scholarship support
2. Provide medical students with relevant education to understand the challenges of rural communities
Studies suggest that most physicians working in rural regions have obtained rural medicine learning experiences while receiving training in medical school. Medical education is universal, though it is also contextual.
There are notable demographic and geographic differences between rural and urban areas, especially with regard to social determinants of disease and illness patterns, health, and health status.
Tailoring medical graduates for rural practice requires the development of an education support structure that integrates experiential learning and rural curriculum context to promote their understanding of the rural communities, as well as their health challenges. This can also steer more students to a preference in practicing in rural regions.
3. Offer post-graduate training in rural regions
While it is necessary to introduce medical students to the rural medical environment while still in training, it is just as important to offer vocational training in rural areas to provide the practitioners with specific skills and knowhow to succeed in rural practice.
Well tailored rural medicine postgraduate training programs can enhance the ability of physicians to care for a population with limited access to highly technical services and specialist support, and possibly motivate more physicians to venture into rural practice.
4. Create opportunities for professional development
One of the biggest concerns for physicians involved in rural practice is the lack of sufficient channels to develop and maintain deep skills and a wide knowledge base that is necessary to work efficiently.
The distance barrier keeps them from interacting with specialists. Fortunately, medical schools can integrate rural relevant research and education with healthcare. Such integrated outreach opportunities for physicians, students, and residents can allow the parties to share their experiences on a regular basis, and learn together, without physicians having to leave their busy rural practices.
With governments, communities, and medical schools working hand in hand, it is possible to come up with strategies that include financial incentives, better health systems, and relevant practice environments, it is possible to not only improve the education and recruitment of rural physicians, but also retain their expertise in rural regions.